How to cope with postpartum ‘baby blues’—from a clinical psychologist

I wish someone had warned me about day three postpartum.

After I gave birth to my son, I had been coasting along on a hazy, surreal, but blissful, cloud of euphoric love hormones for all of two days, when out of nowhere a metaphorical lightning storm struck me on my sleep-deprived head.

Suddenly, I was overcome with a sense of… well, I can only describe it as a hopeless misery. There was no trigger, no warning or any particular reason for my distress but I felt as though my whole world was ending. I remember walking around my house just sobbing. Everything felt so hopeless and dark, and I didn’t have the first clue why or what was wrong.

I couldn’t see things getting better—but couldn’t articulate what things. As a clinical psychologist, I was aware of the symptoms of depression, but this felt like something different. It was scary! It scared my husband, too. It scared my husband, too. At one point, as stumped as I was, having exhausted all other options of what could possibly be wrong with me he jokingly asked, “The baby is mine, isn’t he?”

For me, these feelings lasted for around three days, peaking around day five, and then just went away. But those three days were a nightmare for me. If I had have known what was coming, I may have been able to lay low and wait it out (preferably with movies and cake).

But I didn’t know. No one talks about it. I thought I had ruined my life by having a baby. I thought I was going to feel like this forever. I thought this was what being a mom was going to be like, forever.

All of my existing idiosyncrasies were magnified during this time. My introverted temperament elevated to full-hermit. My senses, already sensitive to excessive noise, light and touch at the best of times, were in complete overdrive during week one postpartum.

If the TV was up too loud, I would be close to panic. I would need to turn down the TV, dim the lights and take some time to breathe in the quiet darkness

This was not lining up with my idealized expectations. Wasn’t I supposed to be in bliss-land, subsisting solely on baby snuggles and lullabies?

You’re not alone, mama

The reality is that about 70% of women experience something called the “baby blues” after giving birth. It normally rears its ugly head around day three and lasts for a few days—just like it did in my experience. But not one person warned me about it and when I spoke to other moms for this article, they were equally as shocked to discover themselves feeling, shall we say, unstable, on day three (Note: Unstable is a massive understatement).

Research indicates that most women report symptoms, like being really sad, mood swings, insomnia, loss of appetite, and anger, all within the first week after giving birth. Not exactly the magical, dreamy scenario I had painted in my mind.

If the “blues” symptoms are severe, that can be seen as a prodromal stage (risk factor and something to keep a close eye out for) of clinical level postpartum depression later down the track.

The science behind the baby blues

Little had been known about what causes the “baby blues” in the past. There were hypotheses that it might have been because of the sudden loss of freedom, realization of the realities of being a parent, and overall adjustment. But mothers weren’t reporting the same symptoms after giving birth to their next children. Surely there was more to it—and there is.

The “baby blues” experience has recently been attributed to the drop in estrogen in the first three days of giving birth, and the increase in the levels of the enzyme monoamine oxidase A (MAO-A). Levels were found to be up to 43% higher in women who have just given birth than the control group who did not have kids or had had them a long time ago.

The levels of MAO-A were found to hit their peak on around day five postpartum which is consistent with what a lot of moms told me when I asked them about that first week, and indeed how I felt myself. MAO-A’s job is to break down the neurotransmitters serotonin, dopamine and norepinephrine. These components greatly influence and regulate our mood.

If not balanced, it causes feelings of sadness, anger, and anxiety—even making women more likely to develop more serious mental health disorders.

For most women, the increased levels of MAO-A are temporary and quickly return to normal. But in some cases, they stay raised and this can lead to postpartum depression. If your experience is severe, you aren’t coping well, or notice it hasn’t gotten better in a few weeks, then it is important to seek help. Your first step should be your general practitioner who will be a wealth of information regarding treatment and referral options. The GP may provide you with medication, counseling suggestions or both and should take your preferences into consideration when it comes to treatment options.

What to do during your first week postpartum

Have realistic expectations and give yourself a break. Now that you know that it is likely that this first week may be pretty tough emotionally, you can plan for it.

• Ask for help and accept help: Meals, cleaning, errands, debriefing, you name it! Be specific and tell people what you need—your village is alive.
• Plan to your temperament: Think about how you would like to manage these emotions if they come on. Are you an extrovert who copes with things by having lots of visitors around? Are you an introvert who needs “me time” who should perhaps limit the number of visitors in that first week in case of potential overwhelm? Let people know in advance what you need from them, so you don’t have to deal with awkward moments in an already vulnerable time.
• Create a self-care bag: Fill it with things that generally help you cope with stress—poetry, chocolate, bubble bath, music, crossword puzzles, whatever. Then use it!

Most importantly, remember that you will be okay— this is a physical, relatively normal, hormonal reaction, and will most likely pass very, very soon. If it doesn’t or if you are not okay – help is available for you; please ask for it.

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