“Is this normal?” Common Mental Health Questions in Postpartum

“Is this normal?” Common Mental Health Questions in Postpartum

The first few weeks (months, even years) postpartum are FULL of questions. Bringing a baby into the world is a completely new experience that even the most prepared parents can’t fully prepare for. No matter how many books you read, podcasts you listen to, or friends you ask for advice, bringing home a new baby is full of unexpected moments and challenges. Even if you have children already, each baby has unique needs, different temperaments, and their own preferences. 


While this is a beautiful and special time, each day in postpartum can bring up new questions. As a perinatal mental health therapist, I hear many common experiences surrounding the challenges of sleep, feeding, recovering from delivery, hormone shifts, and navigating the many emotions in the first few months after birth. One of the most frequent worries I hear is if women’s experiences are normal, or if their questions mean there is something bigger to be concerned about. Let’s wade through some common questions around mental health in postpartum to discern what is a typical occurrence and when to seek out more help. Chances are, whatever you are wondering about, another mama is wondering about too.


I can’t stop crying, is this how it’s supposed to be?

One of the most common but often overlooked experiences in postpartum is what’s referred to as “the baby blues”. The baby blues typically begin in the first couple of days after birth, and can last around two weeks. Up to 80% of women the baby blues, which can look like feeling very tearful, being overwhelmed or having trouble making decisions, experiencing mood swings, feeling angry or bothered by those around you (yes, even your baby), having difficulty bonding to your baby, and feeling anxious or worried. 


The baby blues can be confusing for a lot of new moms, who might expect to feel so happy and bonded with their little one. The baby blues are completely normal, and are caused by the massive shift in hormones that happens after birth along with the sleep deprivation that comes with a newborn. Typically, these symptoms resolve on their own within a couple of weeks. If these symptoms don’t go away on their own within two or so weeks, get worse instead of getting better, or if you ever have feelings of hurting yourself or your baby, it’s time to get more help. These are signs that you may be experiencing a perinatal mood and anxiety disorder (PMAD), like postpartum depression, that requires further treatment to resolve. So, while it is completely normal to be teary and cry often after giving birth, if you find that this continues after the baby blues period or that your emotions are getting in the way of you being able to go about your days, please connect with a professional like your OBGYN or a therapist for more support.


Why don’t I feel bonded to my baby?


A lack of interest or lack of bond with your baby is a common symptom of the baby blues. This can be really hard for new mamas, and can cause major feelings of guilt and questions around being a good mother. If you’re in the first two weeks postpartum and you’re struggling to bond with your baby, hang in there. Focus on taking breaks from your baby, getting some time for yourself, even if it’s just 10 minutes alone to breathe or take a shower, and asking for help with tasks like diaper changes and putting the baby down. 


A struggle to bond with your baby can also be impacted by other factors including having a hard time with breastfeeding, traumatic birth experiences, or NICU stays. If you are still working on getting breastfeeding down, you’re definitely not alone in this. Many hospitals or birthing centers have lactation consultants that you can connect with even after you are discharged, so it’s worth getting support if your struggles with breastfeeding are impacting your ability to bond with your baby. If you experienced a complicated or traumatic birth or your baby was or is in the NICU, it’s a good idea to check in with a professional or support group as these experiences can definitely impact mental health in postpartum.


If it’s been more than two weeks since you delivered and you’re still struggling to feel a bond, this is a good indicator to connect with your provider or therapist about any other symptoms that may indicate a PMAD. Remember, not feeling bonded to your baby does not mean you are a bad mom or that you’re doing anything wrong. Chances are you are a great mama and with a little extra help, you will be feeling bonded to your baby soon.


I feel so worried all the time, how can I calm down?


Anxiety and worry are extremely common in postpartum. Imagine your first week at a new job where you have no experience, there isn’t a clear job description, and your boss can’t communicate whether you are doing things right. Of course you’d be feeling worried! You are adjusting to a completely new world, so try to focus on meeting yourself with compassion. 


Though some worry in postpartum is completely normal, this is another area where it’s important to tune into how you’re feeling to know if it’s baby blues, a typical amount of worry for a new parent, or something more serious to look out for. Though many people are familiar with postpartum depression, less people are aware that postpartum anxiety also exists. Postpartum anxiety is characterized by constant worry, rumination, a fear that something bad will happen,  and physical symptoms like dizziness, nausea, or a rapid heartbeat. There are also specific forms of postpartum anxiety including panic disorder and postpartum obsessive compulsive disorder. If your worry is crossing the line into panic attacks, intrusive thoughts that you find scary or disturbing, or anxiety is making it challenging for you to sleep or eat, it’s time to chat with a professional. 


If you aren’t experiencing severe symptoms but are struggling with worry and anxiety, there are a lot of helpful tools you can use to feel more calm. First and foremost, try to focus on getting as much sleep as you can. That may mean asking for help with the baby or with household tasks so you can take naps. When we are sleep deprived, it’s hard for our brain to manage anxious thinking, so focusing on sleep can make a huge difference. Additionally, making sure you are eating enough and staying hydrated is an important tool in coping with anxiety. Taking deep, slow breaths or doing a quick meditation can also help. Basic self-care can make a world of difference in postpartum, so try to find ways to take breaks to prioritize your needs.


Does everyone feel like this, or is it just me?


I promise, it’s not just you. One of the biggest challenges around supporting mental health in postpartum is the ongoing shame and stigma around having open and honest conversations. Though it’s improving, there is still a strong culture of unrealistic expectations and comparison in parenthood, which leaves little space for parents to be real about how tough this time period can be. This can be exasperated by social media, where we often only see the positive side of things. 


The frequency of the question of “is this normal” is a great indicator of how important it is to know we are not alone in our experiences. There is power in sharing these vulnerable parts of yourself and hearing someone else say “I feel that way too”. So, the most important thing you can do is to share your experience, with a friend, a therapist, a partner, a support group, really with anyone who you trust to reassure you that you’re not alone.


When will I feel like myself again?


People are often surprised to learn that PMADs can develop anytime throughout pregnancy and in the first year postpartum. Sometimes new parents feel alright in the first few months but develop symptoms later, and can be caught off guard by this. The good news is that all PMADs are temporary and treatable, so with the right help, you will start to feel better. 


Whether you are managing a PMAD or not, everyone has different experiences in postpartum, so it’s impossible to say when you may start to feel more like yourself. The reality is that your brain chemistry, hormones, and body have changed drastically throughout pregnancy, so you may not ever feel exactly the same as you did before having a baby. Instead of focusing on getting back to where you were before, it can be helpful to focus on what you need to adjust to your new normal. Even if you don’t need professional support, building a community can be so helpful to navigating the new territory of motherhood.


To all of the new mamas out there, you’re doing great! Remember to take care of yourself and ask for help where you can. With time, you will get the hang of things and start to adjust to this new world.


Note: if you ever feel like hurting yourself or your baby, it’s imperative that you reach out for help immediately. These thoughts do not make you a bad mother, they are a sign that you can no longer carry what you’re experiencing alone and you need support to make sure you and your baby are safe.

If you are having thoughts of hurting yourself or someone else, please call 988 or 911 immediately. If you are not having thoughts of harm but want to talk to someone about your experience, please contact the Postpartum Support International Helpline at 1.800.944.4773.

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