Baby blues or postpartum depression? How to tell the difference

When you have a baby, it’s normal to feel a bit off for a week or two, especially during the early days. Thanks to shifting hormones and sleepless nights, not to mention caring for a brand-new baby while recovering from labor, the first few weeks after you give birth can be a tough time, so remember to take care of yourself as well as the new addition to your family.  

These first weeks after you’ve given birth are called the postpartum period. There’s currently some discussion about how long the postpartum period should be defined. It’s often considered to be the first six to eight weeks after you’ve given birth. However, pregnancy and birth can impact everyone’s bodies differently. This is why the American College of Obstetricians and Gynecologists considers the postpartum period to extend up to 12 weeks after birth. You might have heard this time referred to as the fourth trimester.

If you feel anxious, weepy, sad, or irritable a few days after giving birth, this is normal. So normal in fact, that experts have coined the phrase “baby blues” to refer to the mood dip most new moms experience at this time. However, if you feel consistently low for more than two weeks after your baby is born, and you struggle to eat, sleep, or generally cope with your new responsibilities as a parent, this could be postpartum depression (PPD). 

If this sounds familiar, be kind to yourself. Adjusting to your new role as a mom can take time, and many parents feel the same. That said, postpartum depression is a serious mood disorder that is unlikely to resolve by itself, so if your symptoms persist, it’s important that you reach out to your doctor. Support is available, and there are lots of small steps you can take to feel better, so don’t be afraid to ask for help. 

Here psychologist Kelly Vincent, PsyD, Nourished Wellness Group, California, US, explains the difference between the baby blues and postpartum depression and shares expert tips on how to recover from both.

Key takeaways

• Up to 85% of new moms struggle with the baby blues after giving birth, but it’s usually short lived.
• The baby blues are not the same as postpartum depression, although symptoms do overlap.
• Postpartum depression is a more serious mood disorder that affects 1 in 7 new parents.
• Baby blues symptoms usually ease within the first two weeks, while postpartum depression can last up to a year if you don’t get treatment. Reach out to your doctor if you’ve been feeling sad, anxious, or hopeless for longer than two weeks since you gave birth.
• With the right support and treatment, most people make a full recovery.
• If you have thoughts about harming yourself or your baby, call 911 or your local emergency assistance number right away. You are not alone, and help is available.

What are baby blues?

If you’ve been ambushed by a wave of mixed emotions a few days after giving birth, try not to worry. As many as 50% of new moms experience the baby blues at this time. “Baby blues, also known as postpartum blues, are often feelings of sadness, worry, or fatigue that many women experience after giving birth,” says Vincent. “These feelings typically begin a few days after childbirth and can last for a few days to a couple of weeks.” 

If you were expecting to feel deliriously happy and instead feel flat or tearful, try not to be hard on yourself. You might just need a bit of time to adjust to your new life. “The experience of baby blues is considered a very normal and common response to the hormonal changes, physical discomforts, and emotional adjustments that occur after childbirth,” explains Vincent. “Bringing a child into the world is often a big life transition, so of course there will be emotions tied to the experience that might feel heavier and overwhelming.” 

What causes baby blues? 

During pregnancy, your estrogen and progesterone levels increase to support your growing baby and then drop immediately after you give birth. This dramatic drop in hormones could be responsible for your unexpected mood dip, but the baby blues can have a handful of contributing factors, says Vincent: 

• Hormonal fluctuations
• Physical exhaustion from childbirth
• Lack of sleep
• Stress, lack of support, marriage/relationship issues, or not having a partner to support you 
• Physical pain or discomfort from childbirth
• Predisposition to anxiety or depression
• Adjusting to the new role of motherhood

How long do baby blues last? 

The baby blues are usually short lived, while postpartum depression can take longer to recover from and doesn’t always start immediately after birth. According to Vincent, the common rule is that the baby blues last up to two weeks. If you have sad feelings that last longer than this, reach out to your health care provider. “After two weeks, an assessment for postpartum depression or anxiety is recommended,” she says. 

What to do if you’ve got the blues after giving birth

If you’ve been hit by the blues when you were expecting to feel happy, it can be confusing, but try not to worry. Most new moms just need a bit of time for these feelings to pass. Having a baby is a huge life change, and it’s important that you look after yourself during this transition. 

“Oftentimes, baby blues are treated by validating the individual’s experience and acknowledging and normalizing how common the experience is for new moms or moms in general,” says Vincent. “It is a big transition on so many levels, so mood shifts and fluctuations are to be expected.”

Try the following lifestyle tips to lift your mood:

• Get enough sleep (when possible). Try to sleep when your baby sleeps and rest as much as possible.
• Eat a healthy, balanced diet. Nutritious food will make you feel better and help you recover from birth.
• Stay physically active. If you can, go for a walk or sit outside. Gentle exercise and fresh air may help reduce stress and combat postpartum depression.
• Phone a friend. “Have a safe person to talk through your feelings and experiences as a mom,” says Vincent.
• Ask for help. Recruit your partner, family, and friends to help out at home or hold the baby while you rest.

What’s the difference between baby blues and postpartum depression?

The main difference between the baby blues and postpartum depression is the timeline and severity of your symptoms. “Essentially, postpartum depression is a more severe and persistent form of mood disorder that often requires professional support,” says Vincent. “Unlike PPD, baby blues usually resolve on their own without treatment and do not significantly impair a woman’s ability to function or care for her baby.”

However, postpartum depression can occur at any time during the first year. And left unchecked, it can impact your ability to care for yourself and your baby. It’s also worth noting that PPD symptoms can get worse over time if you don’t get treatment, so call your doctor if you are concerned.

Causes of postpartum depression

It’s not always clear why some new moms struggle during the postpartum period, but a number of factors can increase your chances of experiencing depression at this time. 

“Research has shown that postpartum depression can be caused by a combination of physical, emotional, and lifestyle factors, including hormonal changes after childbirth, lack of sleep, changes in routine, and the stress of caring for a newborn,” says Vincent. 

“Also, mothers who have a predisposition or a history of depression are at a higher risk of developing postpartum depression,” she adds. “At the end of the day, transitioning into parenthood can be very challenging and overwhelming, and it can be very normal to experience these shifts in mood.”

Symptoms of postpartum depression

If you’ve had depression before, then you might notice similar symptoms. However, “Postpartum depression can be thought of as a specific type of depression related to a specific situation/life experience,” says Vincent. 

She explains that common symptoms of postpartum depression include:

• Low moods: Persistent sadness or mood swings
• Feeling tearful: Crying spells for no apparent reason
• Anxiety: Feeling unhappy or guilty
• Struggling with attachment: Difficulty bonding with the baby
• Loss of appetite: Changes in your appetite or eating habits
• Insomnia: An inability to sleep 
• Feeling bad-tempered: Irritability or anger
• Brain fog: Difficulty concentrating or making decisions
• Suicidal ideation: Thoughts of harming yourself or the baby. If this happens, then it’s considered a mental health emergency. Go to the emergency room right away. Doctors there will be able to provide help, support, and a treatment plan.

Rarely, a form of mental illness called postpartum psychosis can also develop after childbirth. If your moods become erratic or extreme, or you see or hear things that don’t exist outside of your mind, then get medical help immediately.

All of these symptoms can feel scary and isolating, but please know that you’re not alone. Your health care provider is trained to help you. They may recommend that you speak to a mental health specialist to decide on the best next move for you. With the right support and treatment, you can start to feel like yourself again and enjoy this time with your baby.

Can you prevent postpartum depression?

It’s important to remember that postpartum depression isn’t caused by something you did or didn’t do during pregnancy or after your baby was born. Mental health issues can affect any new mom. “It is hard to fully prevent yourself from experiencing postpartum depression, as you don’t know exactly how your body, mind, and mood will respond,” says Vincent. 

“However, I think there are many, many protective factors you can put into place to prepare if that is something you are concerned or worried about,” she explains. “Even if you are not worried about PPD, it is important to be aware of it so that if you do experience it, you have an idea of how to support yourself.”

There are a few things you can do to reduce your risk of postpartum depression:

• Prepare for parenthood. A support system is essential for mental well-being, so reach out to friends and family and ask for support before your baby arrives. Reading parenting books, taking a prenatal class, and chatting to like-minded friends can also help you feel better prepared.
• Talk to your doctor. Your mental health is an important part of pre- and postnatal care, so let your doctor know if you have a history of mental health problems that may increase your risk of postpartum depression. “It can be super helpful to work with a maternal mental health therapist prior to giving birth to talk through concerns, develop a postpartum plan, and enhance your coping skills,” says Vincent. 
• Find your people. If you’re the first new mom in your friend group, or you don’t have close-knit family nearby, finding a local support group is a great way to meet other moms going through the same thing as you. Pregnancy yoga, prenatal classes, or coffee mornings are all great ways to meet like-minded moms.  
• Practice self-care. From yoga and meditation to finding new walking routes near your home, eating a varied and balanced diet, and attending exercise classes with friends, self-care comes in many forms and plays an essential role in maintaining your mental health. Even small acts of self-care can have a big impact, so figure out what makes you feel happy and make time for yourself where you can.
• Get help if you need it. If you do develop postpartum depression symptoms or you’re worried you might be at risk of developing symptoms, reach out for help as soon as possible. Your mental health is important, and depression can intensify over time if you don’t get treatment.

When to go to a doctor

Baby blues usually subside after about two weeks, while postpartum depression can get worse over time. “​​If the baby blues persist for more than two weeks, or if it begins to impair your ability to function, seek support,” says Vincent. 

“I think you should seek support for PPD as soon as you become aware of it,” she adds. “As soon as we acknowledge it, address it, and work to build a supportive treatment plan, we can work to relieve some of the symptoms.” 

Your doctor may recommend you to a mental health specialist who can talk you through your best next step. The most effective treatment for postpartum depression involves a combination of medication, therapy, and self-help techniques. Everyone responds differently to treatment combinations, so you will need to discuss your options with your doctor. With the right support, most people make a full recovery.

Some treatment options include:

Antidepressants 

Your doctor may talk you through the different kinds of antidepressants you may be able to take. Selective serotonin reuptake inhibitors are just one kind. If you’ve decided to breastfeed, this could be a good option for you, as many types of antidepressants are compatible with breastfeeding. Talk to your doctor about the risks and benefits of different options. 

Psychotherapy

Your doctor will likely refer you to a mental health professional who has experience treating new moms. Postpartum depression is often treated with cognitive behavioral therapy, a talking therapy that can help you manage your problems by changing the way you think and behave. Your doctor may also suggest solo or group counseling sessions along with mindfulness practices. 

Self-help

Finding ways to take care of yourself, such as sharing your feelings with family and friends, getting enough sleep, exercising regularly, eating a healthy diet, and taking time to enjoy your hobbies, can all make a huge difference to your mental health.

In case you’ve been affected by anything in this piece or are struggling with your mental health and would like to speak to someone, Flo has gathered links to support services that might be helpful. Please visit this page for helplines in different countries.