What Are “Baby Blues”?
Confidence and pride one minute give way to overwhelming anxiety and despair the next. These rapid mood changes are very common in the first two weeks after giving birth and are often attributed to hormonal changes. Typically, there is a sharp decrease in progesterone, estradiol, and prolactin immediately following delivery.
Hormonal-induced mood changes aren’t the only symptom. You may also experience the following:
- Feeling overwhelmed
- Anxiety
- Reduced concentration
- Irritability
- Unhappiness
- Worry
- Exhaustion and/or trouble sleeping
Classic “baby blues” usually begin when your baby is 2-3 days old and generally continue for the first two weeks of your baby’s life.
Some tips to help navigate the “baby blues” include:
- Accepting help when people offer it.
- Sleeping as much as you can and resting when baby naps.
- Continuing to eat a nutritious diet.
- Getting out of the house for some light exercise. Going for a walk in the sunshine will boost your vitamin D levels. Many studies have shown an association between vitamin D levels and postpartum depression.
- Relaxing and focusing on taking care of yourself and your baby. Don’t worry about chores, especially during the first two weeks postpartum. Your body needs this time to recover from the stresses of childbirth.
The most important factor in managing “baby blues” is recognizing that the symptoms are temporary and should not last more than two weeks. If your symptoms last over two weeks or get worse, it’s time to call your doctor. Don’t wait. The risk of “baby blues” becoming postpartum depression rises.
A study in Africa found that women with “baby blues” on postpartum day five were 12 times more likely to get postpartum depression one month after giving birth. They were 10 times more likely to be diagnosed two months after delivery.
What Is Postpartum Depression?
Recent research by the Centers for Disease Control and Prevention (CDC) shows that about one in eight women (13%) experience symptoms of depression related to childbearing. The percentages are even higher for teenage mothers (25%-36%) and women living in poverty (up to 48%). Most often, people call this condition postpartum depression. But, a more accurate term is peripartum or perinatal depression. This is because it can start during pregnancy and continue after childbirth. While it may start as — or be mistaken for — “baby blues” at first, postpartum depression (PPD) symptoms last beyond the first two weeks of your baby’s life and are more intense. They may eventually interfere with your ability to handle daily tasks or to care for yourself or your baby.
Postpartum depression symptoms include:
- Feeling hopeless or worthless
- Feeling alone all the time
- Crying excessively; being unable to stop crying
- Not bonding with baby
- Feeling a sense of overwhelming despair
- Experiencing anxiety or panic attacks
- Withdrawing from family and friends
- Loss of appetite – or eating more than usual
- Inability to sleep – or sleeping too much
- Loss of interest in activities you used to enjoy
- Anger
- Intense irritability
- Reduced ability to think clearly or make decisions
- Restlessness
- Thoughts of harming yourself or your baby
- Recurring thoughts of death or suicide
You may be embarrassed or hesitant to admit feeling depressed after your baby’s birth. But postpartum depression is not a weakness, a judgment of your parenting ability, or a character flaw. If you have the above symptoms of PPD or if the “baby blues” symptoms are continuing beyond two weeks, it’s essential to seek help quickly. Get in touch with your doctor right away. Don’t wait for your six-week checkup. Treatments are available and can help you feel like yourself again.
Jane’s Story
Jane* (a pseudonym) is a first-time mother who ticked many of the boxes of PPD symptoms outlined above. She remembers that before leaving the hospital, the nurses educated her and provided her with a take-home pamphlet on the difference between “baby blues” and a bigger problem. She acknowledges that at her two-week postpartum visit, her doctor inquired if she was experiencing any depressive symptoms. She was, but didn’t have the courage at the time to admit it. “My husband said, ‘You really need to tell the doctor that you need to talk with someone.’ I’m like, ‘yeah, yeah, I know’, but I didn’t have the guts to do it.”
While she had 12 weeks of maternity leave, her husband had to return to work sooner. “I just felt really alone when my husband went back to work. Like, I knew it wasn’t true, but I felt like the only person going through that situation.”
She acknowledges she had a strong family support system. Her mom came to help for a week or so after her husband returned to work. Nevertheless, the depression continued to suck the color from her world. “I was just sleeping all the time,” she said. “I love being outside, but I didn’t even want to leave the couch. The only reason I’d get up to do something was because the baby needed something.”
She experienced inconsolable crying jags. “I cried all the time, like at stupid TV commercials and songs that I’ve listened to a million times before. There were times when I felt like I couldn’t stop crying, even though I really wanted to.”
By her six-week postpartum appointment, her depressive symptoms had intensified, but she still didn’t think she would be able to get the words out when the doctor asked the standard screening questions for depression. “I had to bring my husband to one of my appointments, and he told the doctor, ‘No, she’s not okay,’ and then that got the ball rolling from there,” she said. “I started therapy first, and then they said, ‘You should probably talk to your doctor about taking some medicine.’ They put me on a low-dose SSRI [selective serotonin reuptake inhibitor], which is common.”
Talking with her therapist helped her untangle the thoughts she had been having. “I was telling myself: I chose to be pregnant, I chose to have a child, I chose to be a present mother for that child, and I felt like if I was sad about it for any reason, that’s my own fault, not anyone else’s to have to deal with,” she explained. “And then that made me feel worse because I don’t feel like I’m being the best mom right now because I can’t even take care of myself, let alone a newborn.”
She states that the therapy helped her make sense of her feelings. “Since I started therapy, I’ve learned that a lot of it came down to I didn’t feel validated to have those feelings,” she said.
She encourages all new moms to understand they are not alone and that help is available. The dual treatments of medication and therapy have helped her get her bearings and learn better coping strategies. “I needed time to get back to feeling like myself again,” she acknowledges. “They say about two years is what it takes for a mom to really get back to her ‘new normal,’ mentally.”
Help is Available
Please don’t suffer in silence. Talk to your doctor. If you don’t feel ready to talk to your doctor, there are many online resources that you can access from your phone or computer. The Postpartum Support International (PSI) website states: “You are not alone. You are not to blame. With help, you will be well.” PSI offers over 50 free, virtual support groups. Some of the groups include Birth Trauma Support, Black Moms Connect, Mental Health Support for Special Needs and Medically Fragile Parenting, Military Moms Perinatal Mood Support Group, Post-Abortion Support, Queer and Trans Parent Support Group, Single Perinatal, Pregnancy and Postpartum Parent Support, Support for Parents of High Needs Babies, and many more. There are also Kansas and Missouri chapters that focus on creating resources, offering programs, and advocating for change to ensure perinatal mental health is a priority.
Non-birthing Parents Experience Postpartum Depression, Too
All new parents can experience “early parenthood” depression, not just the one that gave birth. Fathers, partners, adoptive, and non-biological parents can all experience feeling sad, anxious, overwhelmed, and having disrupted sleeping and eating patterns. According to a study titled “Sad Dads: Paternal Postpartum Depression,” paternal PPD can negatively impact a father’s relationship with both his partner and his children. A Maternal Mental Health Leadership Alliance “Dads & Depression Fact Sheet” infographic notes that one in 10 fathers will experience PPD, usually occurring when the baby is between three and six months old. The fact sheet further notes that men experiencing depression often display higher levels of anger, irritability, and negative parenting behavior, such as harsh discipline tactics. It can also lead to increased conflict with the spouse/partner and behavior problems displayed by the children.
Causes of paternal PPD include adjusting to new and demanding roles, a change in hormones, lack of social support and good role models, feeling excluded from mother-infant bonding, and difficulties in developing attachment with the baby. Maternal depression, however, is the most critical risk factor for paternal depression.
Dads need to know that it’s common for them to experience depression around the time of pregnancy and postpartum, that there is no shame in it, that help is available, and that asking for help is the best thing you can do for your family and yourself.
Paternal depression treatment includes:
- Individual talk therapy
- Couples therapy, especially if both parents are experiencing depression or if the relationship is contentious
- Medication
Other tips to help dads navigate postpartum depression symptoms they may be experiencing:
- Be involved in the baby’s care as much as possible (feeding, dressing, bathing, bedtime routines).
- Tag-team childcare shifts so both parents can get adequate rest.
- Understand it’s common for your sex life to change after a baby.
- Spend time together with your partner.
Postpartum Psychosis – An Emergency Situation
Postpartum psychosis is a rare (affecting 0.1% to 0.2% of women) but extremely dangerous mood disorder that usually develops within the first week after delivery. According to the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, the risk of experiencing postpartum psychosis is more common in women on their first delivery or with a prior personal or family history of depressive or bipolar disorders. In addition, the risk of recurrent pregnancy-related depressive episodes with psychotic features increases by 30% to 50% with subsequent pregnancies and deliveries.
Experiencing the following symptoms may lead to thoughts of harming yourself or your baby. They require immediate attention. Call 988 for emergency assistance.
- Feeling confused or lost
- Hallucinating, having delusions
- Having too much energy
- Feeling paranoid
- Making attempts to harm yourself or your baby
If you have life-threatening thoughts
Call or text 988 to reach the 988 Suicide & Crisis Lifeline.
988 Spanish language phone line: 1-888-628-9454 (toll-free)
988 Lifeline Chat: Free and confidential.
Text HOME to 741741 from anywhere in the U.S., anytime, about any type of crisis. You will be connected to the National Crisis Text Line.
