Becoming a new parent can unleash a roller coaster of emotions. Many of those feelings are positive and come from special firsts, like your infant’s first day at home or their first smile.

But just as a roller coaster moves upward, it sometimes dives downward too.

“Having a baby is supposed to be such a happy, joyful time,” says Samantha Meltzer-Brody, M.D., chair of the department of psychiatry at the University of North Carolina in Chapel Hill. Dr. Meltzer-Brody is also director of the UNC Center for Women’s Mood Disorders. But it’s also a time when lots of new parents go through bouts of crying for no reason, says Michele Ewing, a certified case manager for high-risk pregnancies based in Merchantville, New Jersey. Also common: fatigue, restlessness, sadness, mood changes, and even insomnia.

It’s known as the baby blues. And it’s very common. About 70% to 80% of new birth parents have the baby blues after giving birth. It’s caused in part by your hormones crashing down to pre-pregnancy levels. The stress of being a new parent and the lack of sleep also play a role. The baby blues usually kick in a day or 2 after you come home from the hospital. Your mood should begin to improve in about 2 weeks.

But for some people who have just given birth, those baby blues turn into something serious and potentially dangerous: postpartum depression. That’s a more severe and longer-lasting form of sadness. Symptoms can include:

• Loneliness.
• Extreme guilt.
• Anger.
• Anxiety.
• Insomnia.

“More than 1 in 8 new moms will experience postpartum depression,” Meltzer-Brody says. “And unfortunately, that can come with a lot of stigma and a real sense of shame.” But please don’t let that stop you from getting the support you need. If you’re feeling down after delivering, here’s what to do.

Step 1: Ask for Support While You Gauge How You Feel

You’re more likely to have depression after giving birth than at any other time in your life, Ewing says. That’s why it’s so important to take care of yourself mentally and physically during this period. “Let your spouse or significant other know how you’re feeling so that they can help you through this time,” Ewing suggests. “It may be challenging, but try to get some regular rest. Eat a balanced diet. And let family or friends help you with household chores or minding your other children.”

Getting help and support can give you some time to heal. It will also free up some super-important time to bond with your baby. “Keep communicating your feelings,” Ewing says. “Within a few days, you’ll probably start to feel a lot better.”

If your feelings of sadness go on for more than 2 weeks, you might have postpartum depression. “The symptoms tend to be more severe than baby blues,” Ewing says. They can include:

• Anger.
• Guilt.
• Withdrawal from family members — including the baby.
• Thoughts of harming yourself or the baby.

“If you’re by yourself and feeling overwhelmed, and think you may harm yourself or the baby, call 911 for help right away,” says Ewing.

Experts aren’t exactly sure what causes postpartum depression. Possible causes range from hormonal changes following pregnancy to the constant sleep deprivation of new parenthood. One animal study showed that postpartum depression may be triggered by chronic stress during pregnancy.

It’s also important to note that it isn’t just women or the partner who gave birth who can have postpartum depression. Men can too. One study found that about 10% of men go through depression after becoming fathers. It can be caused by hormonal changes, lack of sleep, and new stress.

Be on the lookout for these symptoms of postpartum depression in yourself and your partner:

• Constant sadness.
• Anxiety.
• Feeling overwhelmed or empty.
• Panic attacks.
• Chronic fatigue.
• Less interest in activities.
• A sense of self-doubt.
• Different sleep or eating patterns.
• Hopelessness, helplessness, or guilt.
• Irritable or angry moods.
• A sense of detachment from the baby.
• Difficulty concentrating or making decisions.

Step 2: Get More Help When You Need It

If you have any of the postpartum depression symptoms listed above, try these tips to get some relief.

Talk to your doctor. “Get in touch with your obstetrician or primary care provider as soon as possible,” says Ewing. There are effective treatments available. That includes antidepressant medications.

The most common antidepressants used to treat postpartum depression are called selective serotonin reuptake inhibitors (SSRIs). They usually have the fewest side effects of any type of antidepressant. They work by increasing levels of the feel-good chemical serotonin in your brain. You may need to take these medications for 3 or 4 weeks before you get relief. And your doctor may suggest that you keep taking them for 6 months to a year.

Are you breastfeeding? You can still take antidepressants. But your doctor may want to prescribe a certain type of SSRI, such as sertraline, which passes in lower amounts into breast milk.

Reach out to your partner, family, and friends. “Never try to keep these feelings to yourself,” says Ewing. Even a quick text to a sympathetic friend can boost your mood. It’s important to know you don’t have to suffer in silence. What’s happening to you is real. You shouldn’t hesitate to get help or talk about it.

Connect with a counselor or a support group. Your doctor should be able to recommend a therapist or group. You can also take advantage of a free postpartum wellness program that’s offered through your health plan. You can join through your Wellframe app.

“Counseling and support will help you start to feel more like yourself,” says Ewing. Two types of therapy that have been shown to work well in these cases:

• Interpersonal therapy. This short-term form of therapy connects problems to mood.
• Cognitive behavioral therapy. It’s a type of talk therapy.

Can’t get to a counselor’s office or a group meeting? A telemedicine visit can be just as helpful. In a recent review of 10 studies, telemedicine interventions (through phone calls or web-based apps) significantly lowered symptoms of postpartum depression in women.

Get moving. “Once you have your doctor’s okay to resume normal activities, try exercising,” suggests Ewing. It’s a great way to get some of the body’s feel-good endorphins flowing. A review of several studies found that exercise can reduce postpartum depression symptoms and help new parents feel better. And no need to hit the gym or go hard: An outdoor walk with your baby in a stroller was shown to deliver mood-boosting benefits. Simple and soothing — just what the doctor ordered!

[Sources:]

[1] “Baby Blues.” American Pregnancy Association, https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/baby-blues/. Accessed November 3, 2021.

[2] Paulson JF and Bazemore SD. “Prenatal and Postpartum Depression in Fathers and Its Association with Maternal Depression: A Meta-Analysis.” JAMA, vol. 303, no. 19, 2010, pp: 1961-1969.

[3] Langan RC and Goodbred AJ. “Identification and Management of Peripartum Depression.” American Family Physician, vol. 93, no. 10, 2016, pp: 852-858.

[4] “Postpartum Depression.” The American College of Obstetricians and Gynecologists, November 2019, https://www.acog.org/womens-health/faqs/postpartum-depression. Accessed November 3, 2021.

[5] Steward DE and Vigod S. “Postpartum Depression.” The New England Journal of Medicine, vol. 375, 2016, pp: 2177-2186.

[6] Laskey CS. “Antidepressant Use in the Breastfeeding Patient.” U.S. Pharmacist, vol. 46, no. 5, 2021, pp: 17-22.

[7] Fitelson E, Kim S, Baker AS, et al. “Treatment of Postpartum Depression: Clinical, Psychological and Pharmacological Options.” International Journal of Women’s Health, vol. 3, 2011, pp: 1-14.

[8] Hanach N, deVries N, Radwan H, et al. “The Effectiveness of Telemedicine Interventions, Delivered Exclusively During the Postnatal Period, on Postpartum Depression in Mothers Without History or Existing Mental Disorders: A Systemic Review and Meta-Analysis.” Midwifery, vol. 94, March 2021, pp: 102906.

[9] Poyatos-Leon R, Garcia-Hermoso A, Sanabria-Martinez G, et al. “Effects of Exercise-Based Interventions on Postpartum Depression: A Meta-Analysis of Randomized Controlled Trials.” Birth Issues in Perinatal Care, vol. 44, no. 3, September 2017, pp: 200-208.