Is it postpartum depression or anxiety?

Sometimes new moms aren't sure if they are suffering from pregnancy-related or postpartum depression or not. In my practice, I use the Edinburgh Postnatal Depression Scale, which is a validated screening tool.  You can review the questions here.  Screening is different than diagnosis, so if you are concerned in any way about the way you feel, then I urge you to discuss it with your health care provider.  Postpartum anxiety can also go unrecognized, and anxiety disorders appear to be more common in pregnancy and postpartum compared with other women of childbearing age. Sometimes women under-report feelings of anxiety because worrying is thought to be "normal" - but what matters is the degree of worrying, and how it's affecting you.  Although labels and diagnoses can be helpful, I also like to take a step back and simply look at whether someone feels they need help; you, the patient, are the best judge of this.  

The article "The Difference Between Postpartum Depression and Normal New Mom Stress" is a useful article. In it, Social Worker Kate Kripke provides a list of experiences that reflect "healthy" or "normal" adjustment, and those that suggest "postpartum distress that requires support". 

For example, the following experiences are common:

  • Fears about harm coming to your baby that come and go, that you know are not “realistic” but that do not cause lasting distress, and that decrease as your experience and comfort with motherhood grows.
  • Sleeplessness that occurs from caring for your baby at night, while still having the ability to sleep when your baby is sleeping or when given the option to rest.
  • Fatigue that comes from late night feedings and interrupted sleep.

While these may indicate the need for greater support:

  • Sleeplessness that occurs due to “monkey brain” –  anxious thoughts that will not go away.
  • A deep fatigue that is not alleviated with rest and/or a desire to remain in bed all day.
  • Unrelenting anxiety about having others help care for your baby and a deep fear and inability to let go of some of this control.

Recovery from pregnancy and birth and adjustment to life with a baby - whether your first or not - is challenging, and often new moms don't have a lot of support to draw upon. NEST-S is a way to remember the areas of self care that are important: nutrition, exercise, sleep and rest, time for yourself, and support. It's especially important to consider these areas if you have a history of depression or anxiety, Practical tips for all of these areas can be found in BC's excellent Self Management Guides for Perinatal Anxiety and Depression. Whatever the diagnosis you think you may have (or not), if you're feeling the need for more help, please do not hesitate to seek it.  Seek support not only from your health care provider but from your family, friends, and community.

Of course, if you are having thoughts of hurting yourself or your baby, think you are hearing or seeing things that aren't there, or feel you are in crisis, please get immediate help. In London, the HOPEline for postpartum support is 519-672-HOPE (4673).

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