You’ve spent the past few months anticipating the birth of your baby. Now that you’re home with your little one, adjusting to your new role as a mom can start to wear on you, especially when your hormones are surging and you seem to cry at the drop of a hat.

Most of the time, this is a normal case of the “baby blues,” which will pass as your hormones stabilize and you get the hang of caring for your newborn. For one in five moms, however, that cloud sticks around longer than it should, and this may be a sign of postpartum depression.

“Postpartum depression is depression that occurs within the first one year after delivery,” says Dr. Kathleen Rustici, an obstetrician and gynecologist with Stapleton OB-Gyn. “Some women have family and friends helping them out, which kind of ‘masks’ the depression early on. We’ll routinely make diagnoses six, seven, and eight months out from delivery.”

Bringing home a baby ushers in a new normal for moms. Gone are the days of the “normal” night’s sleep or a “simple” errand. Yet this makes it easy for many women to second-guess themselves and think that the depression they’re experiencing is normal after having a baby.

“It sometimes comes down to someone else in their lives saying, ‘This is not normal,’ that finally gets them to come in and talk with us,” Dr. Rustici says.

Some symptoms of postpartum depression include:

• Not enjoying activities you used to previously enjoy
• Withdrawing from friends and family
• Not being able to take care of yourself
• Eating and sleeping pattern changes

“It can be a little confusing because there is some overlap with normal postpartum stuff, but sadness, feelings of guilt, crying all the time, and increased anxiety can definitely factor in,” says Dr. Rustici. “There are more severe symptoms, like thoughts of hurting yourself or someone else, to watch for.”

Many screening tools are available, but the Edinburgh Postnatal Depression Scale is the one used by the OB-GYN community. “You can actually give it to patients before they have the baby to learn if they’re at high risk for developing postpartum depression,” says Dr. Rustici. “Classically, we’ll screen everyone at their six-week postpartum visit.”

Depending on the severity, there are three different types of treatment.

1. Support groups, exercise, and holistic treatment. Low intervention includes getting women plugged in with support groups or mom groups where they can share similar experiences. Women are also encouraged to exercise and try meditation. “They’re kind of more holistic types of treatment, but they can be really effective for mild cases of postpartum depression.”
2. Talk therapy. “The next more aggressive step is talk therapy, and we have a range of psychologists that we refer patients to,” says Dr. Rustici. “Studies have shown that medication and talk therapy are similar in terms of efficacy. This is reassuring to patients who want to avoid taking medications.
3. Medications. Women who may need medications can take antidepressants, such as Zoloft. “Zoloft has had the most studies done on it and is safe in breastfeeding,” says Dr. Rustici.

Postpartum depression does not mean a woman has major depressive disorder. “If I treat women for postpartum depression, I treat them for about six months and then trial them off whatever treatment they were doing,” says Dr. Rustici. “That’s another thing that is reassuring to these moms, it’s not a diagnosis that they’ll have for life—they’re not depressed people.”

Even though postpartum depression can affect 10 to 20 percent of new moms, many people don’t talk about mental health problems, and women end up feeling alone. “When I have a woman in my office who may have postpartum depression, the very first thing I say to her is, ‘This is not your fault and this does not in any way reflect on you as a mother,’” says Dr. Rustici. “This is something related to hormonal changes postpartum—it’s a transient chemical imbalance that is out of their control—and they did nothing to deserve it. It unfortunately is happening to them, but we’ve got really safe and effective treatments to get them through this difficult time.”

If you’d like to find resources about postpartum depression, Dr. Rustici recommends www.postpartum.net. Women can learn more about depression, join online support groups, and get help.