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PPA vs. PPD: Knowing the Signs and Getting Help

October 1, 2024Dr. Elena Rodriguez, Psychologist

"I should be happy. Why am I not happy?" Postpartum Mood and Anxiety Disorders (PMADs) are the #1 complication of childbirth. They affect 1 in 5 parents. Yet, we rarely talk about them honestly.

The Baby Blues (Normal)

  • What it is: A hormonal crash (estrogen/progesterone drop) combined with sleep deprivation.
  • Timing: Starts days 3-4, peaks day 5, resolves by day 14.
  • Symptoms: Weepiness, irritability, mood swings.
  • Treatment: Sleep, good food, time.

Postpartum Depression (PPD)

If the "blues" last longer than 2 weeks, it might be PPD.

  • The Vibe: A heavy fog. Numbness.
  • Signs:
    • Feeling detached from the baby ("I'm just babysitting").
    • Inability to sleep even when baby sleeps.
    • Loss of appetite.
    • Thoughts of harming yourself or running away.
    • Note: It is not always "sadness." It often manifests as Rage.

Postpartum Anxiety (PPA)

This is actually more common than PPD but less discussed.

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  • The Vibe: buzzing, vibrating skin, inability to sit still.
  • Signs:
    • Intrusive Thoughts: "What if I drop the baby down the stairs?" "What if the car crashes?" These are scary, flash-images.
    • Checking: Checking the baby's breathing 50 times a night.
    • Dread: A constant feeling that something bad is about to happen.

The "Scary Thoughts"

Intrusive thoughts (dropping the baby, stabbing, etc.) are a hallmark of PPA/OCD. Crucial Distinction: Parents with PPA are horrified by these thoughts and do everything to prevent them. They are not psychotic. They are terrified.

How to Get Help

  1. Tell ONE Person: Your partner, your mom, your friend. Just say "I am not okay."
  2. Call the OB/Midwife: You don't need a psychiatrist. Your OB can prescribe safe medication (Zoloft is the gold standard for breastfeeding) immediately.
  3. Therapy: Cognitive Behavioral Therapy (CBT) is incredibly effective for rewiring anxious brains.

You Are Not Broken

You are not a bad parent. You have a medical condition. With treatment, you will feel like yourself again. Do not wait. You deserve to enjoy your life.


Disclaimer: The information focused here is for educational purposes only and not medical advice.