The postpartum period is a wild ride! Beautiful and exciting, exhausting and confusing. It's everything, all at once.
We put so much energy into planning for birth--when to call your provider, when to go in, the stages of labor--that we almost forget that birth happens but the postpartum is, well, the rest of your life. Anticipate that the first two weeks are going to be intense, with major adjustments in sleep routines (not that you were sleeping great anyways), changes to your body, physical recovery (possibly from surgery), making milk, and caring for a new tiny human.
You are going to need care. Someone to lift the responsibilities of everyday life so that you don't have to tend to them (laundry, food prep, walking the dog, etc). Maybe that's your partner, but keep in mind that they'll likely be exhausted as well, especially if they don't have a ton of time off of work.
When I had my daughter, my policy was that if someone offered to help ("just let me know what I can do!") I wrote down their name--otherwise I would forget in the melee of diapers and lost sleep. I suggest that you have a friend or family member organize a meal train--give them names of people and foods you want prepared for you, and have them set it up.
Make a list of people who can come by and help out, even if it's doing some quick chores or taking your baby for a walk for an hour (maybe not in the first couple of weeks, but later on down the line this becomes your golden hour). Make a list of people you can reach out to if you're feeling like a train wreck, people who can be your lifeline. Think of people who have walked this road and know what it's like, who can reassure you that it's going to get way easier (it will, I promise).
People want to help, but they don't always know how. Hopefully you will have someone in your life who does know exactly what to do--someone who walks straight up to your sink and does your dishes, sets down a hot meal and a cup of tea, fills your water bottle, changes a diaper, cleans your plate and tucks you into bed--but sometimes you need to really spell it out. Make a list of tasks around the house that friends and family can take care of.
And finally, ask for help. We didn't get this far as a species by being super moms. I guarantee that's a relatively recent project. Until recently, we parented in interdependent communities where families supported one another when there was need to. Your community loves you and wants to show you support, so bless them with opportunities to do so!
All traditional cultures have careful foodways around the postpartum, almost universally limiting or eliminating foods that are thought to be "cold" and emphasizing warm, well-cooked and easily digestible foods. These support your digestion (important after a vaginal birth and critical after cesarean birth), promote healing and lactation, and are gentle for your baby's digestion (via breastmilk).
Ugh I'm such a broken record. I'm just going to put these names here again because I think all these people are fabulous. At some point, go get yourself some bodywork. Google massage therapists who can do in-home visits for the first two weeks postpartum (a great gift to ask for from a baby shower!).
There are three types of mood disorders that show up in the postpartum: postpartum depression, postpartum anxiety, and postpartum psychosis. Up to one in five women experience depression and/or anxiety in the postpartum (which means that if you're going through it, you are not alone). One in 1,000 will experience postpartum psychosis, a psychiatric emergency requiring immediate treatment. If you think you're experiencing a postpartum mood disorder, contact me so we can discuss the best ways to support you.
If you think you might be experiencing depression, use the Edinburgh Postpartum Depression scale as a self-screening tool.
What is postpartum depression?
Postpartum depression is a mood disorder that occurs within the first year postpartum, and typically within the second month postpartum.
The symptoms include sadness and hopelessness, shame ("I'm the worst mother ever..." or "why is everyone so much better at this than me?"), irritability, anxiety, crying “for no reason,” oversleeping or difficulty sleeping, difficulty concentrating or remembering details, or making decisions, anger or rage, loss of interest in previously enjoyable activities, physical problems including headaches, stomach problems and muscle pain, eating too little or too much, withdrawing from friends and family, difficulty feeling an emotional attachment to the baby, doubting one’s ability to care for a baby (and feeling like your baby thinks you're a terrible parent), and thinking about harming the baby.
Risk factors for postpartum depression are biological, social, psychological: previous depression and depression in pregnancy, previous trauma, traumatic birth, relationship instability, lack of family and community support, poverty, financial instability and job insecurity, health problems with the baby, a stressful life event during pregnancy, and alcohol or drug abuse. It is compounded by loss of sleep, difficulties with breastfeeding, and other challenges around caring for a new baby. I would add that an additional risk factor is cultural. When there are expectations that we should just "bounce up" and take care of everything--new baby, partner, kids, home, maybe back at work within a few weeks, and so on--or that we should be grateful for just having a healthy baby and forgetting whatever else we might have been through, then these can make it harder to ask for help.
It might not be postpartum depression...
Thyroid hormone imbalances are common in the postpartum, and commonly misdiagnosed as postpartum depression. I recommend doing lab work to check your thyroid, including TSH, thyroid antibodies, free T4 and free T3. It is not enough to only check TSH, so insist that your provider run a full panel.
The "postpartum blues" is a transient period of emotional ups and downs, sensitivity, irritability, and fatigue that occurs with the hormonal transition postpartum, typically between days 2-4, and is finished by the time postpartum depression shows up.