The Difference Between the Baby Blues and Postpartum Depression

Is it just the baby blues or something more serious? Here's what 50-80% of new moms need to know.

Is it just the baby blues or something more serious? Dr. Judy Greene describes the difference between the baby blues and the symptoms of postpartum depression.

Anywhere from 50% to 80% of new moms suffer from the baby blues—a normal, short-lived period of feeling sad, weepy, or moody that's triggered by hormonal changes after giving birth. But why do we hear so little about the baby blues?

Samantha Meltzer-Brody, M.D., Associate Professor and Director of the Perinatal Psychiatry Program, UNC Center for Women's Mood Disorders, thinks there's still a stigma attached to admitting that you're feeling sad after you've just given birth to a beautiful baby. "There's societal pressure to feel happy and blissful, so women don't talk about [the baby blues]. There's enormous guilt and shame," attached to the experience, Meltzer-Brody says.

But there shouldn't be. Levels of the hormones estrogen and progesterone are sky-high during pregnancy—higher than they will ever be at any other time in a woman's life—and after delivery of the baby and the placenta, they plummet. This neurobiological process triggers the baby blues.

In addition, you've just been through the birth process, which is both profound and exhausting. And you've just been handed a brand-new baby to take care of, manual not included, Meltzer-Brody explains. "The vast majority of women find both the birth and the transition to motherhood to be challenging. Certainly there's lots of joy and it's a time of great happiness, but it's really difficult the first few weeks."

Other factors could also make you even more likely to experience postpartum mood changes, such as a traumatic birth, planned C-section or induction, difficulty breastfeeding, sleep deprivation, a personal/family history depression of baby blues, and the amount of social support you have (or don't have) at home.

When baby blues lasts longer than a few weeks, it could actually be clinical postpartum depression, which comes with more intense symptoms. Women experiencing postpartum depression usually seek treatment in the form of medication, talk therapy, support groups, and more.

Meltzer-Brody thinks it's important for women to know the signs and symptoms of both the baby blues and postpartum depression before giving birth. That way, you know what to expect if you’re among the majority of women who experience short-lived mood changes (the baby blues), or something more severe and persistent (postpartum depression).

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Signs You Have the Baby Blues

1. You feel weepy (crying "all the time"), emotional and/or profoundly vulnerable. Some women describe it as "very bad PMS," Meltzer-Brody says.

2. Your symptoms peak around five days postpartum, and they last about two weeks after giving birth.

3. You also might experience mood instability, depressed mood, sadness, irritability, anxiety, lack of concentration and/or feelings of dependency.

4. Symptoms go away on their own.

Signs You Have Postpartum Depression

1. Your symptoms last longer than two weeks after giving birth, are much more severe than baby blues symptoms and interfere with functioning.

2. You might experience feelings of anxiety, sadness (crying a lot), depression, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, thoughts of hopelessness and sometimes even thoughts of harming the baby or yourself, rumination, obsessions, loss of interest in usual activities, feeling worthless, incompetent or inadequate to cope with your baby, fatigue and/or excessive worry about the baby's health.

3. Postpartum depression typically emerges over the first 2-3 months after childbirth but may occur at any point after delivery.

"Generally I tell people if two weeks go by and the symptoms of anxiety and depression persist, the woman needs to contact her doctor for an evaluation by her Ob-Gyn," Meltzer-Brody says. Your doctor will then follow you or refer you to a specialist for possible treatment, which most commonly can include psychotherapy, medication therapy, some combination or other types of treatment. Women experiencing the baby blues can also find some relief early on by obtaining extra sleep and adding more social support and help if possible, she adds.

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