Is it baby blues or postpartum depression? How to tell the difference

Becoming a mother can be a vulnerable time. It’s even been described in literature and research as a time of crisis.

So much changes—our identity may be confused, our body undergoes a huge transformation, family dynamics shift, sleep is interrupted—and yet we’re left with little support and false promises that “this will be the best time of your life.”

So what happens when it’s not?

Shame arises. It fills our brain with ideas of who we are as people. I imagine this is why so many women go undiagnosed and untreated when they truly need a village of supporters. It can also be hard to distinguish what’s normal and what’s not.

New motherhood is full of emotions. We’ve all heard the well-intentioned explanations by those in a new mom’s life: “It’s just the baby blues!” and “Your hormones are all over the place right now.”

But when do these comments become harmful? When do these comments actually stop a mother from further exploring her emotional pain because she’s chalking it up to hormones?

Let’s take a look at postpartum mental health. Mama, you are not alone.

What are the baby blues?

The baby blues are a common experience. In fact, 50-80% of new mothers will experience the baby blues. Women with the baby blues may experience the following symptoms:

• Crying
• Feeling overwhelmed
• Acute sleep deprivation and fatigue
• Being emotionally reactive
• Mood swings

Despite these symptoms, the mother’s general mood tends to be happy, and her symptoms mild.

Baby blues is not a psychiatric condition. It’s postulated to be due to hormonal withdrawal after delivery. It’s time-limited, in that it presents a few days after delivery and lasts no longer than 2-3 weeks postpartum. It resolves spontaneously in most cases.

What is a postpartum mood disorder?

What does this mean for the mothers who continue to struggle beyond the point of a few weeks? Well, it could mean that something else is going on, and it’s worth investigating. It’s estimated that only 40% of all cases of perinatal depression are detected, and 60% of those detected cases get treatment.

It’s important to know what to look for. Women experiencing postpartum depression often report:

• Sadness
• Increased tearfulness
• Feeling overwhelmed
• Loss of interest
• Poor concentration
• Changes in appetite and sleep
• Unexplained physical ailments
• Having a hard time caring for oneself (or baby)
• Guilt
• Shame
• Suicidal thoughts*
• Feelings of “this doesn’t feel like me,”
• Irritability and anger

*If you are having thoughts of harming yourself or someone else, call 911 or go to the emergency room right away.

Not every symptom needs to be present. Some women experience more of an irritable depression where the simplest things may trigger anger and agitation.

What are the differences between the baby blues and postpartum depression?

Severity, timing and duration.

The baby blues are mild, occurs within days of delivery, and last no more than a few weeks.

Postpartum depression can be increasingly severe, can present at any time during pregnancy and throughout the first year postpartum, and may persist for a longer duration, especially if left untreated.

Depression doesn’t necessarily present alone. In many cases, women report comorbid anxiety symptoms. A mother experiencing anxiety may feel like she is on high alert at all times. She may develop excessive concern for her own health or the health of her baby. These thoughts can keep her up at night and even result in developing behaviors she believes are protective (i.e., checking on the baby, cleaning excessively, disinfecting, etc.)

What many people do not realize is that postpartum mood and anxiety disorders include:

• Depression
• Anxiety
• Obsessive-compulsive disorder
• Posttraumatic stress disorder
• Bipolar disorders
• Psychosis

It’s during this postpartum period that women may be at greater risk of experiencing a mental health condition than at any other time in their lives. It’s important to be mindful of changes in mood, to discuss changes with those we trust, and to advocate for ourselves.

If this is you—if you are struggling to feel like yourself during pregnancy or postpartum, I assure you that you are not alone. There is help out there, and you can feel better. I encourage you to connect with a provider you trust. This can be your obstetrician, midwife, doula, lactation consultant, primary care physician, or pediatrician.

If you do not feel comfortable with your provider(s) or feel like your attempts to seek help have been dismissed, I encourage you to call Postpartum Support International (PSI) at 1-800-944-4773 or go to postpartum.net. You will find local resources for individual therapy, medication management, support groups (both in-person and online), as well as resources for partners.

You may not feel like yourself right now, but you can feel like yourself again. You mattered before; you matter now; you’ll matter always!