PORTSMOUTH — Having a baby is a joyful experience for most moms

PORTSMOUTH — Having a baby is a joyful experience for most moms, but some, despite wanting to love their child, struggle with feelings of inadequacy that can lead to a very real condition called postpartum depression.

About 10 percent of mothers experience what is commonly referred to as “baby blues,” or postpartum depression. The symptoms vary but usually include the mom feeling overwhelmed, sad, unable to cope and, in extreme cases, she may have thoughts of harming herself or her child. Many doubt their ability to be a good parent.

Help is available and the stigma surrounding PPD has been mostly eradicated. It is a medically recognized disorder.

“The most important part is asking for help and many people are not comfortable with that,” said Dr. Jacqueline Baselice, an OB/GYN with Core Physicians. “There is no shame in needing help. Many moms are isolated and, in some cases, just getting help can do the trick.”

Dr. Deborah Mueller, an OB/GYN with Caring Partners, associated with Frisbie Memorial Hospital, said PPD can appear at any time but is usually seen within a year of giving birth.

“It can manifest as the mom feeling sleep deprived and stressed,” Mueller said. “Maybe they are having difficulty handling breast feeding. These are problems for every new mom, but in a case of PPD, the feeling is pervasive, are out of the norm and they take over.”

“PPD is more than just feeling overwhelmed,” Baselice said. “It comes about through a major life change and can impact a person’s ability to function. They are constantly worried that something bad will happen.”

One in five women may be diagnosed with a perinatal mood disorder and that is not always PPD, said Beth Brown, a licensed clinical social worker at Arbor Counseling, associated with Anna Jaques Hospital, who specializes in pregnant women. She is also a certified yoga instructor and teaches yoga to expectant moms.

“There are a variety of anxiety-based conditions both during pregnancy and postpartum,” said Brown. “Many moms and moms-to-be struggle with obsessive compulsive disorders and can have intrusive thoughts that increases their anxiety disorder. They worry obsessively about the safety of the baby, about their feelings of isolation. They can be irritable, crying a lot and not sleeping well. They are worried about weight gain.”

Support groups are a wonderful way to get through new mom anxiety, Brown said. She said it’s great to learn that the feelings you are having are not unique, and that other moms are having the same feelings and experiences.

“Some are struggling to connect with their babies,” Brown said. “Sharing their fears can be enough to alleviate them. I am a huge fan of support groups.”

Not all cases of PPD are severe, and not all require medical intervention. Mueller said there is a universally used tool to help determine if the patients is experiencing PPD, the Edinburgh Postnatal Depression Scale https://psychology-tools.com/epds.

“The scale asks 10 questions, and we give the test to all of our new moms,” Mueller said. “It asks questions on a scale, like asking if the woman has been able to laugh at the things she used to find funny, yes, not so much, etc. Question number 10 asks if the woman has had thoughts of harming herself or her child.”

"Everyone has random thoughts, like imagining bad things happening, but when it becomes a pervasive thought, it might be a problem,” Mueller said. “We need to recognize the risk factors. It can be harder depending on outside factors, like tough social situations, or a sick child.”

Ask for help

“People love to help with babies because babies are cute,” Baselice said. “PPD can happen anywhere within the first year. Often it manifests right away, but sometimes, it’s when all the help goes away and the mom is suddenly left on her own. Sometimes a person can’t ask. I had one mom who seemed to be doing well, burst into tears in my office. She was trying to do it all herself. It can be completely overwhelming.”

Past incidents of depression or an underlying medical diagnosis like bipolar increase the woman’s risk for PPD.

“Past depression issues can be caused by a chemical imbalance and that may still be there,” Baselice said. “Medication and therapy can help the mom get through it. There is absolutely no stigma and it is better for both mom and baby.”

Treatment for PPD is multi-faceted. Mueller said mild cases sometimes only require someone to talk to, someone to help, to validate their feelings. She said seeing other adults regularly is important to avoid feelings of isolation.

“Other cases can be treated using therapy, medication, or a combination of the two,” Mueller said. “We use SSRI medications such as Zoloft or Lexapro with pretty good effects. I tell PPD patients that sometimes they are a better mom if they are medicated, and there is no shame in that.”

In extreme cases, Mueller said there is a need to assess the risk for mother and child.

“Out of every 10 cases, nine are probably not at that level of risk,” Mueller said. "A lot of depressed people have thoughts of harming themselves, but most never take it farther and even say they would never do it. I ask if there is a plan. I ask them to promise if the feelings escalate, that they will go to the emergency room for a crisis evaluation.”

There is a condition called postpartum psychosis, but Mueller said it is rare. She said the mother would be out of touch with reality, could hear voices, and there is a definite danger, but most PPD cases don't reach that level.

“If it does and there is risk of a crisis, I would send the mom to the emergency room,” Baselice said. “They need to be evaluated by a psychiatrist. An OB/GYN is not qualified in a case of postpartum psychosis, not in my opinion. The mom might require in-patient treatment and the hospitals are prepared for that.”

Brown trains people who work with pregnant and postpartum women about the perinatal disorders they might encounter through a coalition called the Pentucket Perinatal Health Coalition. She can be found on Facebook at

The Pentucket Moms Support group (https://www.facebook.com/ pentucketmomssupport/ ?hc_ref=SEARCH).

It is having its first fundraiser at Flatbread in Amesbury, Massachusetts, on May 16. Brown said they are raising money for the Pentucket Perinatal mental health coalition.

“The money will be used to educate moms and local health-care providers about perinatal mood disorders (fliers, cards, trainings),” Brown said. “We are also trying to fund a new MotherWoman support group (focused on supporting new moms) in the Pentucket area (facilitator costs plus day care and food). We want to develop a website to share local resources because all we have now is the Facebook page.”