The One Thing No New Mother Wants
The difference between “baby blues”, PPD, and postpartum psychosis
There’s so many aspects of pregnancy and birth that no one talks about. Thankfully, with places like Medium, that trend is slowly changing. But 13 years ago, I’d barely heard of postpartum depression, and it was always spoken of in judgy whispers like it was some kind of dirty secret. Like the mom was somehow to blame for how her brain chemistry and hormones reacted to a pregnancy.
Looking back on it today, the injustice of that mentality makes me so angry. Baby blues, postpartum depression, and postpartum psychosis are all very real issues with significant symptoms that weigh heavily on moms of newborns. But for the uninitiated, let’s back up a bit and talk for a moment about what postpartum depression and postpartum psychosis are, what “baby blues” is, what symptoms they entail, and how they differ from each other.
According to the Mayo Clinic “Most new moms experience postpartum “baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues usually begin within the first 2 to 3 days after delivery and may last for up to two weeks.” Healthline.com puts that percentage as high as 80%. So, it’s easy to see why we are so familiar with postpartum blues or “baby blues” as they’re more often called.
Postpartum depression (PPD) is more rare, but not unheard of, and significantly more serious. It’s defined as a mood disorder that shows up as frequently as 15% of births and shares many symptoms with “baby blues” with the differences arising in duration and severity of those symptoms. It tends to show up during times of major hormonal changes after giving birth as your body begins to rebalance after pregnancy. This, coupled with other emotional, environmental, and physiological causes explains why it can take up to a year after giving birth to rear its ugly head.
The most rare of the conditions is called Postpartum Psychosis. Psychosis is a term that refers to losing touch with reality. Postpartum Psychosis is a serious mental illness that only shows up in 1 to 2 out of 1,000 women. Most people have never heard of it before; I know I hadn’t until I was diagnosed with it. People often confuse it with a severe case of PPD, though that couldn’t be farther from accuracy. It has very few symptoms in common with either “baby blues” or PPD.
Symptoms
As you can see in the image above, the vast majority of symptoms between “baby blues” and PPD have a crossover to some extent. These in-common symptoms include: mood swings, anxiety, irritability, crying, insomnia, and changes in appetite. But even with those symptoms in common, it’s important to note that in cases of PPD, the symptoms are more severe and the duration can be in the months, not days as in the case of “baby blues”.
But the two notable differences in the symptoms between PPD and “baby blues” are also the most important in my opinion:
1) Difficulty bonding with the baby
2) Thoughts of death/suicide
Regardless of other crossover symptoms that a woman may have, these two are major red flags. But due to the lingering taboo aspect of these conditions, it can be very hard for a woman to come forward and be honest about these two symptoms specifically. There’s a shame associated with not bonding with your child. As if it’s somehow a character flaw. As if you went into this parenting gig determined not to connect. As if you’re a bad parent or don’t care about your child. NONE of these are true. They are convoluted and distorted thoughts that are designed to make a new mom feel alone and isolated.
What I’m talking about is called stigma. A mark of disgrace associated with a particular circumstance. In this case, people shy away from topics like suicidal ideation and lack of parental bonding. And that stigma can actually be dangerous to new moms. Especially those who may not know much about PPD and dismiss their own symptoms as a bad case of the “baby blues” and not even bring it up with their doctor or loved ones.
But PPD is something that requires a medical professional’s monitoring and treatment. Without it, the risk of suicide increases. With it, most women experience a full recovery. It can be a long and arduous process of healing, but there is every hope that this will not affect the new mom long term. However, if she has experienced PPD with one pregnancy, there’s a 30–70% chance the mother will encounter this form of depression again after a subsequent birth. This can depend on a multitude of external circumstances as well as internal ones. As the saying goes “no 2 pregnancies are alike”. But the second time around, a woman knows her body a little better and is more aware of the warning signs of the condition.
As I mentioned previously, postpartum psychosis has a very different set of symptoms from “baby blues” and PPD. This is due to the psychotic nature of the condition. There is also a stigma surrounding mental illness that those with this condition have to navigate. While the acceptance of depression has become more commonplace, symptoms affiliated with postpartum psychosis such as: hallucinations, delusions, and paranoia are still seen as “scary” symptoms.
But imagine for a moment how scary those symptoms are for the person experiencing them. We may see their symptoms as making that person a wild card, but until you’ve experienced it, you can’t fully appreciate the fear that comes with second guessing everything you think you know. When your gut instincts are wrong, and your intuition is lying to you, and everyone starts to question your sanity and treat you like a pariah. It’s torturous. It’s terrifying.
Even though postpartum psychosis is rare, there are factors that make it more likely for a woman to be diagnosed with this condition. Some of these factors include:
- Having a history of bipolar disorder. According to PostpartumDepression.org, statistics show that women with this history are 40% more likely to develop postpartum psychosis.
- Having a history of postpartum psychosis in a previous pregnancy.
- Having a family history of bipolar disorder or postpartum psychosis.
- Having a history of schizophrenia or schizoaffective disorder.
- Discontinuing psychiatric medications during the pregnancy.
Due to the severity of symptoms and the danger they present to the mother and child, postpartum psychosis is considered to be a medical emergency and should be treated as soon as possible. These treatments can range between talk therapy, medication, hospitalization, or some combination thereof. Tragically, 10% of these cases will result in the death of the mother or the child. There is hope however. With proper and immediate treatment, most women experience a full recovery with no further symptoms.
More than anything, it’s important to remember that these conditions are not something that the mother chose or wanted. They are a result of a hormonal and chemical imbalance outside of her control. There are so many factors at play that it’s impossible to predict whether or not a woman will have any of these conditions with any pregnancy. But having a solid support system that you can trust to share your feelings with is a great step towards preparing for the possibility. Always remember that you are not alone and that there are hundreds, if not hundreds of thousands of mothers out there that have been through what you’re going through and are here for you.
Together, we can support each other through thick and thin and create a world where moms lift up and encourage other moms regardless of specific situations. In this way, we can all live better.
