Baby Blues vs. Postpartum Depression

Several people have expressed concern that I may be suffering from PPD.  No, no, I’ve said – I’ve experienced PPD before and that’s not what I’m dealing with now.  When I had it before – after Kevin was born, and after Joey was born – it was truly like I was weighed down by a black cloud.  Although I never had any issues bonding with my babies, I was profoundly sad.  I had no appetite and had to force myself to eat a little something a few times a day so I could nurse the baby.  I would sit with the baby in the rocking chair and stare into space for long periods of time, thinking about all the terrible things that could befall him, and I would cry and cry.

 Yes, I’m feeling less than sunshiny.  Yes, I cry easily.  Yes, my temper is short.  But given the circumstances, I’d say that what I’m feeling is to be expected.

To reassure myself, I decided to do a little research.  What I found was that, pretty much across the board, the experts say that if a mom isn’t feeling mostly like her old self within two weeks (two weeks!) of giving birth, it’s most likely PPD and not just the baby blues.

This news, of course, left me in tears.  Scarlett is two and a half weeks old, and I’m still feeling low.

But the truth is – at the risk of coming off like someone in denial – I’m still not convinced that what I have is bona fide PPD.

I probably don’t have much standing to argue with the experts, but two weeks seems like very little time for a mom to get back to her old self, emotionally speaking.  She’s still bleeding, she’s still adjusting to a massive hormone shift, it’s doubtful that she’s well-rested (especially if she’s got other kids besides the new baby to care for), she’s likely still trying to figure out her newborn and get into a groove – in short, she’s still adjusting.  It’s a huge adjustment, by the way – even for a seventh-time mom.

There are so many things I’m dealing with.  At the top of list are some serious behavior/discipline issues with the older kids – mostly the twins and Finn.  Finn is prone to awful tantrums lately – he will scream his head off when he’s unhappy about something (and he’s very often unable to communicate what it is he’s unhappy about, but sometimes it’s as simple as being told “no” to a snack or TV time).  Daisy – who is highly emotional to begin with – has become almost incessantly whiny and complainy and screechy.  And Annabelle . . . Annabelle.  Naughty Annabelle is driving me to drink with her antics.  Coloring on the outside of the house with crayons.  Digging in the outside garbage cans for god knows what.  And the hair-pulling.  More on that in a separate post, but it’s worse than it’s ever been, and it’s breaking my heart.

Here I am, alone, with seven kids.  SEVEN!  My hat is seriously off to all those other moms of large families who seem to hold it all together so easily, and with smiles on their faces.  I’m not one of them.  I feel like I am barely hanging on with my fingernails.

I’m overwhelmed.  I thought it was going to be a real positive for Scarlett to be born during summer break, when we had no schedule to adhere to, when the long, lazy days would make it easier to handle a newborn.  In reality, I think the lack of routine is causing everyone to run amok, and I feel like I’ve lost control over all the kids – and with that comes a whole lotta guilt.  “You’re failing,” this little voice keeps chanting at me.

I miss being pregnant.  This is a feeling I’ve struggled with after every single one of my babies has been born.  It’s not that I don’t adore the baby, I just miss that magical time full of anticipation, when it’s all still in front of me, when the baby is all snug and cozy inside, and with me all the time – not crying, not demanding, just along for the ride – all mine, not something I have to hand over and share with everyone.  And this last pregnancy, especially, perhaps.  It was a bonus, so out of the blue, and so unexpectedly wonderful – I felt like Wonder Woman: who would have thought that a 44-year old woman could have such a positive, easy pregnancy?  Now, I just feel old and frumpy and drained.

I miss my midwife.  The thing about home birth and that sort of midwifery care is you spend all those months in this very personal, intimate relationship – and then the baby is born, and poof, she’s gone.  Onto other clients, other births, other stories.  And I’m left sitting here, grappling with the end of something.  It’s a sort of loss, and I’ve always felt it keenly.

All this to argue the fact that I may or may not have PPD.  I don’t know if I do or not.  I feel like, regardless of what the articles say, it’s still too soon to say.  Give a girl a chance to catch her breath!

This is part of the path I’m on, and hopefully, it’s just a relatively short detour.

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17 Comments on “Baby Blues vs. Postpartum Depression”

  1. Holly F.
    July 10, 2012 at 9:18 pm #

    As I said before, I’m a huge pusher for women to get help if PPD is suspected, but I have to agree with you. 2 weeks is too early. Too much going on out of the ordinary, especially hormones, to say “Yes, this is a depression.” I am glad, however, that you are watching out for yourself.

    And though this will mean little, YOU ARE NOT FAILING!

  2. ET
    July 10, 2012 at 10:44 pm #

    Your amazing Lisa, and I believe the hormone shift is definetly to blame….hang in there. Think good thoughts. You are a wonderful mother!!

  3. jen
    July 10, 2012 at 11:03 pm #

    Sounds like you’ve got a handle on things, all things considered. I can’t even imagining parenting SEVEN children, one of them a crying newborn. If you feel like you’re doing okay, relatively speaking, there’s no need to label it PDD yet. You’ll know if it gets to that point, since you’ve been there before.

    That said, I wonder how PDD might look different this time around, if it happens to turn into that. You said you had it with your first two – but you didn’t have six other children to care for back then. Maybe you won’t be sitting for in the rocking chair and staring into space, because you’re too busy running after all the kids. I’m just thinking, it could look very different with seven kids than it did with one or two….

    Anyway, I hope it never gets to that point for you.

    -Random blogger

  4. Caryl Becker Phillips
    July 10, 2012 at 11:28 pm #

    I would feel better if you would let me help you more. I think that, as with any syndrome or illness, there are varying degrees of PPD. I think the baby blues and PPD are one and the same. Baby blues is just a nice epithet for a mild case of PPD. I too had PPD and it was mostly crying, crying, crying, and crying some more. Do you think that admitting that you are suffering is a failure in some way? That perhaps your body has betrayed you? Lisa, you are 44, you just had a baby, you have 7 children with 7 different sets of needs that call you mommy!. And on top of that, or maybe because of that, you have postpartum depression. Whether you just say you are depressed, you have the baby blues, or you have PPD, you are still suffering and not yourself. Let your friends help you. Please.

  5. Stacey
    July 11, 2012 at 12:13 am #

    Obviously the sooner a woman is diagnosed with PPD & gets treatment, the better, which might be why the experts say to seek help if you’re not feeling somewhat normal by that point. I agree with you that two weeks seems really early to have recovered from the birth and have hormones level out somewhat and adjust to having a new little person in your life, especially if you’ve had a rough birth or have a passel of other kids taking some of your attention. At two weeks with Tiven I was still strung out on pain meds most of the time, and in breathtaking amounts of pain if I slept too long & missed a dose. It was right about three weeks that I came out of “the birth fog” and realized that I needed help. With Weston, on the other hand, I knew within two weeks that I was just fine. I think if your gut is saying you’re OK, then you are, and it just might be that you’re taking a little longer to get back to normal. Give it another week, but be mindful that, as Caryl said, you might not recognize it this time with all the other demands on you that don’t allow you to sit & stare into space.

    Another thought is that your BP medication might need to be tweaked. You’ve likely lost some weight, and your pregnancy hormones are going away, so that might be giving you a sluggish down kind of feeling. Sending you tons of good thoughts!

  6. mumofone
    July 11, 2012 at 12:40 am #

    Who gives a f*** about a label! Labels just stigmatise and alienate people. No-one really knows what causes Baby Blues or PPD anyway – they are probably the same thing at different points on a spectrum – BB self resolving within weeks vs PPD potentially lasting months. Who cares? Labels Schmabels.
    The point is whatever you are feeling or however long it may last – I gather from your post above that you are not feeling yourself right now.
    I offer the following advice (partly with my doctor hat on). Answer to yourself the following questions:
    1/. Do I feel like harming myself?
    2/. Do I feel like harming my new baby or my other children?
    If you answer yes to either then seek the help of your local doctor straight away.
    If not, then follow the steps recommended for any new mother with either BB or PPD:
    1/. Eat a healthy diet (are there friends who can cook a meal for you?)
    2/. Get consistent sleep (are there friends who can take care of your other kids so you can sleep when Scarlett sleeps?)
    3/. Access support groups (e.g. via internet chat groups of mums feeling the same or specific PPD support websites)
    4/. Access home visits (have friends over to chat with, get them to help you fold the washing, get a baby sitter to mind the older kids and go and have coffee with someone)
    5/. Access counselling services (if only to have someone “outside” the situation to bounce ideas off, bitch too or talk more openly to)
    And remember two final points:
    1/. BB or PPD can occasionally have a physical cause (e.g. postpartum hypothyroidism) so don’t suffer for too long before seeing your local doctor in case the cause is actually a reversible problem.
    2/. Drugs are an absolute last resort for PPD – this was emphasised to me when I was a med student doing a visit with a Psychiatrist to a clinic for mums who were at risk of PPD – so don’t assume that this will be the first suggestion of any good doctor – the other points above are far more important for helping someone with BB/PPD than medication.
    And finally – ((((HUGS)))) from across the sea 🙂

    • Holly F
      July 11, 2012 at 2:19 am #

      I disagree slightly that the only two questions should be about harming yourself or the children. A mother can feel a lack of attachment to the baby, which while not as dangerous as physical harm, can lead to slight neglect and/or extreme feelings of failure and guilt.

      The slope can be slippery and fast between BB and PPD. One day, the mother is just weepy with BB and the next day she wonders why she had a baby. The next day she doesn’t feel attached to the baby. Then she is wishing the baby would die. Extreme, of course, but I’ve seen it happen. PPP (Psychosis being the last P) doesn’t frequently start the minute the baby is born. It begins as BB, moves to PPD, then starts.

      Medication: I agree it should not be first resort for every woman, but once the woman is in PPD, I think it is unwise to wait to get on a low-dose of anti-depressants just because it can take two weeks for the medicine to start working. Two weeks is enough time for PPP to settle in, and then the situation is dangerous…especially if there is no counseling going on. Your recommendations are excellent ones just not always doable for a lot of moms. (I see a lot of military families where husbands are deployed, there is no extended family nearby, and friends come and go.) Medication shouldn’t be discounted. And for those women who have a history of mental illness before pregnancy, medication is a must after birth.

      Lisa, at the risk of sounding like G.I. Joe, “Knowing is half the battle.”

      • Lisa
        July 11, 2012 at 2:29 am #

        I don’t want anyone to worry about my feelings towards Scarlett! For the record, I’ve never had any thoughts about harming myself or any of my babies/children, and I’ve never had issues with not feeling attached to any of my babies, this time included. I’m very attached to her, love her to pieces. But yes, I am feeling overwhelmed. And I’m staying very conscious of it, as is Michael.

      • mumofone
        July 11, 2012 at 3:28 am #

        Holly – I really hate it when people start arguing on Lisa’s blogpage – so perhaps I should shut up now 🙂
        * Post Partum Psychosis is relatively rare – perhaps 1 in 1000 births vs PPD which is perhaps 145 in 1000 births vs BB (maybe all of us to some extent!!)
        So it is not something that would be high on my list of immediate concerns for Lisa.
        * There can be any period of time between weeping to lack of attachment to thoughts of harm – or it may never happen – but concern for a mothers or child’s life is the highest priority at any stage – and requires an immediate response if someone is having these thoughts. I emphasised these 2 questions for Lisa’s benefit to highlight to her my feelings on whether she should be rushing to see a doctor or not. Not that these are the only 2 questions to be asked if you think that someone has PPD. The Edinburgh Post Natal Depression Scale has many questions (been a few years since I’ve seen it so can’t remember exactly) all with different weightings designed to give an idea of severity of PPD. It is an excellent screening tool.
        * There is really no such thing as “low-dose” anti-depressants. You are either on them or you’re not. If you take a non-therapeutic dose (e.g. say half a normal dose) it is next to useless. Like taking 1 Paracetamol tablet or half a course of antibiotics. When people talk about “low dose” most of the time it is just marketing to make people feel better. (Like “low fat” food!!!)
        * I agree that for SOME women medication is essential. I disagree that just because you have mental illness before pregnancy that you MUST have medication if you have PPD.
        In any case my particular emphasis on medication was simply to reassure Lisa – who hates taking tablets (I remember her agony of whether to take anti-hypertensives or not) that it should NOT be the be all and end all of treatment for PPD.
        In a recent study of 80,000 women (from a highly reputable medical journal) which stated that about 6 in 100 women were on anti-depressants in the months after childbirth BUT this included both women with PPD and women who were already on anti-depressants and continued them. Either way 145 in 100 women have some kind of PPD but only 6 in 100 women take medication for whatever reason. A long-winded way to support my assertion that medication is NOT the only treatment nor even necessarily the preferred treatment.
        * I agree that not ALL the recommendations I suggested are suitable for ALL women. That was not my point. My point was simply to make a list of ideas for someone who might not have thought of them. Resources are simply that – a list of things that maybe someone can read and use if it applies to them.
        On a personal note my partner and I had minimal access to these either – we had no close friends or family who could supply food or drop in for a visit or whatever. My husband was actually the one who got PPD (and sadly the true rate of fathers with PPD is a very under-reported and under-treated statistic). He did eventually take anti-depressants after struggling to manage it via other methods for about 2 years.

  7. Asha
    July 11, 2012 at 4:44 am #

    Lisa, Honey- that’s exactly how I feel after having a baby. For me the “blues” last 6 weeks. The baby is needy- might have some feeding issues, you feel guilty about “upsetting’ the order of things for the older kids, you have no energy, bleeding… all of this puts me in a “fog”. I just try to function as best as I can. I don’t try to be some super mama. Eventually the baby will “settle” and your family will regain the sense of normalcy. It just takes time and 2 weeks is not enough!
    You are right, having more kids to worry about IS very draining, do accept help. I think of villages where women take care of the post partum Mama for a month – there is some merit to that. This is the time when letting others help you will soothe you- it will feel like you are not carrying the weight alone. I know Michael helps when he is home, but there is nothing wrong with having some help during the day.
    Sending you big hugs, thinking of you!

    • Holly F.
      July 11, 2012 at 4:32 pm #

      Mumofone, arguing implies that we will be ugly to each other. I try to never disagree with someone in a manner that I wouldn’t do to their face when manners are at their best. I promise my disagreeing with you won’t turn into childish name calling nonsense. And you responded to me with respect and maturity also so I have a feeling you aren’t looking for a cat fight either. 🙂

      I didn’t clarify some things as well as I could have. By low-dose, I meant the smallest therapeutic milligram dosage available for that particular medicine. For example, if the lowest prescribed dose is 10mg and the highest is 40mg, then the mother would be given the 10mg. There would be no reason for the mother to be put on 40mg, especially because the higher the dose, the more likely the medicine could come through the breast milk. That implies to pretty much any medicine, start with the lowest dose and work up to higher doses if needed.

      I was also not clear that I am not concerned for Lisa, especially not for PPP. She stated that she feels attached to Scarlett and I have no doubts in what she is saying. I interpreted your post as sounding slightly anti-medicine but it is clearer to me now that you are anti-medicine in Lisa’s case, due to Lisa’s own preferences. So my response was more to you than tailored to Lisa’s situation. I’m not a huge drug pusher but I have faith in medicines that work. I dislike the stigma that seems to be attached to women (anyone really) taking medicine for mental illness. The stigma causes some people to forego medicine even when it is vital to their health and sanity.

      I will also add that our opinions are colored by what we see everyday. I work for my state’s department of health. My state ranks poorest in the nation with the highest rate of teen pregnancies. PPD is pretty prevalent here, perhaps because these young mothers are already hormonal just by being teens and then the baby comes, and the baby is not the fun real-life doll the mom thought it would be. Then the baby’s father is no where around and the grandparents may or may not be supportive.

      Also, I admit that “must” was probably a strong word to use for women who have had mental illness before. Or I should have clarified that if the woman was on medication for mental illness before pregnancy and stopped taking it during pregnancy for fear of harm to the baby, it is likely that medication should be continued after pregnancy as the mental illness may return and could possibly worse because of the hormonal changes, lack of sleep, etc etc.

      Regarding PPP, I don’t want to take up too much more of Lisa’s comment page, but I have a “friend” (read into that what you will) that went into psychosis after denying that she had PPD for a few months due to the guilt factor. People cooked for her, watched the baby while she got extra sleep, and she had a supportive husband. But one day, she thought her baby had been stollen and replaced by someone else’s baby. She felt nothing for the child and had darker thoughts. Luckily, she was still “with it” enough to take the baby to a family member and drive herself to a mental clinic for crisis. While driving, she hallucinated that billboards were laughing at her and that if she drove off a bridge, her life would restart like a video game. Medication was started with intensive therapy. Later, it was discovered that mental illness is huge in the family tree (too embarrassing and stigmatized to openly talk about it) and upon more therapy, it was discovered she probably had depression for years just functioned through it. With two pregnancies after, her medication was stopped during the first 3 months and resumed after the first trimester. After birth, she took the highest dose possible that would be safe for breastfeeding. Anectodal yes and family history is the huge variable, but it is my long winded way of saying I believe in medication and strong awareness.

      • Lisa
        July 12, 2012 at 2:40 am #

        Holly, that is really scary. I’m glad your friend got the help she needed.

  8. Janet
    July 11, 2012 at 5:02 am #

    Shew, sounds like you’ve received plenty of advice and help already. I had a form of PPD after my first child, although for me it was more a sort of anxiety rather than depression. I loved my daughter to bits and would have done anything for her so that was never an issue for me. Nor did I ever feel like harming myself, but I did have ongoing issues with my appetite (I lost 17kgs – about 37lbs – in 6 weeks) and I was a bit emotional and extremely anxious. I do think PPD can come in many different ‘guises’ but right now you don’t sound as though it’s all gone south. Personally, I think a really good multivitamin and extra iron certainly couldn’t hurt, even if your diet is extremely healthy, the extra load on your shoulders means your body is probably working on hyperdrive and needs a boost. If you are worried about taking supplements while breastfeeding then perhaps you could have a chat with your midwife about it. We had a fantastic recipe in South Africa for something we called ‘Jungle Juice’ and all midwives would recommend this to new mums to help with energy, breastfeeding, etc. But I’m afraid I don’t know if you would have all the ingredients available in America. Here goes anyway, in case you do: 50ml Blackthorn Berry Tonic (Schlehen Elixir), 1 litre apple/berry/grape juice, 2 litres water, 1 sachet fruit flavoured electrolyte/rehydrat solution, 1 Cal-c-vita tablet. Really not sure if this will be helpful at all, perhaps your midwife knows of a similar drink in the US that would do the same thing? You’re a star for coping with 7 kids during school holidays, especially with one a newborn! If all else fails just keep saying the mantra ‘it does get better with time’ – sometimes that was all that got me through and I’ve only got 4! 🙂

  9. Heather
    July 11, 2012 at 3:31 pm #

    I always got the baby blues after having my babies. I don’t think I ever had PPD though. Griffin was a super fussy baby and it definitely compounded the baby blues. I remember still feeling ‘off’ at my 6 week appointment with my OB and asking about antidepressants. He gave me other ideas to help with the blues and wanted me to try that before medication. I think it was shortly after that that I started feeling more like myself. Griffin was also a summer baby. I think it is sooooo much harder to have a baby when the kids are out of school. There is no routine and so much more chaos already and then to add a newborn and their erratic schedule and needs. It’s just too much at times. Just know it will get better when the kids go back to school and that will happen in no time. Scarlett is such a beautiful little girl. Already looks so much older than she is with all of that cute blonde hair!

    • Alyson
      July 11, 2012 at 4:02 pm #

      Well like I have told you,Michael may recognize it before you do. As long as you are being open with him( which I know you are),then I have complete confidence knowing Michael will let you know if it’s more than baby blues. I do agree that PPD looks different when you have more children because you have so many dependent on you to be functioning. I believe you and I are similar, we need specific help, but,have a hard time accepting it and truthfully most people don’t understand the help you need. So I am putting it out there. You need people who will be willing to do something fun with the other kids. People who would be ok with not seeing the baby or visiting with you. If I wasn’t across the country I would bring them all over to my house for a day to get crazy with my kids;) ((( hugs))) Lisa I know ” This too shall pass” xoxo

  10. Maranda
    July 11, 2012 at 5:34 pm #

    To be Frank.. Overwhelmed.. You are the poster child for it.. 7 children, just gave birth 2 weeks ago at 44 years of age. Honestly, I wouldn’t expect anything other then overwhelmed. If you where skipping through the tulips seeing unicorns and rainbows, I would think you where on some Strong Drugs. I give you Props for going the distance when it comes to mothering on top of being there for your husband through his sickness. Your tired, physically and emotionally. Your body can only be strong for so long, so let your mind body and soul heal and give Mrs. Strong a vacation.

    Wishing you all the best…

  11. Melissa
    July 31, 2012 at 10:52 pm #

    Bridget will be 5 months old next week, I’ve only got 2 kids and I still feel completely overwhelmed many days. I’m in awe of you keeping up with a new baby and your other kiddos too!

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