Health Matters 10/18: Recognizing signs of postpartum depression and get help

By: Sarah Carstens, L.C.S.W.

Feeling sad or blue after giving birth is a normal occurrence for most new moms.

In fact, up to 80% of women experience some form of the “baby blues” after childbirth, according to the National Institute of Mental Health.

However, if feelings of sadness become more severe or linger for more than a couple weeks, they could signal postpartum depression, a more serious condition that normally requires treatment.

The Women’s Program at Penn Medicine Princeton House Behavioral Health offers care for new mothers experiencing postpartum depression, helping them to regain a sense of control and improve their ability to tolerate stress.

Baby Blues or Postpartum Depression

Women with the baby blues may have mood swings, feel sad or overwhelmed, have crying spells, lose their appetite or have trouble sleeping. These feelings may come and go and normally resolve within three to five days without any treatment.

Postpartum depression is different in that feelings of sadness, anxiety and despair are so intense that they prevent women from being able to carry on their daily activities.  These feelings typically do not go away on their own.

The National Institutes of Mental Health estimates that postpartum depression occurs in nearly 15% of births.

It is important for women to recognize that postpartum depression is not their fault and does not mean they are bad moms or don’t love their babies. Any woman can become depressed after childbirth.

Hormonal changes may trigger symptoms

During pregnancy, the levels of the female hormones estrogen and progesterone are at their highest. In the hours after childbirth, these levels decrease sharply. Researchers believe this sudden drop in hormone levels may lead to depression.

Other risk factors include:

  • Complications during pregnancy or childbirth
  • Personal or family history of depression or mental illness
  • A stressful life event during pregnancy or after giving birth
  • Mixed feelings about the pregnancy
  • Postpartum depression after a previous pregnancy
  • Having a baby with health issues or other special needs
  • Difficulty breastfeeding
  • Lack of a strong emotional support system
  • Alcohol or drug abuse problems

When to seek help

Postpartum depression usually begins within the first month after childbirth, but it can also start during pregnancy or for up to a year after birth. If you have any of the following symptoms for more than two weeks, see your doctor as soon as possible. Do not wait until your postpartum checkup.

  • Feeling restless or moody
  • Feeling sad, hopeless and overwhelmed
  • Crying a lot
  • Having thoughts about hurting the baby or yourself
  • Not having any interest in the baby, not feeling connected to the baby or feeling like your baby belongs to someone else
  • Having no energy or motivation
  • Eating or sleeping too little or too much
  • Having trouble focusing or making decisions
  • Having memory problems
  • Feeling worthless and guilty, and like a bad mother
  • Losing interest or pleasure in activities you used to enjoy
  • Withdrawing from friends and family

Treatment for postpartum depression usually involves talk therapy, often in combination with medication.

Offering partial hospital and intensive outpatient options, the Women’s Program at Princeton House provides a combination of group psychotherapy, group psychoeducation, and individual therapy. It can also incorporate medication management—including safe medication options for women who are breastfeeding.

Women in the program benefit from learning dialectical behavior therapy skills, including:

  • Often mothers of infants are on autopilot without much attention to caring for themselves. Mindfulness expands insight about what they are feeling and experiencing so they can identify what coping skills will benefit them in the present moment.
  • Emotion regulation. These skills help new moms manage moods and better care for themselves, focusing on topics like sleep deprivation, planning ahead to cope with difficult situations and healthy eating.
  • Distress tolerance. Therapists provide strategies to widen the window of tolerance and decrease emotional intensity, so patients can respond rather than react.
  • Interpersonal effectiveness. This skill area focuses on being more effective in interpersonal relationships, including with a spouse or partner.

Additional tips

If you experience symptoms of postpartum depression, it is important to see your doctor right away. The National Institutes of Mental Health also offers these tips in addition to seeking professional care:

  • Rest as much as you can. Sleep when the baby is sleeping.
  • Don’t try to do too much or do everything by yourself. Ask your partner, family and friends for help.
  • Make time to go out, visit friends or spend time alone with your partner.
  • Talk about your feelings with your partner, supportive family members, and friends.
  • Talk with other mothers so you can learn from their experiences.
  • Join a support group. Ask your doctor or nurse about groups in your area.
  • Don’t make any major life changes right after giving birth. More major life changes in addition to a new baby can cause unneeded stress.

The Women’s Program at Princeton House is offered in Princeton, Hamilton, Moorestown, Eatontown, and North Brunswick. For more information, visit or call 888-437-1610.

Sarah Carstens, L.C.S.W, is a licensed clinical social worker. She is the clinical manager for the Women’s Program at Penn Medicine Princeton House Behavioral Health’s Eatontown location.