Postpartum Depression vs Baby Blues

Becoming pregnant, giving birth and raising a baby can be an immensely rewarding experience, but it can also be a stressful one for both your body and mind.

During pregnancy and shortly after giving birth, it’s common to experience negative changes in your moods, including feelings of unhappiness and anxiety. It’s also common to feel exhausted, both physically and mentally.

When these feelings occur shortly after you give birth, they’re generally referred to as the “baby blues.” For most new mothers, these feelings eventually disappear. However, for some women, feelings of sadness and anxiety can persist for a long time after pregnancy and childbirth.

When baby blues don’t get better or are intense, they’re referred to as postpartum depression, a recognized medical illness. Postpartum depression can often involve serious symptoms and requires treatment to ensure that you and your baby remain healthy and safe.

Below, we’ve explained the key differences between postpartum depression and the baby blues that many women develop after pregnancy.

We’ve also explained what you can do to treat both conditions, from changes to your habits and lifestyle to psychotherapy and medication.

The “baby blues” is a term that’s used to refer to the mild changes in mood that many women go through after childbirth. These mood changes usually occur in the first two weeks after having a baby and can involve feelings of worry, anxiety, unhappiness and exhaustion.

Caring for a newborn baby can be an exhausting, overwhelming experience, and it’s common to go through the baby blues as a new mother. According to the American Pregnancy Association, 70 percent to 80 percent of all new mothers experience negative changes in mood after giving birth.

Symptoms of the Baby Blues

The postpartum blues that many women experience after giving birth usually involve a range of symptoms. Common symptoms of baby blues include:

• A low or sad mood

• Irritability

• Anxiety

• Crying

• Lack of sleep

• Sudden mood swings

• Decreased concentration

• Other mild symptoms of depression

Most of the time, these symptoms develop two to three days after delivery and peak during the week after childbirth. The baby blues generally aren’t very long-lasting — for most women, they gradually go away on their own within approximately two weeks.

What Causes the Baby Blues?

A variety of factors can all play a role in the development of the baby blues. One of these is the stress and difficulty of adjusting to motherhood. Babies require constant care, and the physical and mental effort involved in providing this may take a toll on your wellbeing.

Some research suggests that certain biological factors may be involved in the baby blues. For example, experts have suggested that abrupt changes in hormone levels, including your levels of estradiol, progesterone and prolactin after pregnancy, may affect your moods.

Changes in levels of some neurotransmitters and enzymes, such as serotonin and monoamine oxidase, may also be involved in the baby blues.

Some genetic factors may also be involved. For example, women with a history of the following mood issues may be more likely to develop the blues after childbirth:

• High levels of depressive symptoms during pregnancy

• A history of depression involving one or more previous cases

• Previous cases of premenstrual syndrome (PMS) depression or other changes in mood that occur as a result of your menstrual cycle

Finally, a range of additional factors may affect your risk of experiencing the blues after having a baby. These include your economic status, your ethnicity, whether your pregnancy was planned or unplanned, your previous pregnancy history and the method of delivery.

Although the baby blues usually clear up on their own, it’s best to follow up with your healthcare provider if you feel sad or experience any other symptoms after giving birth.

This is because the baby blues can potentially develop into postpartum depression — a far more serious mood disorder that may affect both your health and the health of your child.

Postpartum depression is a form of perinatal depression — a mood disorder that can develop in women during pregnancy and after childbirth. More specifically, postpartum depression tends to develop in the days, weeks and months after giving birth. 

Unlike the baby blues, which are usually mild and short-lasting, postpartum depression is a far more serious type of mood disorder that can involve severe depressive symptoms that don’t go away without treatment.

If your baby blues don’t seem to improve on their own after two weeks, you may be affected by postpartum depression. According to data from the CDC, 11.5 percent of women are affected by postpartum depression during pregnancy or after giving birth.

Symptoms of Postpartum Depression

Postpartum depression can affect both your mental health and your physical wellbeing. It may involve persistent, severe symptoms that get in the way of caring for your child or maintaining an enjoyable life. 

Common postpartum depression symptoms include:

• Feelings of sadness, hopelessness or that you’re overwhelmed

• Loss of interest in hobbies, activities and other things you used to enjoy

• Losing interest in your baby, or feeling like it’s another person’s child

• Not feeling emotionally or physically connected to your baby

• Feeling as if you’re a bad mother, guilty or a worthless person

• Difficulty falling asleep, sleep disturbances or sleeping too much

• Withdrawing from your friends, family and/or partner

• Thoughts that involve harming yourself and/or your baby

• Crying often or excessively

• Feeling very little energy or motivation

• Difficulty focusing on tasks or remembering information

• Finding it difficult to make decisions

• Changes in your appetite, eating habits and body weight

• Pains, aches and other physical symptoms without a clear cause

It’s normal to experience some of these symptoms shortly after giving birth, such as low energy or difficulty falling asleep. These are common, normal aspects of becoming a mother that stem from the immense amount of work involved in caring for a child.

However, when these symptoms are intense, worrying for your safety or the safety of your baby, or when they last for two weeks or longer, it’s important to take them seriously as potential signs that you may have postpartum depression.

What Causes Postpartum Depression?

Like the baby blues, a variety of factors can play a role in the development of depression after giving birth. 

Experts believe that changes in your levels of certain reproductive hormones after delivery are involved in postpartum depression. When you’re pregnant, your levels of sex hormones such as estrogen and progesterone increase to their highest levels.

It’s normal to experience a rapid drop in hormones after delivery. In fact, within 24 hours of the time you give birth, your levels of estrogen and progesterone will typically return to their levels prior to pregnancy.

Other hormones, including those produced by your thyroid gland, can also change rapidly after you give birth. Low thyroid hormone levels may contribute to symptoms of depression.

In addition to hormonal changes, changes in your life after giving birth and while caring for your child can have a real impact on your self-esteem and mental wellbeing. 

It’s common for new mothers to feel overwhelmed, stressed and doubtful during the first months of their child’s life. Issues that affect your physical health, such as a lack of sleep caused by the needs of your baby, may also affect your mental wellbeing and contribute to depression.

Depression is often triggered by life changes, and becoming a mother can be a major change in your life and self-perception. It’s common for new mothers to develop grief about “losing” their old self, or feel as if they’re less attractive after going through pregnancy and childbirth.

Some beliefs, such as an unrealistic expectation that you need to be a “perfect” mom or a need to balance every aspect of your life, can also cause or contribute to postpartum depression that goes beyond the typical baby blues.

Risk Factors for Postpartum Depression

Certain factors may increase your risk of postpartum depression as a new mother. Risk factors for this type of depressive illness include:

• A personal history of depression or other mental disorders, such as bipolar disorder 

• If you’ve had children before, a personal history of postpartum depression

• Experiencing medical or mental health problems during pregnancy or birth

• A family history of mental illness, such as major depression or bipolar disorder

• Having a child when you’re under 20 years of age

• Getting pregnant without planning to have a child

• Having an alcohol or substance use disorder, or a history of drug abuse

• Having a baby with special needs

• Experiencing money problems 

• Finding it difficult to breastfeed or care for your baby

• Lacking support from your family, friends and/or partner

Postpartum pregnancy is common, and many healthcare providers that specialize in pregnancy and childbirth are familiar with the risk factors associated with it. If your provider thinks you may be at risk for postpartum depression, they may ask you questions about how you feel.

Make sure to give honest, complete answers when you talk with your healthcare provider about how you’re feeling. This process is called a postpartum depression screening, and it’s important for helping your provider to understand if you need any further care and treatment. 

Your provider may give you helpful advice that you can use in your daily life to deal with feelings of depression after childbirth and seek help if or when you need it. 

Experts often think of mood disorders as occurring on a spectrum, from mild and self-limiting to more severe and intense. 

The baby blues are generally viewed as a mild, transient group of symptoms that gradually get better on their own over the course of a few weeks. For many new mothers, treatment doesn’t involve therapy or medication — only support and reassurance that things will be okay.

The best way to deal with the baby blues is to take care of yourself. This means talking to your trusted friends and family members about how you’re feeling, keeping a journal of how you feel, maintaining a balanced diet and getting some fresh air throughout the day.

Balancing your personal needs with the seemingly never-ending work of feeding your newborn baby, dealing with spit-up, changing diapers and other tasks can be very difficult, so try to focus on doing what you can. 

Even a very brief moment of quiet time outside can be helpful for your mental health. If you can, don’t feel afraid to ask a close friend or family member to lend a helping hand when you need it. 

If you have the baby blues and don’t feel like you’re getting better after two weeks, it’s important to talk to your healthcare provider about your symptoms and their severity. 

If your symptoms are severe or persistent, your healthcare provider will evaluate you to check if you meet the diagnostic criteria for postpartum depression.

Postpartum depression is treatable. If your healthcare provider thinks you could be affected by postpartum depression based on your symptoms or screening results, they may refer you to a mental health professional for treatment.

It’s important to take a diagnosis of postpartum depression seriously and act quickly in seeking out treatment. When it’s left untreated, postpartum depression can:

• Make it difficult to tend to both your needs and the needs of your baby.

• Reduce your levels of energy and prevent you from maintaining a stable mood.

• Affect your perception of yourself and your parenting abilities (for example, by causing you to think you’re a bad person or bad parent).

• Increase your risk of self-harm or suicide.

These issues could potentially affect your child’s development, causing problems in areas such as behavior, developing problem-solving skills, learning languages and even certain aspects of physical development and health.

Most of the time, postpartum depression is treated using therapy, medication and changes that you can make to your habits and lifestyle.

Therapy for Postpartum Depression

Postpartum depression often improves with psychotherapy, or talk therapy. This type of therapy involves learning how to identify and make changes to the feelings, thoughts and behaviors that are contributing to your depression symptoms.

Several types of therapy are used to treat postpartum depression, including cognitive-behavioral therapy (CBT) and interpersonal therapy. These forms of therapy are used to treat depression that occurs during pregnancy.

Therapy can offer real benefits, but its positive effects aren’t instant. You may need to take part in several sessions over the course of weeks or months to gain more control over your feelings and reduce the severity of your depression.

Medications

Like other forms of depression, postpartum depression is often treated using medications called antidepressants. These medications work by increasing the levels of certain naturally-occurring chemicals, called neurotransmitters, that control your moods and levels of stress.

There are several types of antidepressants, some of which are safe while breastfeeding. Your healthcare provider will select a medication that’s safe for you to use while you breastfeed your baby. You may be prescribed medication for use on its own or in combination with therapy.

Antidepressants are usually effective at relieving the symptoms of postpartum depression, but they can take several weeks to start working. Make sure to tell your mental health provider if you don’t notice any improvements after using your medication for four weeks or longer. 

In some cases, postpartum depression may be treated using a medication called brexanolone (sold as Zulresso™). This type of medication for depression is administered as an intravenous injection and should only be administered by a trained doctor or nurse in a medical facility. 

If your postpartum depression doesn’t improve with other treatments, your healthcare provider may prescribe a spray called esketamine (Sprayvato®). This medication is not safe for use during pregnancy and should not be taken while breastfeeding.

Brain Stimulation Therapy

In rare cases, such as when postpartum depression doesn’t respond with psychotherapy and medication, a form of treatment called electroconvulsive therapy (ECT) may be used.

This type of therapy involves directly stimulating certain parts of the brain using small electric currents. It’s performed under general anesthesia and may require several sessions over the course of three to four weeks to produce improvements.

Habits and Lifestyle Changes

Many habits that can help to get rid of the baby blues can also lower the severity of postpartum depression. 

Try to talk to your partner about how you feel, get as much sleep as you realistically can, spend quality time with your friends and family members and, if possible, reach out to trusted people to help you with the many stressful aspects of motherhood.

Also, try to avoid making major changes to your life, such as moving house or switching jobs, in the first few months of your child’s life. Instead, it’s better to delay these changes until you feel more comfortable with your life and responsibilities as a parent.

Finally, whenever possible, prioritize your needs. Being selfless can be tiring, and it’s fine to put yourself first sometimes. Our list of self-care tips for women shares tips that you can use to take care of your needs as a mother and stay in control of your mental wellbeing.

Becoming a parent can be an incredibly rewarding experience, but it can also be both physically and mentally overwhelming. 

Many women develop the baby blues after giving birth. You may notice these during the first few days after having your baby, but they should gradually fade away. If you still feel down after two weeks, it’s important to get checked for postpartum depression.

The good news is that postpartum depression is treatable. With the right combination of online therapy, care and/or medication, you’ll be able to overcome your symptoms and enjoy the experience of motherhood. We have an article on postpartum depression resources if you want to check it out.

If you’ve recently had a baby and feel like you need help, don’t feel afraid to reach out. You can get help by talking to your primary care provider or using our telepsychiatry services, which give you the opportunity to talk to a licensed psychiatry provider from the privacy of your home and get depression treatment online.

As part of your telepsychiatry experience, you’ll receive a personalized treatment plan and, if it’s appropriate for your needs, evidence-based medication to help you treat your symptoms. 

Interested in learning more about post-pregnancy mental health? Our free online mental health resources share proven, evidence-based approaches that you can use to deal with issues such as stress, anxiety, depression, sleep problems and more.