As magical as the journey of parenthood is, it often begins with a period of feeling blue. Most new mothers (perhaps as many as 90%) will have periods of weepiness, mood swings, anxiety, unhappiness, and regret. A little further along the sadness spectrum are postpartum blues, which 30-75% of new mothers experience. And, at the furthest end is full-blown postpartum depression, which occurs in as many as one in ten women.

Most women with real postpartum depression are never diagnosed. Even though postpartum depression is very common, and even though identifying it can help both the baby and the mother, most cases slip through the cracks. A 3-question test has been shown to be very reliable at detecting postpartum depression, able to identify accurately 95 percent of the depressed women in a September 2008 study.

What are the 3 questions? They focus on a unique and important part of postpartum depression: excess anxiety. Some anxiety for new parents, of course, goes with the territory. Parenthood is, after all, a new adventure into the unknown. You love a new person so much, it’s normal to feel fear and anxiety. But when anxiety or fear predominate your daily experience with a new baby, it can be a sign of postpartum depression.

3 Questions to Help Identify PPD

Please underline the answer that comes closest to what you have felt IN THE PAST 7 DAYS, not just how you feel today.

1.  I have blamed myself unnecessarily when things went wrong.
    a. Yes, most of the time (3)
    b. Yes, some of the time (2)
    c. Not very often (1)
    d. No, never (0)

2. I have been anxious or worried for no good reason.
    a. No, not at all (0)
    b. Hardly ever (1)
    c. Yes, sometimes (2)
    d. Yes, very often (3)

3. I have felt scared or panicky for no very good reason.
    a. Yes, quite a lot (3)
    b. Yes, sometimes (2)
    c. No, not much (1)
    d. No, not at all (0)

The way I have presented it here, the maximum possible score is 9. Most women with a score of 3 are not depressed, but enough are that they deserve further evaluation to be sure. If a cutoff score of 4 or even higher were used, the results would more likely indicate depression, but some depressed women would be missed. The purpose of a screening test is to find those who would benefit from more evaluation. (Note: This test has only been validated as a screening tool for moms. Depressed dads are also important to identify, but they may have very different symptoms.)

How did you do? If you scored 3 or more, the recommendation is to consult your doctor - even your child’s pediatrician can be of help. In addition, I have several tips below.

4 Tips to Cope With PPD

Depressed mothers deserve treatment, both for their babies’ sakes, and so that the mothers do not miss out on enjoying one of life’s unrepeatable joys — the all-too-brief babyhood of each child. While you may not be able to follow all of these tips every day, do your best to take care of yourself. The better you take care of yourself, the better equipped you’ll be to care for your child.

1. Enlist support. PPD is a serious condition and admitting you have it and need help, does not mean you’re weak or a bad mom. It takes strength and courage to ask for help overcoming this tough time and you can do it. Ask family and friends to help out with as much as they can. Avoid emotional and social isolation. Support groups and professional counseling can help mothers express their feelings and find connection with others.

2. Rest. New mothers need time to rest. Plan to use some of your baby’s nap-times to sit quietly in a well-lit environment. Even an hour of quiet rest with no responsibilities can significantly improve symptoms of depression. The laundry will wait. Dirty dishes aren’t the end of the world. Take this important time to take care of you.

3. Exercise. Exercise is particularly difficult in the postpartum period — both time and energy are often lacking. But exercise has been proven to help specifically with postpartum depression. Cooperation and commitment will be needed from family and friends to guard Mom’s sleep and to free her up for daily aerobic exercise — outside if possible. An hour of aerobic exercise daily can be as powerful as even the strongest antidepressant medications. Even 10 minutes a day can make a noticeable difference.

4. Get ample skin-to-skin contact with your baby. Skin-to-skin contact raises your levels of oxytocin, a “feel-good” hormone, and a recent study showed it could be an effective alternative to medication in alleviating symptoms of PPD. In addition, skin-to-skin contact reduces baby crying by as much as 43% and improves sleep when done for at least 3 hours daily. Less crying and better sleep for baby means less stress and more sleep for mom, too. Both are imperative to coping with PPD.

Follow these tips regardless, but if treating the depression without medicines isn’t satisfactory, I am in favor of using antidepressant medicines.

Whether your situation is the blues or full-blown depression, don’t minimize it. The weeks following a child’s birth are different from any other time in life. They are rich, complex, and often out of control. So take a deep breath. Relax. Pamper yourself. Enjoy the little things. When life seems particularly hard, take comfort in knowing that this time will soon be over. Though life will never be the way it was before, soon things will settle down. In the meantime, remind yourself that this is a once in a lifetime experience that you don’t want to miss.