The birth of a new baby is an exciting time. Family and friends come over to fawn over the new baby. They bring gifts and take turns holding the new addition. But what happens when a mother doesn't feel that same joy—when she feels disconnected from all the excitement around her?
That can be a deeply isolating feeling, but it's far from uncommon. Experts estimate that as many as 1 in 5 women experience mood disorders like depression and anxiety during pregnancy and after giving birth. These feelings in the weeks and months after giving birth were once labeled the "baby blues."
But Dr. Maria Muzik says there is an important distinction between the "baby blues" and actual perinatal mood disorders.
"So what is the baby blues? It’s very common. It’s almost a normative experience of women after the birth," she explained.
Muzik is an associate professor in psychiatry and in obstetrics and gynecology at the University of Michigan. She also runs the Zero to Thrive program which gives social and emotional support to families with young children.
Between 80 and 90% of women, said Muzik, have some mood instability in the two weeks following the birth. Much of that is caused by the rapid hormonal shifts that women experience during that time.
"The hormones at the end of the pregnancy—estrogen, progesterone—are 100, 200 times higher than any time in a woman’s life. And then within hours, it’s going down to almost zero. So this is a hormonal roller coaster that leads to an emotional roller coaster," she said.
But if feelings of sadness or irritability persist past two weeks, it could point to postnatal depression or anxiety. The symptoms can include difficulty bonding with the baby, irritability, intense anxiety, loss of appetite, among others.
Those are feelings that Carrie Kolehouse knows well.
"Immediately after giving birth, I felt empty. I felt like an empty shell. And I just remember the nurses taking me to the shower, and I remember standing in the shower and thinking ‘My life is over. I’ve made a terrible mistake,'" Kolehouse recalled.
Kolehouse is executive director of MomsBloom. The Grand Rapids group trains and pairs volunteers with new mothers who reach out either during or after their pregnancy. For approximately three months, the volunteers provide support to any family with a newborn free of charge. That includes both emotional and practical support, like helping with housework or watching the baby while mom takes a nap.
Women struggling with a mood disorder after giving birth, Kolehouse said, often find it challenging to open up with family members, close friends, or even their doctor. Sometimes, it's far easier to tell a stranger. That was Kolehouse's own experience. What finally led her to seek help for her own postpartum depression was a visit from a volunteer with a breastfeeding support program.
"Being able to tell a stranger felt so safe because she was going to leave that day and maybe I was gonna never have to talk to her again, and wouldn't have to, I could go on in my denial if I wanted to," she recalled.
While there has been a “positive change” when it comes to awareness and understanding about postpartum depression, Kolehouse said, there are still obstacles to getting help. A big one is stigma. Some mothers still believe that if they receive a postpartum depression diagnosis, they will be “labeled as crazy,” said Kolehouse.
Another obstacle to getting help is the fact that by the time symptoms of postpartum depression and anxiety show up, there's a good chance a mom has already stopped seeing her OBGYN.
“The peak is actually around week six. And between week six and sixteen, that’s where the postpartum depression really hits," Muzik said.
That can lead to moms falling through the cracks. The good news, said Muzik, is that in the past 10 to 15 years, more pediatricians have started screening moms for postpartum mood disorders. Since babies have regular appointments through the first year of life, pediatricians are often the health care providers who have the most contact with the mom.
"We call it now the fourth trimester," Muzik explained. "Pediatricians have recognized that this is a mother-baby unit in the first year postpartum. The baby cannot be well alone."
Muzik and Kolehouse both emphasized that there are effective treatments for postpartum mood disorders. After she finally talked to her doctor and got medication and therapy, Kolehouse said her whole world changed.
"It was like I was seeing my baby with new eyes. I felt so different about motherhood and about my relationship with my baby, and I was able to bond with him in a very different way."
This post was written by Stateside production assistant Catherine Nouhan.