Postpartum Mental Health: Baby Blues
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GRETCHEN MALLIOS: After you have your baby, you find that you're experiencing a wide range of emotions. You feel joyful, weepy, tired, weepy, in love with your baby, and weepy still. Is this normal? Do you have the baby blues? I'm Gretchen Mallios, licensed clinical social worker and board president of the Postpartum Health Alliance and you’re listening to Newbies.
KRISTEN STRATTON: Welcome to Newbies broadcasting from the Birth Education Center of San Diego. Newbies is your online, on-the-go Support group guiding new mothers through their baby's first year. I'm your host, Kristen Stratton. I'm also a certified birth doula, postpartum doula and owner of In Due Season Doula Services.
If you haven't already, be sure to visit our website at www.newmommymedia.com and subscribe to our weekly newsletter. You can also subscribe to our show through iTunes so you'll automatically get new episodes when they're released. Alright, let's go ahead and introduce our panelists.
SHANNON BULZONE: Hi. I'm Shannon. I am 31. I'm a stay at home mother and part time photographer. I have two children. Gabriella is going to be 2 next month and Emerson is 2 months old.
JENNIFER KELLY: My name is Jennifer. I’m 36. I'm actually also a Dona trained doula. I'm a student midwife. I have two children of my own. My daughter is 12, my son is 5. I'm actually carrying currently a second surrogate baby for friends of mine.
BRITTANY CIUFERRI: I'm Brittany. I'm 26. I'm a stay at home mom. I'm also training to be a doula – birth doula. I have one seven month old baby girl who is boggling grabby and she's here with us today.
SUNNY GAULT: Hey everybody. It's Sunny. I'm producing today's show. Before we get started, I just wanted to address a couple emails that we’ve received within last couple weeks regarding the Newbies app and the New Mommy Media app. You've heard Kristen and I talk about these apps in the past and both of them are pretty new. People are wondering when they should download Newbies versus when they should download the New Mommy Media app.
Here's the deal. First, you should know that pretty much the same information is on both. If you are more of a person where you like all your of apps to be separate and you don't want to have to go digging deeper into an app to get the content you want, then I would suggest going with the Newbies app.
It's got some really good features on it mainly obviously you can download and listen to the episodes whenever you want. You can start your favorite episodes, you can access all the bonus content and all that great stuff with just a few simple clicks.
However, if you are someone who loves the New Mommy Media podcast and you listen to several of them, hopefully you guys know that we produce more than just Newbies. In fact we have 5 podcasts right now that we're producing. If you're a fan of our other shows and you want perhaps I don’t know—maybe you download a bunch of apps on your phone, your iPad, your android device and maybe you're running out of room and you just want one app that has everything on it.
That's a great opportunity to download the New Mommy Media app. All 5 shows you can access the podcast through that app. You don’t have to load all of them. So let’s just say you listen to 2 out of 3 or 4 out of 5 or something like that, you could just download the ones you want and have easy access to them with just through one single app.
The nice thing is we have apps available on every single platform you can think of. Hopefully that breaks that down a little bit more. If you guys have further questions, please email us. You can go to the contact link on www.newmommymedia.com and just let me know your questions and I’ll try to get them answered.
KRISTEN STRATTON: Today on Newbies, we're beginning our series on postpartum mood disorders with an episode on the baby blues. On our show we have Gretchen Mallios, licensed clinical social worker specializing in maternal mental health. Thanks so much for joining us Gretchen and welcome to the show.
GRETCHEN MALLIOS: Thank you. It's great to be here.
KRISTEN STRATTON: Gretchen, as a licensed clinical social worker, how many moms experience the baby blues?
GRETCHEN MALLIOS: The baby blues are commonly understood to happen in about 8-10 months. 80% of moms will experience the baby blues in the first couple of weeks after giving birth.
KRISTEN STRATTON: How many moms nationwide experience postpartum mood disorders?
GRETCHEN MALLIOS: Postpartum mood disorders are different than baby blues because that's actually a stronger symptom. It happens for fewer moms but we estimate that there are about 400,000 live births in the United States every year. If we went conservative, 15% of moms get some kind of mood disorder after giving birth. That's about 60,000 moms a year in new cases.
If we go up to 20% which is commonly referred to as sort of the baseline of the number of cases in a given year, or new cases, it's 80,000 new instances of maternal depression. Dads – we’re starting to recognize that dads get it too and that's 10% of new cases. 10% of dads experience depression after childbirth and 50% of dads when there's already a case of depression in the home. So if mom develops depression, dad is 50% more likely to develop it as well.
KRISTEN STRATTON: Thank you for sharing that. It’s new information for me. What are the different kinds of mood disorders that mom can experience? We'll just touch on a few.
GRETCHEN MALLIOS: Mood disorders are depression, specific. But the different kinds of mental health disorders that mom can experience are anxiety, depression and trauma, post traumatic stress disorder and OCD or psychosis. Mood disorders are the most commonly studied and the most commonly occurring. But these days, most of us that are working with moms and dads, we're finding that anxiety is about as common as depression even though depression has been much more studied.
KRISTEN STRATTON: What does the new mom experiencing emotionally those first few days after she's had her baby?
GRETCHEN MALLIOS: Most of us experience that kind of euphoric elation that's so overwhelming. That sense of love when that baby first arrives. It's like nothing we've ever experienced before. We didn't know we could have that bandwidth, that feeling of love. So that's commonly the first reaction or the reaction within the first day of getting used to that new being in your life and that new relationship.
But after that, the nurse's expectation: oh, does that stay? It doesn’t. There's hardship, there's adversity, there's questions, there's doubts, there's the baby health, that or I don't know, this medical environment, this family environment that's sometimes monitoring.
After the elation and euphoria that comes naturally with the body in the whole start of the experience, there can be worry, there can be stress, there can be fear, there can be sadness and confusion. So there's a range of feelings that parents feel. And I don’t just mean after the first child is born.
Because when the second or the third comes along, now you have that baby and then those other relationships to negotiate. Life's complex and relationships are complex and that what welcomes a whole gamut of emotional responses.
KRISTEN STRATTON: What about our panelists? How did you feel that very first day that you had your baby?
SHANNON BULZONE: Tired. It was a long night.
BRITTANY CIUFERRI: Just happy and just really honestly though, I was tired. That was the biggest thing for me. I was happy that my husband was able to be there. He's in the military and I had a great doula and a healthy baby. So I really don’t know but I felt like I could have asked for a lot more.
KRISTEN STRATTON: How about you Jennifer? How did you feel?
JENNIFER KELLY: So far, I’m 3 for 3. Day one is elation. I’m very grateful for that. I'm so excited. There's this new person in the world and even if they’re not my person, like there's this new baby in the world. Just best day when baby's come. Day 2 might be a different story. But day one is awesome.
KRISTEN STRATTON: That’s right. You’re a surrogate.
SHANNON BULZONE: I'm going to break the trend. Because with my first daughter, the first day was elation and that continued. I would say through day 3. For the first two weeks with her, I had some baby blues that I was dealing with and it was very hard to just do anything. I slept a lot and I nursed a lot, and just kind of stayed in the bed. I had a lot of doubt about my emotions. I would get very angry very quickly. Is this warranted or am I just hormonal? And this is me being hormonal. A lot of doubt. And then it cleared up. All you know it was just gone and with Emerson this time around, it has not cleared up and I’m two months – he’s eleven weeks on Thursday.
Right before he was born, my grandmother passed away. When I had him, he was a C-section. I was excited that he was there but it was nothing like the flood of emotion that I had with Bri. It was much more subdued. I would say a large part, because I was grieving. I'm still grieving and it's challenging. I feel like I go out of my way to make a connection with him so that he isn't sensing anything different with my mood or with the love that he receives. I kind of fake it till I make it right now. Fake it till I feel it deeply.
KRISTEN STRATTON: I had a similar experience as you. None of my births were beautiful and oh, I just felt it right away. In fact I felt very detached at birth with all of them. Not that I don’t love them. I just didn’t feel that euphoria and probably that had a lot to do with trauma like you mentioned. So fake it till you make it. I get that now. I look at my 5, 3, and 2 year old and I’m like “oh gosh you’re so cute. I just love you so much.” But I did not feel when I first saw them.
SHANNON BULZONE: That's good for me to hear, that it comes, because sometimes I doubt. I’m like, am I ever going to connect with Emerson the way that I connected with Gabriella and have that strong bond with her. It's very, very different. I mean even the red flag for me was when I would hear Bri cry, I would cry. My milk would let down. When Emerson would cry and he's upset, my milk does not do anything and I’m just like “Ugh, he's crying again”. You know it's very different. And that was the red flag for me to go talk to my doctor and see because something was chemically different, because it's the oxytocin that triggers your milk to let down.
Even now when I’m home with Gabriella, when I think about her, or I’m out dealing with my day and I ‘m just hanging out and think of her, my milk lets down. I kind of leverage my relationship and that elation that I had with her to trigger my milk and to trigger that hormone while I’m looking at Emerson. I'm very, very conscious and very proactive about creating that bond there so he has no idea what his mom went through when he's older.
JENNIFER KELLY: That's interesting because I can almost exactly relate to that experience but the opposite. Everyone of my kids when they were born, I was so excited and so ecstatic but I was not in love with them. I didn’t have that instant “Oh my gosh. I'm so in love with my child”.
I remember feeling a bit guilty when my daughter was born. What's wrong with me? I finally mentioned it to one or two friends and they say, “No, no, no. It's okay. It comes. Give it a chance”. I think when my son was born, I knew what was coming. I knew I would fall in love with him so I kind of casted to that and hang on to that feeling and it did happen faster with him.
It is interesting because with my daughter I was actually just in the process of going through a divorce when she was born. There was a lot happening there so I was prepared to be unhappy or had to work really hard through it and those kinds of things. Thanks to my mother, who was a really huge support system?
With my son, I was happily married; I had this great guy that I’ve known forever. We've been married for three years at that point. Again I had my mother. I know it will come and just tried to be a little patient with myself and it did come. So it does come. Just give yourself time. But at some point, I look at it and, wait, everything's great. Why am I still so unhappy? And that's when I reached out and said okay, something's wrong.
GRETCHEN MALLIOS: I love what you all are sharing because this absolutely captures what we see from the emotional health side when we're working with families. I'm so excited for your listeners to hear that there's such a range of responses. The biggest thing is listening to yourself and having safe, loving people that you can safely talk to, to share what you're experiencing. To sound it out until you determine what you need to be well.
Can someone say, can a friend say “it's okay that you're not in love right away? The relationship takes time to develop. We're social beings. But some of us cue off right away and some of us take time. And that's really healthy. That's really typical and that’s not a sign of your value as a mother or your love for your child. You're just going through a process”.
I also love the description of all the different life events that people are describing that they went through. We have loss. We have marital loss. We have transition. We have a doubt about whether or not our spouse will be able to be there at their birth. These are such significant things. They distract us away from the process of mothering and birthing. So to have a response is really normal.
That's where support systems like really loving and non-judgmental support systems. If you don’t happen to have that around you, well then leverage professionals. Get creative. Get to support groups where you are going to encounter caring, non-judgmental people so you can walk this path and get back to yourself.
I really appreciate what people are sharing. And what they're sharing is that sometimes it goes outside of the typical baby blues experience. Sometimes, it's something a little more significant.
KRISTEN STRATTON: What should we look for specifically as the symptoms of baby blues?
GRETCHEN MALLIOS: I love you're asking that. When I was asked what baby blues are, it’s a phrase we use. What exactly does it mean? I'm trained more in the mind-body training field and I think about emotions as energy. When I think about baby blues and how it aligns with what it's typically described, it is the process your body goes through as it courses through all of this physical and psychological adjustment.
You are growing a being and preparing a being to survive in the world. Then you’re bringing that being into the world through the birth process and then you’re adjusting to that relationship, and then the responsibility of keeping that being healthy, alive, and safe right? That is a whole slew of experiences. If you imagine a small pool of water, whether it's an ocean, a lake or a bucket, every one of those transactions creates a current of energy. Baby blues, the way I think of it is sort of--it's your emotional body moving around and sort of course-correcting from all this sudden activity. And then eventually within two weeks, it should stabilize and be fairly steady.
You should be fairly steady and easy in your emotional flow. Baby blues feels like kind of a sudden upset, tearfulness, some confusion. A little bit of emotionally disoriented, like, what am I feeling? What am I doing? Maybe some confusion about what was I just working on? It's sort of a mental and emotional confusion but it should be relatively functional, it should be fleeting and you should not feel deep despair or distress about yourself, your family or your newborn. When it gets to a deeper sense of despair or distress, we're really talking about something stronger. We're really talking about having that wisdom: I think I need to talk to someone because I think my body is not course correcting well enough, fast enough. Something's not right.
KRISTEN STRATTON: What are some ways that a partner or a family could support a mom during the baby blues?
GRETCHEN MALLIOS: What I like to think of is one, we should listen. So when a mom says: I don’t know, I don’t feel right, I feel like I'm going crazy, I can’t stop crying; I don’t want to hear: Oh you're fine, go sleep, have you taken a bath today? Are you drinking coffee right now? I don’t want to hear that. I want to hear: Really? Oh, how's it going? How long has that been going on for? How strong is that? I want the mom to be listened to. I want her to hear and sense that she can keep talking, that you don’t need to interrupt. And then after some time if she starts to sort of makes sense of it, and finds solutions like “you know I realized this is how I felt with my first. You know my friends all told me I'd feel this way”. And she starts to live. “I think I’m okay. I feel better. Thanks for listening”. Then that’s the normal course-correction.
Or she continues and she's getting a little distraught and she's not able to figure a way through, then what I want a family member or a support member or a partner to say is “do you think you're okay? Are you concerned about this? Are you concerned about how you're feeling? Do you want me to do something? Do you think we should go talk to someone?” That would be okay right? So I want someone to listen first and then ask for partnership and helping them get support. But if she's really distressed, one of the things is for more significant depression or anxiety. The ironic thing about it is the person who's suffering can't see it. If a person really doesn’t look like themselves, if a mom really doesn’t look and sounds like herself, I want their partner to say: trust me, we're going to talk to someone. And she may resist, “I don’t want to”. “It’s okay. I want us to. I need us too so I can know how to navigate this because this is a little confusing for me”. If it gets more severe, I want someone looking out for her and thinking for her.
KRISTEN STRATTON: Our panelists, did you feel like your baby blues experience for the first couple weeks reflected some of what Gretchen said or did you feel like you had something different going on?
BRITTANY CIUFERRI: I think both happened with me. I definitely think there were some baby blues but then I didn’t recognize it. So it had a chance to progress and it just kept getting worse and worse and my husband did deploy. I was alone. I don’t have family nearby. Kristen was actually the one who caught it. She said, “What’s going on?” “I’m tired. I just can't get past this." She said, “Maybe there's something more that we should look at.
GRETCHEN MALLIOS: I think something that’s really important to recognize is that we moms are warriors. We take care of our babies no matter what. Someone thinking about I can't be depressed. I'm getting up, I'm taking care of my baby every day. I'm fine. But if you look at it: I’m tired, I’m not feeling well, I’m not having that energy but I’m getting through it. That's usually a pretty good sign.
SHANNON BULZONE: I had the same experience that you described. It was really pivotal to have the support person. My husband was the first one to say “you don’t seem like yourself” or “what’s going on? How are you feeling?” with Gabriella, I was able to talk through it. With Emerson, this time around, I was like “no, I'm fine. I’m okay. Nothing’s wrong”. My husband had been at me two weeks before I actually went to the doctor, to go to the doctor and reach out for a therapist and for some additional assistance. When I went, it had gotten past what it probably should have if I hadn't listened to him. But I was convinced that I was okay and it was just going to resolve itself and I was grieving for my grandmother, grieving for her. So I expected to feel kind of down and low but not to extent that I was.
JENNIFER KELLY: I actually like your description. I remember with my surro-baby that I had. For me it was an easy recovery and very little baby blues and nothing offset. But his parents actually described very similar to what you're saying. Everyone's looking at me saying “you know we kind of "what have we got ourselves into?” It was. It was first 10-12 days of adjustment of okay, wait. How does this work and how do you take care of this human being and how is my life to change and what have I gotten myself into?
It only took about 10-12 days for them to find a routine and to find a rhythm and to start feeling: oh that’s right. This is great. I wanted to do this. This is an amazing human being and I’m happy and kind of go past it. It's interesting to watch everyone close to me go through the baby blues and see adjust really well. So that by 2 weeks, a little over 2 weeks, they were ready to go and life was grand.
GRETCHEN MALLIOS: That's the adjustment period right? Any change is adjustment and the question is how tapped are we? Are we not so tapped that we can’t course-correct? Or are we so strained and tapped by other life experiences that the adjustment is hard to recalibrate to. That’s the adjustment.
KRISTEN STRATTON: When we come back, we will continue our discussion about the baby blues. We’ll be right back.
KRISTEN STRATTON: Welcome back to the show. We are talking with Gretchen Mallios about the baby blues. Gretchen, does having the baby blues automatically mean the mom is going to develop a long term postpartum mood disorder?
GRETCHEN MALLIOS: No, no. Not at all. The baby blues like I said, it is this sort of fleeting recalibration of the body’s energy, emotional and psychological system. It should remit within a couple of weeks. If you’re at a month or two months and you say to a family member or your doctor, “I’m feeling upset, I’m feeling emotional, I don’t feel like myself, I’m feeling tired” and they say that’s normal. That’s the baby blues. We’re really actually outside that baby blues window. Now we’re talking about maybe having a little more of a challenge adjusting. So no, it is not equivalent to developing a mood disorder. It should be a short fleeting experience.
KRISTEN STRATTON: At what point in a mom’s postpartum recovery would you be suspicious of another postpartum mood disorder?
GRETCHEN MALLIOS: I’m watching from day one actually. We have stories of women developing it, not feeling themselves before they’d even given birth. We have stories of women really doing great for the first year, two years and then suddenly, they kind of slowly slip into stress. So I’m really watching throughout to see that she’s course-correcting with the changes and the adjustments and that she is seeming like herself and she's finding solutions when things feel hard. And if she can’t find solutions and she’s not feeling like herself or she’s feeling disoriented and confused and it doesn’t course-correct, then I’m concerned that her body is moving into a different state.
KRISTEN STRATTON: That’s really interesting that you said that because I had postpartum depression within 24 hours of having my kids. I was lashing out at my husband in the hospital. My third, I had a really traumatic birth and I actually told a nurse that was not very nice to me that if she came back to my room, I told her I was going to punch her. Seriously. But no one said to me “that’s not normal”.
GRETCHEN MALLIOS: That’s not you. That’s not who you are.
BRITTANY CIUFERRI: They were probably thinking that because your birth was so traumatic, you were at a heightened emotional state.
KRISTEN STRATTON: But I feel like even at that point in the hospital, medical professionals should be screening for that and not just assuming that that was - oh, she’s just having baby blues.
GRETCHEN MALLIOS: And the keyword there is medical. They are medical professionals. They’re not mental health professionals. I do a lot of training and taught for providers that are trained at different levels and in different backgrounds. One of the things that I often share with them is when you have a mom who’s behaving in a way that you want to label—she’s a f-, what a -. If you’re labeling that behavior and that behavior isn’t consistent with her core personality that is a symptom. That’s not her character. That’s not something to judge. That’s a symptom.
KRISTEN STRATTON: Because I was really nice my whole labor. Even 21 hours after, I was still saying “please” and “thank you”. So yes, you’re right. They’re not mental health professionals. They’re medical professionals.
What are some of the warning signs the mother’s partner or family should be on the lookout for?
GRETCHEN MALLIOS: What she’s talking about, the way she’s thinking about herself or her baby. If I’m hearing sounds of despair like she’s not so sure of herself, a little bit of self-doubt, like, I don’t know what I’m doing, is normal. Persistent “I don’t know what I'm doing. I'm not sure how to handle this”. If it’s persistent, now I'm thinking that’s how she’s viewing the world. That’s her perception. Perception—negative perception for some time is really a sign that there’s a depression cloud covering her mind and that's influencing how she sees herself, her baby and her mothering, or her family. That is my concern.
KRISTEN STRATTON: So it's difficult to be objective. When should a mom seek an evaluation?
GRETCHEN MALLIOS: Again, if it’s mild, she’s going to start noticing “I don’t feel like myself”. I think if she’s wondering “I don’t feel like myself and I'm not feeling as positive about things as I expected myself to be. I would want to start talking to a friend or a professional”. Postpartum Support International and Postpartum Health Alliance both have warm lines that you can call and talk to a volunteer who’s trained and experienced to say “hey, I was referred to you. I just want to tell you how I’m feeling and check does this seem like anything’s going on?” And they conduct a screening and help them know if you’re within a healthy range or they're starting to slip into a concerning range. And then beyond that when it‘s sort of like Shannon said when Emerson was born. “I didn’t feel great but I told my husband, "no. I’m fine I’m fine." There’s this irony. A vicious irony and I think the depression is almost an autoimmune disorder. It works against you. Depression clouded Shannon from saying “yes, you’re right. I should listen to you. I should go see someone now”. It made her say, no, I’m fine. Because that’s the depression saying leave me alone. I don’t feel good. I want to be left alone. At some point it’s no longer up to her to seek help. It’s about her support system seeking help for her. Sort of like you would be able to say, “Hey, I’m worried. I’m concerned. Something might be happening here”.
KRISTEN STRATTON: Thank you so much Gretchen and our lovely panelists for chatting with us today about the baby blues for our series on postpartum mood disorders. For our Newbies club members, our conversation will continue after the end of the show as Gretchen will provide more information about the Postpartum Health Alliance and the services they offer. For more information about the Newbies club, please visit our website at www.newmommymedia.com.
SUNNY GAULT: Alright. Okay guys. It’s time for fun segment on Newbies we’d like to call Baby Oops and it’s where you guys share your funny stories of what you’ve done with your babies, the funny things that happen with your babies during their first year. This one comes from Stacey from Texas. And Stacey says: “When we left the hospital, we were both so nervous. It’s not like they give you a handbook or anything. We certainly didn’t feel qualified to be responsible for this precious little life. My husband pulled the car up to the hospital. The nurse inspected our car seat. I was carefully put into the front seat. Seatbelts check. We are ready to go be the best parents ever. My husband starts the car and reverses it right into the car behind us. Thankfully, no damage. We start off again. This time we make it onto the highway. And I start getting annoyed at how fast people drive. I mean we are bringing our perfect new baby into such an awful dangerous world right? My husband agrees and we can’t believe the speeders. And that’s when I noticed he was only doing 35mph.”
Yes everyone else. It’s crazy out there right? So thanks so much for sending this in. We’d love to hear your stories, of things that happened between you and your baby during this first year. If you’re thinking of a story like “Oh everyone will really appreciate this story”. We would love to hear it. There’s couple ways you could submit. You can go to our website, click on the contact link. Just type out an email to us and tell us your story. Or my favorite way is for you guys call our voicemail and tell the story yourself. You can call 619-8664775. Leave a message and we’ll include your story in an upcoming episode.
KRISTEN STRATTON: That wraps up our show for today. We appreciate you listening to Newbies.
Don’t forget to check out our sister show:
• Preggie Pals for expecting parents
• Parent Savers for moms and dads with infants and toddlers
• The Boob Group for moms who breastfeed and
• Twin Talks for parents with multiples.
Thanks for listening to Newbies. Your go to source for new moms and new babies.
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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