Baby Blues: Mental health during and after pregnancy

Woman sitting in car holding sleeping baby. She looks tired and anxious.

Pregnancy and having a baby is life changing for everyone. It’s often an exciting time full of joy and anticipation. It’s often a difficult time full of anxiety and frustration. Frankly, it’s almost always both.

“Up to 80% of people have post-partum blues,” says Dr. Priya Kumar-Kaparaboyna, reproductive psychiatrist at the OHSU Center for Women’s Health. “This is being more emotional or anxious for a short time, usually a week or two, after your baby is born.”

Depression, anxiety and other mood disorders are also more common during and after pregnancy. Up to 20% of people experience the most common one, depression. Seeking support and treatment is important, but struggling with mental health issues at this time doesn’t mean there’s anything wrong with you as a parent or caregiver.

“Society tells you you’re supposed to be happy and so in love with your baby all the time, and if you aren’t there’s something morally wrong with you,” Dr. Kumar-Kaparaboyna says. “The truth is you can really enjoy your baby and still get annoyed, frustrated, sad or angry. Having a range of feelings or developing more serious mental health concerns doesn’t make you a bad parent or a bad person.”

Risk factors

The fact is, during and after pregnancy is a time of higher risk of mental health issues for everyone. Some risk factors relate to your personal history, others relate to the changes and anxieties that come along with having a baby. Your risk of experiencing peri-partum depression, anxiety or other issues is higher if you have:

  • A personal history of mental health issues
  • Family history of mental health issues
  • Severe mood changes during your menstrual cycle as your hormone levels shift
  • Experienced physical or other abuse
  • A history of addiction or substance use disorders

Your risk may also be higher if you experience one of these factors:

  • Your pregnancy is unwanted
  • Your pregnancy or childbirth is traumatic
  • Your baby spends time in the NICU or has health issues
  • You have limited support from family and friends

Signs to seek help

Because these issues are so common, your prenatal or primary care provider is likely already on the lookout for signs and discussing your mental health with you. They can often diagnose and treat you for mild mental health concerns, and can refer you to someone like Dr. Kumar-Kaparaboyna if your symptoms are severe or ongoing.

But you know best how you feel.

“If the thought comes into your head that you might need some help, then you should seek help,” says Dr. Kumar-Kaparaboyna.

She recommends you ask for help if any of the symptoms below impact your ability to function and live your life, or your ability to bond with your baby.

  • Feeling irritable, moody, upset, or fearful
  • Feeling anxiety or having panic attacks
  • Feeling numb or indifferent
  • Feeling guilty, unworthy or that you’re a bad parent
  • Feeling so anxious that you’re unable to let anyone help with the baby, even a trusted loved one
  • Worrying constantly about the baby or excessively checking on the baby
  • Extreme fatigue or inability to sleep even when you have opportunity and are tired
  • Hopelessness or inability to feel joy
  • Suicidal thoughts or thoughts about harming yourself, the baby, or others

What can help

Medical support ranges from counseling and therapy to medication. In addition, research shows that some simple lifestyle changes can often help.

  • Attend to sleep. With a new baby, this can be a challenge, and support is critical. Think about ways to take one night feeding off your plate or to get a nap in during the day.
  • Good nutrition and hydration. Make sure you’re eating and drinking enough, and choose healthy options as much as possible.
  • Exercise. Throughout your pregnancy and after childbirth, talk to your provider about how much and what types of exercise are safe and healthy for you.
  • Ask for (and accept) support. Support of all kinds is important, from help with the baby to social interaction with friends.

If you or a loved one have any thoughts of suicide or self-harm, please call the Suicide Prevention Lifeline at 1-800-273-8255. Free, confidential support is available 24/7.