The weeks and months after having a baby are some of the most wonderful in any mother’s life, but they can also be some of the hardest. With up to 1 in 5 new mothers experiencing postpartum depression and anxiety, there is no shame in experiencing these conflicting feelings, and yet the signs of these conditions aren’t talked about enough. After my own births, I suffered from postpartum anxiety and know all too well how confusing it can be. This is one of the things that made me passionate about helping new mothers.

As a postpartum doula in Maine, I take care to screen families for both postpartum depression and postpartum anxiety in order to ensure my clients can get early treatment if needed. But it is also crucial that mothers and their partners know what to look for to understand when they should ask for support.

Baby Blues and Postpartum Depression

You may have heard the term “baby blues” from friends or family in reference to the hormonal changes immediately after birth. As your hormones fluctuate, you lose sleep, and your body adjusts to the new reality, it is common to feel sad or angry in small bursts over the course of those early weeks. This is a common phenomenon, but it is not postpartum depression.

Postpartum depression, often called PPD, involves much more intense versions of the baby blues which can last for a long time and even interfere with daily life, including caring for a baby. This condition can occur any time in the 12 months following a birth, though it usually has a quick onset. Postpartum anxiety, or PPA, is similar to PPD but has different symptoms and manifestations. Both conditions are serious and may require medical and therapeutic care.

Signs of Postpartum Depression

The symptoms of postpartum depression can vary widely. Some mothers have all the symptoms, while others may only have one or two; some people feel constantly depressed while others experience bursts. I see many people write off small signs as normal when they may indicate a larger problem.

It can be difficult to recognize the signs of PPD because many of them are extensions of normal feelings. Most new parents feel overwhelmed, irritable, guilty, or confused and it doesn’t mean they are suffering from PPD. But these feelings in excess, or to the point of causing dysfunction, should be looked at further.

The major things to look for are feelings of deep sadness, irritability or anger, emptiness or a numb feeling, regret, extreme guilt, or a sense of constantly being overwhelmed. Figuring out if you fit any of these boxes may take some reflection and a bit of time, but you should never assume they’re normal; always speak to your postpartum doula, partner, doctor, or a trusted loved one if you need help working through these feelings.

While there are other sure signs of PPD, like thoughts of self-harm or intrusive thoughts, some more common red flags include problems with eating (especially when breastfeeding) or sleeping (when not caused by baby!)

Signs of Postpartum Anxiety

Like PPD, postpartum anxiety is usually an extension of normal feelings and behavior patterns in a new mother. When these thoughts and behaviors begin to interfere with your quality of life and ability to care for yourself and your family, however, they become problematic. PPA is spoken about a lot less than PPD. When I had my first baby, I knew I wasn’t depressed, and assumed everyone felt the way I did. My focus on being “perfect” and controlling everything caused strain on my family and relationships that could have been prevented with the right knowledge.

PPA may involve a more “general” anxiety feeling, like you are overwhelmed or panicked constantly. However, I more commonly see it manifest as fear and in behaviors to control fear. Many people with PPA are fearful that something will happen to their baby and take extreme precautions to prevent it. For example, staying up all night to watch the baby breathe. Others focus their fear more on “performance” as a mother and become obsessive about a certain topic, like sleep or feeding patterns.

If you feel like your mind is racing, you are full of energy all the time, or there is an impending sense of panic throughout the day, these are signs you may be suffering from PPA.

How Postpartum Doulas Can Help

A postpartum doula is not a mental health professional. If you suffer from one of these conditions, it will be important to seek this care elsewhere. However, a postpartum doula can be invaluable in preventing, identifying, and coping with these types of concerns. Our first line of defense is to try and prevent mental health concerns by stepping in and taking care of you in this critical time, offering rest and assistance wherever possible.

While you can’t control whether you experience PPD or PPA, there are also ways you can set yourself up for lowered risk or better coping in the postpartum period. A support system is critical. Not only can support help you identify signs of these conditions, but they can take stress off of you by helping with basic tasks to allow you to rest. Partners and family are always your best support system, but a postpartum doula providers tailored care that is focused just on you. When I was suffering from PPA, I didn’t realize that sleep deprivation made it worse. Someone to watch my daughter while I napped may have gone a long way in helping me begin to cope.

Whether you need a listening ear, relief from the overwhelming tasks in your home, or just a good night’s rest, my job and that of all postpartum doulas is to help you feel your best both physically and mentally. My own experiences are what made me want to become a doula and a sleep consultant, and I strive to give every client the support I needed and didn’t know was out there.

-Kim Chapman, Certified Pediatric Sleep Consultant & Postpartum Doula