"Renu is a 25 year old first time mother. Her baby, Pooja, is just four days old. Renu was very excited when she found out she was pregnant. She had always wanted a baby. She and her husband, Satish, had planned the pregnancy. Now that Pooja is here though, Renus feels down and begins to cry when little things happen. Like the other day when she got upset when she dropped a bowl of food she was carrying. It feels as though she just cannot shake the blues. She tries to sleep, but can't seem to sleep when Pooja is sleeping. She is trying to breastfeed but is having a difficult time with this and feels discouraged. Satish has tried to be supportive, but Renu thinks he doesn't really understand. She just feels exhausted all the time and has become increasingly nervous and fears that she will have to stop breastfeeding. She wonders if this is normal." 

 
"Sheila remembers lying in the hospital bed after the birth of her second child. She had endured a full day of labor and a difficult delivery (who says the second one comes easily?), and was tired beyond explanation. After the relief of seeing her precious new child, came an uncontrollable feeling to close her eyes and sleep. As her husband cradled her newborn, she drifted off, thinking, "I can't do this. I don't have the energy. How will I ever take care of a baby?" 

 
"Mrs. N has given birth to a healthy baby boy. Everyone in the family is overjoyed except for the new mother. She seems listless and disinterested about the baby, she rarely leaves the bed and cries for long periods of time each day. No one around her can understand what is happening and she herself is clueless too." 

Postpartum blues has become more of a reality for many mothers and their families. The most common symptoms include crying easily, feeling unsettled or ‘on edge', agitation, irritability, feeling disconnected, significant anxiety, lowered appetite, mood swings, trouble sleeping or excessive tiredness, not wanting to get dressed, go out, or clean the house. 

 
This isn't something new mothers can control, there's no place for blame. The most wonderful and committed mothers, even experienced mothers of more than one child, can get the baby blues. This article is aimed at providing a clearer picture about this issue, not just for expecting or new mothers but also for the fathers or family members. 

 
It might be difficult to understand why a new mother would be anything other than happy regarding the birth of a healthy child. Some of the main reasons for these feelings are due to changes in the body from pregnancy- especially a rapid drop in the levels of hormones like estrogen and progesterone, and recovering from delivery (some women have a slower or more painful recovery than others). 

 
Changes in work and social relationships, having less time and freedom for oneself, lack of sleep, lack of confidence in one's abilities to be a ‘good mother' as well as changes in marital relationship since the mother's focus shifts to the baby, all can contribute to the blues. 

Coping with the blues 
Here some things to keep in mind that can make a difference: 

Slow down. 

Your baby's arrival is a good reason to let the rest of your chores wait. Don't worry about getting everything done, and doing everything perfectly. Just do what is enough. When your baby is asleep and you are finally sitting down for a much needed break, resist the urge to get the laundry done or catch up on some work. If you're on maternity leave, banish all thoughts of the work awaiting you at the office. Don't worry - you'll get back on track soon enough. 

 
Get some rest. 

The rigors of caring for a newborn 24/7 can leave you exhausted. Unfortunately, moms often can't sleep when they want to. But it's still important to give yourself rest breaks. A lot of mothers go by the "sleep when the baby sleeps" rule. Although it is tempting to do other things when baby sleeps, taking a nap can be very refreshing and will help you cope with broken sleep at night. If you are having difficulty napping (some find it tough to wind down quickly when it's bright and sunny), at least lie down and get physical rest, even if you just read a magazine or watch TV. Ask a relative or friend to watch your baby for an hour or so each day. If no one's available, consider hiring a sitter, who is experienced with newborns. 

 
Ask for support. 

Don't expect so much of yourself. Part of being a good mother is knowing when to ask for help. Help comes in many forms, ranging from friends who cook meals and fold your laundry to your husband taking over household chores and baby responsibilities. You need support from others so you can get rest and are on your way to your full strengh and health. 

 
Share your feelings. 

Tell someone you trust about how you feel. Call a sympathetic friend. If you have a supportive partner, make sure he knows what's going on and how he can help. 

Be good to yourself. 

Try not to feel guilty about the way you feel now. Just because you have the blues doesn't mean you are a bad mother or that you don't love your child. Once you feel better, these feelings will diminish. Take care of your physical health. A lot of mums take great care of their food during pregnancy but not after delivery. Mothers need to make it a priority to eat meals on time and continue eating highly nutritious food as well as plenty of fluids if breastfeeding. Oftentimes mealtime can get pushed due to baby care or other pending things. Make sure your own basic needs are met, and that you are eatting and sleeping well. 

 
As the spouse of someone who is going through this period, helping her achieve a balance between relaxing activities and plenty of rest could be the key to providing good support. The moodiness and irritability might be difficult to handle at times but it helps to remember that this is a temporary phase that does improve with time and proper support. 

 
Could it be more than just the baby blues? 

The baby blues most often goes away within a few days or two weeks. The symptoms are not severe and may not need treatment. As your body gets back to normal, it will slowly disappear. However 10% of mothers go through full blown postpartum depression. This presents itself as a clinical depressive phase with the symptoms much more severe and prolonged than just the blues. It can begin anytime within the first year after childbirth. 
If you have postpartum depression, you may have any of the symptoms of depression like agitation or irritability, changes in appetite, feelings worthless or guilty, feeling withdrawn or unconnected, lack of pleasure or interest in most or all activities, loss of energy and significant anxiety. Along with this you could also have; 

* Negative feelings towards your baby or thoughts of hurting the baby 
* Thoughts of hurting yourself 
* Not having any interest in the baby 

 
Some women also experience postpartum psychosis. This is rare and occurs only in about 1 to 4 out of every 1,000 births. Symptoms may include: seeing things that aren't there, feeling confused, having rapid mood swings, trying to hurt yourself or your baby. This requires immediate and urgent medical attention. 

 
Women who have had some form of mental health history are at a greater risk of having postpartum depression than those who do not. Postpartum depression needs immediate treatment by a doctor. Safe treatment is available, even if you're breastfeeding. If you are in doubt about whether you are going through the blues or depression, it is best to consult a doctor. 

If you would like to discuss this further or need some help or support in this or any other area, our counsellors would be happy to help. 
 
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