The Differences Between Postpartum Depression and Baby Blues

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Baby Blues

After successfully tackling some of the more challenging aspects of pregnancy (countless doctor’s appointments, enormous to-do lists, and unpleasant physical side effects to name a few!), most mothers expect baby’s arrival to bring pure joy and happiness.  It is more common than not, however, for a mother’s emotions to fluctuate in the immediate weeks following delivery.  Childbirth causes major biological and hormonal alterations that contribute to these mood swings, so it’s critical for new mothers to carefully monitor their postpartum mental health.

What are the “baby blues”?

Postpartum blues, often called the “baby blues”, describe the mood fluctuations and sadness that frequently follow childbirth.  The baby blues are often attributed to a drop in certain hormone levels after delivery, which changes brain neurochemistry and in turn affects mood.  As a mother’s body adjusts to these changes and hormone levels renormalize, she might feel very sad one minute and very happy the next, cry more than usual, or have higher levels of irritability or anxiety.   Once these biological changes are compounded with the sleep deprivation associated with taking care of a newborn, it’s easy to see why the baby blues affect the majority of new moms.

What is postpartum depression?

More serious than the baby blues, postpartum depression involves a severe and long-term change in a mother’s mental health.  The drastic changes in hormone levels after delivery and the emotional issues associated with new motherhood contribute to the appearance of postpartum depression.  Postpartum depression can include feelings of sadness, guilt, loss of interest or pleasure, lack of energy, appetite changes, or even thoughts of harming oneself or the baby. These thoughts or behaviors do not indicate that the new mother is weak or negligent, as the biological changes surrounding pregnancy and delivery are out of a mother’s control.

How can I tell the difference between the baby blues and postpartum depression?

Outlined below are some key points that your doctor will consider when differentiating between the baby blues and postpartum depression:

  • Onset: Signs of the baby blues often begin 1-3 days after delivery and peak 3-5 days after baby is born.  Postpartum depression characteristically begins within 3 weeks of delivery but also might not appear until up to 1 year after birth.
  • Duration: Baby blues typically resolve after 10 days, while postpartum depression can last weeks, months or even years if untreated.
  • Frequency: Up to 80% all new mothers experience the baby blues.  Postpartum depression is less common and affects approximately 10-15% of all new mothers. Women with a history of depression or anxiety have a higher risk of postpartum depression.
  • Treatment: A strong network of support from family and friends, focus on a good diet and sleep regimen, and plenty of patience should be sufficient to ride out the baby blues.  Women experiencing postpartum depression, however, will require care from a mental health expert to get back to their normal mental health status.

The biological transformations that go hand-in-hand with having a baby can make new mothers vulnerable to potentially harmful psychological changes.  It is important to know that changes in mood immediately following childbirth might seem abnormal, but are actually quite common.  If, however, these changes are so severe that they interfere with everyday mothering duties or are unresolved a couple of weeks after childbirth, then it is critical to talk to a doctor and get help.

Sources:

Beck CT. Postpartum Depression: It isn’t just the blues. American Journal of Nursing, 106(5) 40-50, 2006.

National Institute of Mental Health. Postpartum Depression Facts.

Pawluski JL, Lonstein JS, Fleming AS.  The Neurobiology of Postpartum Anxiety and Depression.  Trends Neurosci, 40(2): 106-120, 2017.

Kristen Hollinger
Dr. Kristen Hollinger has a Ph.D. in molecular and cellular biology from Pennsylvania State University. She currently resides in Maryland and works as an Instructor in the Departments of Psychiatry and Neurology at Johns Hopkins University School of Medicine. Her research focuses on neurological diseases including depression and multiple sclerosis.

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