Mental Health Check: Is it baby blues, perinatal depression or postnatal anxiety?

There is a difference between feeling a little blue post birth, feeling hopeless all the time and constantly worrying about your baby. By Kim Bell and Xanet Scheepers

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During pregnancy, we eagerly anticipate the arrival of our baby and dream of all the time we will enjoy with them. After the birth, while this dream may become reality for many, it’s not quite so simple for moms who experience this time as one filled with sleep deprivation, hopelessness and constant worry.

While these feelings are a normal part of motherhood, sometimes it’s something more.

We look at the differences between baby blues, perinatal depression and postpartum anxiety.

What are baby blues?

These feelings of irritability, of being completely overwhelmed and losing yourself that set in after birth are completely normal, due to ping-ponging hormone levels, very little sleep, recovering from pregnancy and birth and the realisation that this little person is completely dependent on you. The good news is that baby blues last only a couple of weeks post birth.

However, if dark feelings of hopelessness linger longer, you may be experiencing perinatal depression. According to Dr Lavinia Lumu, a specialist psychiatrist at Akeso Clinic in Randburg, the prevalence of perinatal depression (pre- and post-childbirth) is as high as around 20% in South Africa.

What is perinatal depression?

This refers to depression that occurs during the perinatal period, starting during pregnancy and persisting for up to 12 months post birth. Dr Lumu explains that in the past, the focus was more on postnatal depression. However, research reveals that, quite often, depression starts during pregnancy itself. The term perinatal depression (PD) encompasses both antenatal and postnatal depression. Dr Lumu adds that women who have experienced PD in their past pregnancies, are at risk of having PD in their next pregnancies. “If a mother has had a previous history of PD, it is essential that they inform their healthcare provider. This will ensure close monitoring and early intervention in the next pregnancy.”

ALSO SEE: What you need to know about depression during pregnancy

Symptoms of perinatal depression include:

  • The inability or lack of desire to take care of yourself and/or your baby
  • Low appetite
  • Extreme fatigue
  • Memory problems
  • Persistent feelings of sadness
  • Hopelessness
  • Helplessness
  • Insomnia
  • Feelings of panic.

In severe cases, there may even be suicidal thoughts. “Psychotic features and thoughts of infanticide can also occur in severe cases,” Dr Lumu adds.

You’re not a bad mom

Being depressed doesn’t mean that you’re not a good mother, says Dr Lumu. However, if the depression is untreated, this could be harmful for your baby. “Depressed mothers are more likely to not want to nurture or spend time with their babies.”

Family assistance

Your partner can help with household chores or other duties that a mom would usualy do, advises Dr Lumu. “Family can assist with attending to the other children’s’ needs. It’s essential that support is provided with the care of the newborn and that the partner, above all, provides the necessary emotional support to the new mother. Interestingly, perinatal depression is not just limited to women, with research showing that there is a phenomenon of fathers also developing postnatal depression. It is, therefore, vital that new fathers are also supported by family and friends, to prevent this outcome, says Dr Lumu.

What is postpartum anxiety?

Postpartum anxiety disorder is not the same as baby blues or perinatal depression, but it’s a cousin to postpartum depression.

Symptoms of postpartum anxiety include:

  • Excessive worrying
  • Racing thoughts
  • Feelings of dread

It’s normal to feel anxious after having a baby and having thoughts like ‘What if my baby suffocates while sleeping during the night’ or ‘What if I let her slip under the water while bathing her’ – most parents have these anxieties, but they soon become a background noise.

Mothers who have postpartum anxiety on the other hand, have worries that are irrational. “Say, you have an intense fear that your baby will get hurt if you don’t hold him, and you can’t get them out of your brain, you may be suffering from postpartum anxiety (PPA). This diagnosis becomes a problem when it affects everyday situations (like driving with Baby), if panic attacks come out of the blue, or if it interferes with your ability to function,” explains Dr Margaret Howard, director of the Postpartum Depression Day Hospital on Rhode Island in the US.

Unlike the baby blues, which usually go away on its own after a couple of weeks, postpartum anxiety doesn’t. If you’re experiencing any of the above-mentioned signs, it’s really important to get help immediately, because if left untreated, this can set you up for a lifetime of mental illness.

More about the expert:

Dr Lavinia Lumu is a specialist psychiatrist in full -time private practice servicing inpatients and outpatients from 16 years of age and above. She has a special interest in perinatal psychiatry and general psychiatry. Learn more about Dr Lumu here.

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