Postpartum Depression or Baby Blues? Self-Care Either Way!

April 30, 2019

Written by Dr. Taren Coley, Staff Psychiatrist at HopeWay

The art of prioritizing and personalizing self-care is a learned behavior. Logically we know that it is important to take care of ourselves, but it can be a whole other ball game when it comes to actually incorporating the practice into our daily routines.  Especially in today’s culture, where there are a thousand things to check off what can feel like an ever-growing and completely valid to-do list. 

Plus, is it really ok to spend time just focusing on me?

This is a very common question that we all struggle with. Women in particular can find it hard to validate investing in their health and mental wellbeing.  Many are such natural caregivers, whether they are mothers or simply compassionate human beings to others, that they can easily lose sight of how important it is to care for themselves.

Remember the metaphor that it’s better to put on your own oxygen mask before assisting others?  Yeah, there is a lot of truth behind that line of thinking.

With May 12^th being the start of the 20^th annual National Women’s Health Week, this is a great opportunity to highlight an area of women’s mental health that is often overlooked and misunderstood: postpartum and perinatal health.

There is no doubt that starting or growing a family can be very exciting. But, it’s ok to admit that the experience can also be stressful. A new baby can be yet another reason to place self-care on the back burner.  And for many women, this new chapter in life can bring about feelings of depression and/or anxiety for the first time, or exacerbate a current condition.

Before my role at HopeWay, I worked as a resident physician at The UNC Center for Women’s Mood Disorders. They primarily serve individuals who are trying to get pregnant or who are struggling to get pregnant because of fertility issues, which can lead to a variety or women’s mood disorders.

The Center also helps women who are navigating mental health issues during pregnancy and/or postpartum – which can last for up to two years after the birth of a child.

Thanks to the experience I gained from working at the Center and now at HopeWay, plus the full-time job of being a mom myself, it’s safe to say that I understand the effect that self-care has on a woman’s mental health.

Granted, like any mental health challenge there is definitely a stigma around getting help.  Women in particular, who are expected to be strong members of both family and workplace and naturally slip into the role of mamahood, don’t always want to admit that we are struggling.  After all, that would be conceding that we have not met certain expectations that we, our family, and society has set for the experience of motherhood.

Having a healthy environment and mental state to build an attachment and bond with your baby is vital.  But, this can only be done when a woman takes the time to care for herself, which might include seeking professional help.

And you know what? That’s ok. 

Let’s start with the understanding that baby blues are a normal part of pregnancy.  Typically 50-80% of women will experience the blues from anywhere around day 5 up until the second week after birth.  Symptoms include:

• Sadness
• Tearfulness
• Low Energy
• Trouble Sleeping

For better or worse, these issues come with the territory of being a new mom.  But, baby blues will usually resolve within the first couple of weeks.  They are not attached to some of the red flags we see with mood disorders like postpartum depression.

One of the biggest red flags to look out for is detachment or feeling like you are not bonding with your infant.  And obviously suicidal thoughts are another major sign of something serious. When these symptoms persist outside of a two-week period, that’s when professionals become concerned this might be an ongoing issue.

Admittedly, it can be hard to recognize the signs and symptoms of women’s mood disorders – especially if this is the first time a woman has dealt with such issues. Things can become even more complicated with the added responsibility of caring for this tiny human you just created while juggling what can feel like foreign emotions!

Typically, people around you will recognize there is a problem. A partner, family member or friend may notice that you are off and not seeming to get back to yourself, or are isolating.

Feelings of depression and anxiety can start way before a scheduled psychiatrist visit and can be identified at a follow-up OBGYN appointment or at the pediatrician’s office.  For instance, the Edinburg Postnatal Depression Scale specifically screens for depression to determine if what the woman is experiencing are typical symptoms associated with pregnancy, or if it is something more. If the latter, then typically the doctor will make a referral for the patient to see a psychiatrist. 

At The UNC Center for Women’s Mood Disorders, it was common to see a mix of folks who were either experiencing mental health struggles for the first time or who had dealt with depression and anxiety in the past.  

Some women describe themselves as having an anxious personality, but they never sought treatment before because it did not necessarily disrupt their daily life. Those individuals may be more prone to depression as a result of the hormonal changes that come from pregnancy. Others may have experienced depression before, which puts them at a greater risk of developing a depressive episode before or after pregnancy.

Whatever your experience is with women’s mood disorders, please know that you are not alone. 

Treatment is not a scary thing – in fact, it looks pretty similar to what is offered to individuals who have been diagnosed with classic depression.  It will likely be a combination of talk therapy (usually Cognitive Behavioral Therapy) and, depending on the severity of symptoms, medication.

Sound familiar?  This is an integral part of the model of treatment that is offered to clients at HopeWay.

For any mother, new or veteran, I cannot stress the importance of self-care enough. I know it feels hard, but try not to lose sight of how important and worthy you are.

It could be something as small as taking 30 minutes out of the day to do something for yourself.  And no, this does not include laundry, dishes, or dusting so that the house is clean.  Think about an activity that gives you joy and allows you to take a breath while reconnecting with yourself:

• Journal
• Take a walk
• Soak in a hot bubble bath
• Treat yourself to a massage, manicure or pedicure
• Color a picture from a coloring book
• Listen to music
• Exercise

Make sure that you are getting your rest as well.  The connection between healthy sleep patterns and mental wellness is undeniable. 

I get that this last tip can be hard for moms who are breastfeeding. If possible, find support in this area because sleep disruptions can throw everything off.  At the Center, we often recommended having the partner give the baby a bottle with expressed milk so that the mom can get some rest during those 2am and early morning feedings.

Or, if you find that these efforts are not effective, reach out to your OBGYN or primary care doctor for help and recommended resources.

While May 12^th marks National Women’s Health Week, it’s just as important to remember the value of self-care during the other 358 days in the year.  Sometimes the best “yes” you can say is “yes” to yourself! 

Taren Coley, MD

Dr. Taren Coley is double-board certified in General Psychiatry and Child and Adolescent Psychiatry. A native North Carolinian, she earned her Bachelor of Arts in Psychology from East Carolina University and her Medical Degree from the University of North Carolina at Chapel Hill. Dr. Coley remained at UNC to complete her general psychiatry residency training and a child and adolescent psychiatry fellowship. Through her training, she has gained expertise in human development throughout the lifespan and treatment of individuals through psychopharmacology and psychotherapy. At HopeWay, Dr. Coley serves as the Director of Outpatient Services overseeing the clinical operations at HopeWay Psychiatry & Associates, in addition to treating clients at HopeWay. Dr. Coley’s comprehensive and individualized treatment approach helps clients understand and appropriately manage their diagnoses, allowing them to move forward in their recovery.