Baby blues or postpartum depression: how do I know?
The birth of a child is a highly anticipated, joyous event for many families. Sometimes, though, new moms struggle with feelings of sadness, detachment, and doubt after they bring their baby home. It can be frightening when these unexpected feeling surface, especially if they are severe. But there is a difference between normal “baby blues” and the more serious condition of postpartum depression.
Baby blues
The postpartum, or “baby,” blues are feelings that usually show up a few days after birth and may last around 1-2 weeks. Moms with the baby blues may cry for no reason, fluctuate between being happy and sad, or may get anxious or upset for no reason. These symptoms tend to fade without any specific treatment, but rest and getting help during this time can make those days much easier.
Postpartum depression
This is a more serious version of the baby blues. Women with postpartum depression (PPD) have feelings of sadness, despair, anxiety, and/or anger to a much greater level than with the baby blues. These symptoms usually begin about 2-3 weeks after giving birth and will persist if not adequately treated. All providers should screen for PPD at routine postpartum visits because approximately 15 percent of postpartum moms experience it. If you have concerns, you should definitely make an appointment to be seen.
Moms with PPD may not be able to care for themselves or their babies. This does not mean they are bad mothers! They are suffering from a true problem that needs to be treated, which is usually done with improving sleep habits, therapy, medication, or a combination of all three. If your doctor prescribes antidepressant medication, be sure to let him or her know if you are breastfeeding so you can get a safe option. Keep in mind that being prescribed antidepressants for PPD doesn’t mean you’ll need to be on an antidepressant forever.
Postpartum psychosis
This is the most serious perinatal mood disorder. Symptoms of postpartum psychosis include hearing voices, visual hallucinations, or other forms of altered mental status. This requires emergency medical care.
It is important to remember that being diagnosed with any of these conditions does not make anyone a bad parent. Your new baby needs a healthy mom, and in the excitement of bringing home a new baby it is easy to forget to care for yourself. If at any point you have thoughts of hurting yourself or someone else, be sure to let someone know and seek emergency medical care.
Reviewed by Dr. Jen Lincoln, November 2018
Takeaways
- Having a baby can be stressful, and this doesn’t make you a bad parent.
- Baby blues are mild, temporary feelings that go away quickly.
- Postpartum depression can be treated with getting more sleep, therapy, or medication.
- Contact your provider immediately if you have any thoughts of harming yourself or someone else.
My wife is due in 2 months and has dealt with depression in the past. She’s been hesitant to bring it up with her doctor/therapist but we know post partum depression could rear its ugly head. As soon as there are any signs we will be sure to talk to someone who can help.
Marcus, that is great that you are both so aware. You may want to encourage her to let her doctor know ahead of time that way everyone can just be on the same page in case it does show up. You also may want to find some local resources (many areas have local PPD support groups/hotlines) ahead of time again just in case they are needed so you are not searching last minute with the sleep deprivation of new parenthood to deal with as well. Hopefully they are not needed, but best to be prepared. Good luck!!
Its hard to decipher sometimes whats just normal anxiety, fear, “blues” or actual PPD. Thanks for the info.
You are very welcome!
So my question is how often does a second time mom get ppd verses a first time mom? I would think that a first time mom would have a harder time. So if a mom didn’t get get ppd with her first born can she assume that she wont for the secobd baby?
That’s a great thought Lindsay. In reality. the 15% risk of PPD is for all-comers. Some moms who did not experience it with their first child may well get it with their second. Some moms find having a second baby harder because there are now twice as many needs to fill, and having a little one around who doesn’t understand why they are no longer the only kid in the house (and who may have regressions, outbursts, etc) can make brining a new baby home even more stressful than the first time around. Additionally, some new moms mourn the loss of their “old” family – or at the very least take a while to adjust to it. So in short, while not having PPD the first time around definitely puts a mom at lower risk than a woman who already had it with her first child, it doesn’t mean she is “immune” to it. Great question!
Thanks for this article! I suffer from depression and we’re thinking about trying to get pregnant. It’ll be good to watch out for these symptoms.
You are very welcome! Having a heads up about signs is half the battle, so you are ahead of the game!
I know that it is normal to be more emotional during my pregnancy but I feel like I’m not as happy as I should be, I’m more sad than anything else. I fear that it will get worse after birth.
You are right that pregnancy can be filled with ups and downs (especially at the beginning – adjusting to being pregnant is really a huge shift!). However, if you are finding you are having more bad days than good days, you may have depression now – which should be identified and optimized before you give birth. In addition, we know that women who have a history of depression or are depressed in pregnancy have a higher risk of experiencing PPD. Have you let your OB or midwife know so they can help you?
I appreciate your comment that you are not a bad mom if you experience any of these conditions. I took a childbirth preparation class and knew what the baby blues were but I guess it didn’t really resonate with me until I experienced it myself. I almost wish they would have said, “You WILL most likely experience this and it is OK and it is only temporary.” I remember there was a night about 2 weeks postpartum where I broke down crying and told my husband, “I know I am supposed to be happy but I am so sad, and I am so sorry that I’ve put us in this position.” Luckily my husband had all the right things to say and reminded me of the little amount of sleep that I was running on, the crazy amount of hormones and emotions that were circulating within me, as well as the incredible life change that we were going through. I am often frustrated by this idea of new motherhood being all sunshine and happiness that is perpetuated in our culture. I think social media is a large culprit, we see friends and acquaintances’ photos of their happy babies and put-together lives and we can feel inferior. I often have to remind myself that you can put any portrayal on social media and often it is not an accurate depiction. All this rambling is to say that postpartum mode changes are so common and nothing to be ashamed of, I believe the percentage of new moms that experience baby blue is around 80%! Hang in there, Mamas, you’re doing great!
YES, I totally agree with all of what you said!
I definitely had some of the “baby blues” after the birth of my first child. I felt horrible from my c-section, was exhausted from the lack of sleep, and was just overwhelmed bringing home a new baby. I would cry on and off for no reason. Luckily, I have a wonderful support system who all offered to help out during my recovery. After about 2 weeks I started to feel better and the crying spells stopped. Exercise can often help some people feel better by releasing endorphins. It doesn’t fix the problem overnight, but will eventually help if you keep it up for a while.
I absolutely agree that exercise and even just being outside and getting some exposure to light can be so helpful. It can really help reset your body clock especially when you are sleeping in 2 hour increments. Good advice!
Hi Olga, You should definitely talk with your doctor and/or a therapist if you have concerns. If you are pregnant it would definitely be nice to have a plan in place before you deliver, since that makes you much more high risk for PPD. This review did not show a difference with vitamins and PPD, but more studies definitely need to be done:
http://summaries.cochrane.org/CD009104/dietary-supplements-for-preventing-postnatal-depression
Good luck!
I was going to ask what the likelihood of experiencing PPD is if you’ve suffered with depression prior to pregnancy. I figured you would be at higher risk, but thank for confirming that. I did not have any issues with PPD following the birth of my son, but my best friend did experience mild baby blues for a few weeks following the birth of her son. Luckily, she recognized what was going on and was able to ask her family and friends for help in adjusting. A strong support system is a fabulous thing to have!
sometimes I feel overwhelming! I’ve read articles that
certain vitamins help to prevent depression, im taking
those vitamins…I hope its true…before I got pregnant I
had depression!