Giving birth is tough—it’s not called "labor" for nothing. And what happens next? No rest for the weary. Instead, this fragile, helpless human being needs your attention—a lot of attention. On top of that, you’re dealt some serious sleep deprivation, turbulent hormones, and all the cultural expectations around bonding, bliss, and being “mom enough.” Sometimes, it’s all a rude awakening (and one not instigated by middle-of-the-night feeding requests).
Considering this, it’s no wonder that 9 to 16 percent of moms, through no fault of their own, will experience postpartum depression. Indeed, a mix of genetics, hormones, predisposition, support (or lack thereof), and stress creates a perfect storm for the illness.
Women with postpartum depression were once silenced and written off, but are now speaking out. So this week, we’ll amplify this critical voice by busting four myths about postpartum depression—plus, eight symptoms to watch for.
Myth buster #1: Postpartum depression can start before giving birth. In fully 50 percent of moms with postpartum depression, symptoms began during pregnancy, not just after the baby was born.
Myth buster #2: Postpartum illness can also start later—well beyond the first four weeks after giving birth.
Bottom line: if you are suffering, you don’t have to fit into a neat little diagnostic box to get help. Nothing about having a new baby is clean, including exact symptoms and timing. Many advocates have argued that changing the onset to anytime in the first six months or even the first year after giving birth would reflect the experiences of moms with postpartum depression more accurately. And no matter what the label, your physician or mental health provider should treat you the same way: with compassion and action.
Myth buster #3: There is a whole collection of other postpartum illnesses besides postpartum depression: postpartum anxiety, postpartum OCD, and rarely, but often enough to be recognized, postpartum psychosis. These are all challenging disorders new moms (and even dads) can experience.
Myth buster #4: Postpartum depression consists of more than just the “baby blues,” the period of emotional adjustment that occurs after having a baby. Baby blues go away on their own, and consist of experiencing the symptoms below in a transient way. By contrast, with postpartum depression, you feel some or all of the symptoms more often than not.
So, what are the symptoms of postpartum depression?
- You feel guilty. You feel like you should be doing better than this or handling things differently. The words “I should” pop into your head a lot. You feel damaged or worthless or like you don’t deserve to be a mom. You don’t want anyone to know, and so you hide how horrible you’re feeling. You worry that if you confide in someone, they’ll either judge you or have your baby taken away.
- You can’t be reassured. With baby blues, it’s normal to feel overwhelmed at times, but some kind words from your partner or a friend you trust will make you feel better. With postpartum depression, you feel overwhelmed, sad, or anxious more often than not. Instead of comforting you, reassurance just feels like a lie.
- You fantasize about escaping. This goes beyond joking about a one-way ticket to Jamaica. Instead, you fantasize about driving away and never returning because you feel that your family would be better off without you. You may have thoughts of escape by killing yourself or getting killed, such as being hit by a bus. These fantasies persist even if you get some rest and support. Note: If your thoughts of suicide are more than just passing thoughts, or you have a plan to kill yourself, get help right away. You can even call 911 and tell them you can’t keep yourself safe.
- You feel overwhelmed. With postpartum depression, you don’t just feel overwhelmed at particularly hard moments, but most or all of the time. You feel as if you’re not cut out to be a mom and that this was all a terrible mistake.
- You question your love for your baby. This goes way beyond taking a while to bond, which is normal. You don’t feel affection for your baby, and you may not even want to look at him or take care of her.
- You feel inadequate. You worry you aren’t good enough, that you can’t do this, that your baby will be harmed or stunted forever, and that it will all be your fault. You’re convinced that you’re broken or defective (not just disappointed or regretful, but truly inadequate) because you didn’t give birth “the right way,” or can’t or don’t want to breastfeed.
- You’re angry and irritable. You snap at the baby, at your partner, or anyone who comes near you. You may resent your baby for putting you through this.
- You’re worried your baby’s got you pegged as a fraud. You are concerned that you’re not fit to be a mother and that your baby can tell: he or she doesn’t like you, doesn’t love you, or resents you for crying all the time or for being "crazy."
It’s important to note that not everyone will experience every symptom, plus there are also the classic symptoms of depression such as crying and changes in appetite and sleep. Don’t worry about matching up perfectly—you know if you’re miserable.
The take-home message is this: bringing a new person into the world is tiring, emotional, and, at times, overwhelming. But if you think you’re losing your mind, or feel miserable more often than not, resentful more often than not, or worried more often than not, you deserve some help. A new baby is hard, but it’s not supposed to be torment.
Most importantly, postpartum depression, anxiety, OCD, and psychosis are all treatable. You are not a bad mom if you have postpartum illness, and reaching out for help—to your doctor or a qualified therapist—makes you a great one.
A version of this piece originally appeared on Quick and Dirty Tips.
Disclaimer: All content is strictly for informational purposes only. This content does not substitute for mental health care from a licensed professional.