Postpartum Depression vs Baby Blues: Even though there’s less of a stigma and far more awareness about both postpartum depression and the baby blues today than ever before, there’s truly nothing that can prepare you for the way you feel the first weeks after you give birth, and in some cases, many months after.
There’s a reason that so many people refer to that emotional feeling after giving birth a “hormone dump”—it really is like your brain threw every human emotion that ever existed into a giant bucket and dumped them all out, leaving you totally depleted and in dire need to sort out the mess all while trying to figure out how to keep a tiny human alive and while wearing an adult diaper.
Experiencing feelings of sadness and even hopelessness during what so many people tell you is supposed to be the happiest time of your life can leave you feeling so defeated, and those feelings are only compounded by the stress and sleep deprivation that is so often part of the newborn stage.
It doesn’t mean that you don’t love your baby or that you regret becoming a parent—transitioning into new motherhood can be so hard and comes with a lot of complicated feelings, good and bad.
What’s Ahead
Three years later, I still remember those 3 a.m. feelings of loneliness and fear that had me crying right along with my four-week-old daughter as I changed her diaper in her dark room and wondered how much worse those feelings would become before they’d get better.
In some cases, those postpartum hormones do eventually calm down, and over time, you’ll feel more like yourself. In others, those feelings of depression and anxiety don’t go away; in fact, they might even become worse. But in the earliest weeks of new motherhood, how do you know if what you’re dealing with is the baby blues or postpartum depression (PPD)?
Here’s the difference between the two—and what to do if the symptoms of either sound familiar to you.
- How do hormones change after giving birth?
- What are the baby blues?
- What is postpartum depression?
- How to tell the difference between baby blues and postpartum depression
- Other psychological changes that may happen after giving birth
- When to seek help
How do hormones change after giving birth?
During pregnancy, so many of the symptoms that you experience have to do with all of the hormonal changes going on in your body. It starts with the rise in HCG that makes that second line appear on a pregnancy test, and those pregnancy hormones are what cause you to feel nauseous in the first trimester, too.
So it’s no surprise that, immediately after giving birth, some postpartum hormone changes are going on, too. Progesterone and estrogen will decrease, and prolactin will increase to help stimulate milk production. Another hormone that increases is oxytocin, which may help you feel those warm fuzzies about your baby, and now that your placenta is gone, those hormones are working their way out of your system, too.
If that sounds like a lot happening very quickly, that’s because it is—and it’s no wonder that you may experience some intense emotions during this time as a result.
What are the baby blues?
With all of those postpartum hormones rising and dropping in your body, you’ll likely experience mood swings beginning shortly after giving birth, and when you pair those mood swings with sleep deprivation as you’re also trying to recover from a major medical event, you may feel like your emotions are out of control.
The list of symptoms you may have during this time is pretty long, and the American Pregnancy Association (APA) advises that new moms who have the baby blues may experience:
- Weepiness or crying for what feels like no reason
- Irritability
- Impatience
- Fatigue and/or insomnia
- Mood changes
- Restlessness
- Poor concentration
The APA states that while the exact cause of the baby blues is still unknown, it’s believed to be related to postpartum hormone changes. Symptoms may stick around anywhere from a few minutes to a few hours daily.
If you think you may be experiencing the baby blues, one of the most important things to remember is that you’re not alone. According to Sanam Hafeez, MD, neuropsychologist, an estimated 80 percent of new moms will have the baby blues after birth.
“It’s important to note that the baby blues are considered a normal and expected part of the postpartum experience,” says Dr. Hafeez. “They are usually a result of the rapid hormonal changes that occur after childbirth, along with the emotional and physical demands of adjusting to a new baby.”
What is postpartum depression?
If you’re experiencing postpartum mental health symptoms that seem more intense or severe than mood swings, you may actually have postpartum depression.
The Mayo Clinic states that symptoms of postpartum depression may include:
- Crying
- Deep feelings of depression
- Feelings of hopelessness or worthlessness
- Difficulty bonding with your baby
- Inability to enjoy activities you once loved
- Appetite changes
- Increased anxiety
- Withdrawing from family and friends
- Fear of your ability to be a good mother
- Thoughts of self-harm, death, or suicide
What to Expect
But when can you expect to feel these symptoms? Frances Rosa, LPC, licensed professional counselor and perinatal mental health professional, tells us that the onset of postpartum depression can vary.
“The postpartum period generally includes the first 4 to 6 weeks after birth, and many cases of PPD begin during that time. But PPD can also develop during pregnancy and up to one year after giving birth,” Rosa says.
Though PPD doesn’t discriminate, certain risk factors may make it more likely for you to experience it:
- Previous depression or anxiety
- A family history of depression or anxiety
- Having a baby who is challenging or has special needs
- Being a first-time mom
- Other life stressors occurring at the same time as your baby’s birth, like the loss of a loved one, a recent move or financial stress
Since a stigma around postpartum depression does still exist, some new moms may feel alone while struggling with this postpartum mental health complication, but it’s actually far more common than you might think. The Cleveland Clinic estimates that as many as 1 in 7 new moms will experience postpartum depression.
How to tell the difference between postpartum depression vs baby blues
Since there are so many overlapping symptoms of the baby blues and postpartum depression, it can be hard to tell the difference between them, especially since every emotion can feel so intense during this time (thanks, postpartum hormones). However, there are a few key signs that may tell you which you’re dealing with.
When the symptoms begin
Symptom onset can be one of the most defining factors between baby blues and postpartum depression. If you notice your symptoms begin shortly after birth, they might be the baby blues, while symptoms of postpartum depression may not show up until much later —or in some cases, much earlier, even while you’re still pregnant.
“The baby blues typically occur in the first few days to a couple of weeks after childbirth, while PPD can begin any time within the first year after birth,” says Dr. Hafeez.
Duration of symptoms
The baby blues are very temporary and will start to get better when you’re about a week or two postpartum, and by the time your baby is about two weeks old, you’ll probably start feeling more like yourself. But if you’re experiencing postpartum depression, Rosa points out that you may notice your symptoms “persist or even worsen as time goes on.”
Left untreated, postpartum depression may get worse and could end up lasting years or more. If you’re still feeling like something isn’t right and that two-week period has come and gone, you might be battling PPD.
Severity of symptoms
The baby blues can feel very intense and very real when they’re happening, but the level of that intensity will be milder than if you were experiencing postpartum depression, and those feelings shouldn’t interfere with your ability to care for yourself and your baby. If you’re experiencing the baby blues, your symptoms may peak around four to five days after giving birth, gradually improving from there.
Wit’s PPD, you’ll likely find that your symptoms are so severe you’re unable to carry out even basic daily tasks.
“If a new mom experiences an overwhelming and persistent sense of sadness, hopelessness, or other debilitating emotions that significantly interfere with her daily life and ability to care for herself and her baby, it could be PPD,” Dr. Hafeez says.
Other psychological changes that may happen after giving birth
PPD isn’t the only postpartum mental health complication that may come up after birth. Some new moms also struggle with other psychological changes that can be just as disruptive and scary:
- Postpartum anxiety: Experiencing irrational fears about the health and safety of your baby, panic attacks, increased heart rate, being unable to sleep
- Postpartum OCD: Having overwhelming obsessions related to the fear of harm coming to your baby (or the fear of harming your baby yourself), experiencing compulsive urges or rituals to get rid of those fears, avoiding certain activities with your baby for fear they’ll get hurt
- Postpartum psychosis: A very rare, but serious condition that causes a new mom to have hallucinations and/or delusions alongside extreme mood changes and other symptoms of depression and anxiety
When to seek help for postpartum depression vs Baby Blues
Of course, the best way to know if you’re experiencing postpartum depression or the baby blues is by talking to your doctor, who knows you and your pregnancy best. It’s also important to know the signs of when you should seek help. Reach out to your OB/GYN if you:
- Have symptoms that persist longer than two weeks postpartum
- Are unable to complete basic tasks
- Have symptoms that are disrupting your daily life
Seek immediate medical attention by calling 911 or going to the nearest emergency room if you are experiencing thoughts of harming yourself or your baby, or are experiencing hallucinations or derealization, which could be a sign of postpartum psychosis.
The good news is that there are many treatment options available for PPD, and you don’t have to suffer alone. Therapy may help, and medications can make a big difference, too — in fact, the FDA recently approved Zurzuvae, the first oral medication to treat PPD. Don’t be afraid to lean on your support system during this time, too, whether that’s your partner, a mom friend or a family member.
And though having postpartum depression in one pregnancy makes it more likely that you will experience it again, there’s no guarantee that it will happen in subsequent pregnancies.
“Experiencing postpartum depression in one pregnancy does not necessarily mean that a person will automatically experience it in subsequent pregnancies. PPD can vary from one pregnancy to another, and each pregnancy is a unique experience,” says Dr. Hafeez.
Conclusion
If you are diagnosed with postpartum depression, please know that it’s not your fault. There is nothing you could have done to cause or prevent this from happening.
“Having a baby is really hard, and society leads us to believe it should come naturally to us because it’s what our bodies were designed to do,” Rosa says. “The combination of our genetic predispositions, prior life experience, and current stressors can impact your risk of developing a perinatal mental health disorder. These complications are incredibly common and often ignored when they should not be. You are a good mom for worrying about being a good mom, and you are not alone.”
With the right treatment, your postpartum mental health can and will improve. You deserve to feel your best—not just for your baby, but for you.
If you are struggling with postpartum depression, help is available. You can feel free to call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) 24/7 for free and confidential counseling, information, and resources.
