The magical glow of a smiling pregnant woman and the cherubic face of a new baby are images women hold onto dearly when picturing adding a new baby to the family - whether through pregnancy or adoption...and whether it's the first baby or the fifth! 

Unfortunately, the preconceptions described above, that of the "peaceful" and "blissful" mother and child, ring false for many new parents. The unrealistic images of perfection, and the shame and stigma that come when we feel like we are somehow not measuring up, keep us from reaching out for help and support.     

Enter a far more common and realistic picture...that of an exhausted, emotional, and anxious mama trying desperately to get the diaper bag ready while herding two older kids into the car, and somehow arriving to the doctor's appointment on time without collapsing in a puddle of tears in the parking lot. 

The term "baby blues" usually involves tearfulness, irritability, and fatigue.  It affects around 80% of all new moms and resolves within a few weeks postpartum. However, up to 60% of new moms (in Utah alone) report similar, but more severe symptoms that persist far beyond this time period and often begin during pregnancy. 

These mothers are experiencing a real medical illness called Postpartum Depression, or "Perinatal Depression", which includes pregnancy and the first year postpartum or post-adoption. At least 10% of fathers will also experience PPD. 

So what does PPD really look like? Not how you probably think. Most affected moms take very good care of their babies and their other children if they have them, and usually look very "put together" to the outside world. 

The mom with PDD is usually not under the covers, hiding from life, but she is suffering indescribable anxiety or panic.  She experiences constant worry, is tearful, irritable, and feels anger toward herself, her partner or spouse, and sometimes even her children. 

She may also have intrusive images and scary thoughts she can't control.  Mostly, she knows she just doesn't feel like herself. Moreover, because she is "supposed" to feel grateful for her child/children and complete the superwoman fantasy created by our society, she will usually fear she is going crazy and be too ashamed and afraid of disclosing her true experience. 

So what's a mom to do? The good news is that there are a lot of help and resources available. Here are some ideas for staying emotionally healthy during pregnancy and the first months postpartum: 

1. Know your risk.  The bad news is that all pregnant and postpartum women are at risk. PPD does not discriminate. However, lack of social support, fatigue, a history of PPD, family or personal history of anxiety or depression, marital conflict, financial difficulties and general stress all increase the risk of experiencing symptoms of PPD.  Most importantly, women with bi-polar or a family history of bi-polar illness are at special risk for the far less common, but more problematic, postpartum psychosis.  This type of PPD is what is typically seen dramatized on TV - which scares some women into seeking the help they need fearing they are out of touch with reality. Symptoms of postpartum psychosis include a woman seeing, hearing, and believing things others do not. This type of PPD puts both mother and baby at risk and is considered a psychiatric emergency. 


2. Get as much sleep as you can during pregnancy and the first year postpartum. The brain needs a 4-6 hour stretch a night to maintain the neuro-chemicals that regulate mood and cognitive processes. Being a martyr about sleep doesn't do anybody any good because it will eventually catch up with you. As soon as another person can help with a nighttime feeding, enlist this help. If a 4-hour stretch is only realistic during the day, find a neighbor or family member to care for the baby during that period of time, at least a couple days a week. Sleep is truly that important and can make all the difference. 


3. Seek social support. Enlisting a trusted friend, relative, clergy, or counselor, provides the new mom a safe place to disclose her innermost thoughts and feelings on a regular basis - without judgment.  Additionally, it's important to have non baby-related interactions that remind her she is not only a mother but also a woman and human being - and hasn't suddenly transformed into nothing but a human milk-making/diaper-changing machine! 


4. Stay hydrated. I tell women to drink two pitchers of water a day from the fridge.  A dehydrated brain is often an anxious, confused and exhausted brain.


5.  Add protein to every snack and meal. Protein helps regulate blood sugar levels, which can greatly influence mood. 


6. Exercise. Fifteen minutes of walking a day, when physically able, can do wonders.  A walk around the block, in the sunshine, can greatly impact a mom's mood.


7. Add Fish Oils. The Omega-3 fatty acids EPA and DHA have been shown to help prevent and treat anxiety and depression in new moms - including those who are nursing. Ask your healthcare provider about dosages. 1000-3000 combined milligrams of EPA and DHA have been approved safe by the FDA.

Most of all, pregnant and postpartum moms need to cut themselves some slack. A healthy mom makes for a happy family, and pretending all is well when it's not doesn't really help anyone. Many cities offer free phone and email support and actual support groups for new moms through Postpartum Support International, as well as specialized counseling and psychiatric services for moms who are struggling. 


Amy-Rose White, MSW, CSW is a psychotherapist and Director of Maternal Mental Health at The Healing Group in Holladay, UT and is a survivor of PPD following the birth of both of her beautiful sons. In June 2012, The Healing Group launched the Hey Mom! Campaign, designed to raise awareness, offer support and reduce the stigma associated with postpartum depression (PPD) and related disorders. Permission granted for use on DrLaura.com.