May 2, 2022

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Caitlin Harper

What is the Difference Between Postpartum Depression and the Baby Blues?

Having a baby changes everything (if you're expecting, get ready to hear that constantly). In the days and weeks following your baby’s birth, you might feel sadness, irritability, frustration, and fatigue (well, you’ll definitely feel fatigue). You know you’re supposed to feel happy, but sometimes you don’t, and you wonder if this is the baby blues that everyone talks about or something more serious, like postpartum depression. So how can you tell, and what can you do about it?

Having a baby is a huge life change—any new parent can agree to that. The shock of suddenly being in charge of the wellbeing of a tiny human, the sleepless nights, and the flood of hormones means that sometimes, despite constant urges from everyone around you to enjoy every minute, you just…don’t.

In the days and weeks following your baby’s birth, you might feel sadness, irritability, frustration, and fatigue (well, you’ll definitely feel fatigue). You know you’re supposed to feel happy, but sometimes you don’t, and you wonder if this is the baby blues that everyone talks about or something more serious, like postpartum depression. So how can you tell, and what can you do about it?

First of all, it’s totally normal to feel plenty of emotions other than bliss after your baby is born

Babies are hard. After struggling with infertility and going through two rounds of IVF, a horrific first trimester, Covid, and an NYC summer with a giant pregnant belly (and horribly swollen ankles), I finally gave birth to my daughter. My dream had come true!

Despite being very, very wanted, the first few months were rough. It was a shock to the system to have a mini person in my home, I had no idea how much time and energy went into breastfeeding, and by the time I felt secure enough in my parenting skills to head out for the long walks I had envisioned during my maternity leave, it was the dead of winter. 

The diapers were never-ending, I was surprised to discover that newborns don’t smile or make eye contact (which I found disheartening, if not disturbing), and then Covid pushed back my daughter’s daycare start date twice. I still have guilt-ridden flashbacks of tearfully admitting to my mother that I couldn’t wait for her to go to daycare. What sort of horrible mother wants a break from her baby? I thought. 

Don't get me wrong: I love, love, love my baby, have countless excellent memories from her first few months, and was often incredibly happy...just not all the time. Unfortunately, because we’re all supposed to be so happy, many mothers don’t want to admit when they feel less-than-joyful—and even fewer want to admit or accept that having a baby can have a huge, and sometimes negative, impact on our mental health. In reality, as many as one in five women around the world experience a mental health condition during pregnancy and the first year following birth, yet over 75% of women do not get diagnosed and do not receive adequate treatment and support. 

What are some common perinatal mental health struggles?

Perinatal means the time from the start of your pregnancy through about a year after giving birth (‘peri’ means 'around' and ‘natal’ means 'birth'). While the term ‘postpartum’ is relatively well-known, you might hear the terms perinatal, antenatal (‘before birth’), and postpartum or postnatal (‘after birth’) used during this time.

While there is no “normal” and every experience is going to be different—and valid—there are a few common experiences or conditions that you might hear about during and after pregnancy:

Perinatal and/or postpartum depression

This can cause feelings of anger, sadness, hopelessness, irritability, guilt, trouble concentrating, changes in eating and sleeping habits, lack of interest in the baby once it is born, and sometimes even thoughts of harming the baby or yourself.

Perinatal and/or postpartum anxiety

This can cause extreme worries and fears, often over the health and safety of the baby. You might experience panic attacks, a feeling of loss of control, or physical symptoms like chest pain, dizziness, numbness, tingling, or shortness of breath.

Perinatal and/or postpartum OCD

This can cause repetitive, unwanted, and often upsetting thoughts and sometimes the compulsion to do certain things over and over in order to reduce the anxiety caused by those thoughts.

Postpartum PTSD

A traumatic childbirth or past trauma can cause PPTSD. Symptoms can include flashbacks, anxiety, avoidance, and more.

Postpartum psychosis

This is a less common but serious condition that requires immediate medical care. People who experience this can hear voices or see images that others can’t, called hallucinations. They might feel distrust of those around them, experience confusion or loss of memory, believe thighs that aren’t true, or have periods of manic behavior.

So what are the baby blues?

As we said, the postpartum experience can be exhausting, stressful, and overwhelming—it’s totally normal to feel that way. Sometimes, what you're feeling is not postpartum depression, but the baby blues. If you’re feeling moody, sad, irritable, frustrated, and fatigued, you might be one of the 80% of new mothers experiencing this.

80%??? Yes! It’s extremely common, and while symptoms can come and go, they typically disappear in a few days but can last up to two weeks.

How can I tell if I’m experiencing postpartum depression or the baby blues?

While it can be hard to tell in the haze of new-parenthood, there are some key differences between postpartum depression and the baby blues, mainly that postpartum depression is more serious than baby blues and lasts longer. Here are a few more differences:

Baby blues

  • Very common
  • Usually starts 2-3 days after birth
  • May cause feelings of worry, unhappiness, and fatigue
  • Usually gets better on its own within 2 weeks

Postpartum depression

  • Usually starts 1-3 weeks after birth
  • Interferes with ability to do daily life activities
  • Causes intense symptoms of sadness, anxiety, and hopelessness
  • May include loss of interest in activities, withdrawing from friends and family, or thoughts of hurting self or baby
  • Can occur up to a year after birth
  • Usually requires treatment

It can be hard to admit that you’re struggling with your mental health during pregnancy and postpartum

Everyone tells you that pregnancy and postpartum life are supposed to be wonderful and that you should enjoy every minute. Instead of inspiring gratitude and happiness, what this can actually do is make it incredibly difficult for parents to voice their feelings and seek the support they need. If you’re supposed to be so happy, why would you admit that you’re depressed or anxious?

It doesn’t help that healthcare providers sometimes miss the opportunity to ask women about depression. In the US, about 1 in 5 women are not asked about symptoms of depression during a prenatal visit and 1 in 8 are not asked during a postpartum visit.

It’s not always easy to talk about our mental health, especially when we feel like we should be happy or be able to cope on our own. But if you’re struggling, it’s best to bring it up to your doctor as soon as possible. Here are a few tips for how to do that:

  • Be open and honest—you’re never going to surprise your doctor or tell them something they haven’t heard (remember, these experiences are extremely common)
  • Focus on how you’re feeling and what you’re experiencing rather than trying to match a diagnosis
  • Use words and descriptions that resonate with you—you don’t have to use the “correct” terms to get support
  • Remember that nothing is too small or unimportant—let your doctor know exactly how you feel, what you’re experiencing, and if anything has changed since you last spoke to them
  • If it helps, have a practice conversation with a partner or friend to be more comfortable when you speak to your doctor
  • Print out or write down any materials that might help you explain what you’re experiencing
  • Think about the outcome you’re looking for, such as access to therapy

How can a therapist help with postpartum depression and other perinatal mood and anxiety disorders?

Your treatment will always be individualized, but it can include working on coping mechanisms, building up a self-care practice, finding ways to develop social supports, and talk therapy.

Finding a therapist who understands perinatal mood and anxiety disorders can be a big help, because they will understand what you’re going through and can have specialized training in those areas. Medications are also available to address both anxiety and depression and your doctor can help you find ones that are safe for breastfeeding if you're going that route.

If I’m struggling with my mental health during pregnancy and postpartum, what can I do right now?

While we advocate for getting the mental health support you need, there are ways to take care of yourself right now. Pregnant people and new moms need rest, proper nutrition, emotional support, and social support. If you’ve already had your baby, taking a break for yourself is not a luxury—it’s a necessity. Time to exercise, spend time with your partner, get outside, eat, shower, and relax are essential. You are not a bad mom for needing these things—only human! 

Often, new moms think they have to handle everything themselves. Let your partner or family know what you need, and if you’re taking care of your baby (or babies!) on your own, seek the support of friends or other family and let them know you could use some help. No one will be surprised that a new mom needs a little TLC of her own.

Experiencing postpartum depression or the baby blues does not mean that you’re a bad mom

Depression is common and treatable. If you think you have postpartum depression, seek treatment from your health care provider as soon as possible. And if you’re experiencing the baby blues, you’re part of the majority! Taking small steps like eating, resting, staying hydrated, getting outside, and giving yourself grace and space to take things slowly, make mistakes, and learn from them can help you beat the baby blues—and remember that if what you're experiencing is truly the baby blues, it's only temporary.

Whatever you're experiencing, getting support as soon as possible means that you’ll be in a better position to do what everyone says you should do and enjoy your time with your baby.

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About the author

Caitlin is MyWellbeing's Content Lead, a writer, speaker, communication coach, and the founder of Commcoterie, a communication consultancy. She teaches teams how to use professional coaching communication techniques in their everyday conversations, helps leaders engage their teams with effective and inclusive communication, and partners with service providers to activate their programs and offerings with their own clients through inspiring communication strategies. Find out more, including how to work with her, at www.commcoterie.com.

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