Baby Blues vs Postpartum Depression: Know The Difference
Pregnancy can be a really difficult time. There are often a lot of unknowns, difficulties, aches, and pains. Then comes delivery with more of the same. With the excitement of a new baby, a lot of new parents are inundated with questions about how everyone is doing. When the reality is that there often continue to be difficulties, a lot of new parents will say they’re doing “great!” When up to 85% of women experience the baby blues, being “great” is often not the case.
Baby blues are really common and can present in a number of ways. Symptoms include varying combinations of the following:
crying spells
fatigue
insomnia
sadness
irritability
poor concentration
impatience
feeling overwhelmed
These symptoms typically present in the first few days after delivery, usually around 4-5 days postpartum. Symptoms can present earlier if delivery was in some way difficult or traumatic.
Baby blues is thought to originate from the drop in pregnancy hormones. During pregnancy, the body and the placenta work together to increase hormones to keep someone pregnant. These hormones increase fairly steadily throughout pregnancy and peak at delivery. Then, after delivery, they drop dramatically over the course of about a day to your pre-pregnancy levels.
While we do not fully understand the complicated relationship between hormones and mood, we do understand they do not exist completely independent of each other. With a dramatic drop in progesterone after delivery combined with sleepless nights and a big change in responsibilities, it is no surprise a majority of women experience the baby blues. They usually resolve about 2 weeks postpartum and do not cause significant impairment. Most cases of baby blues are self-limited, meaning they resolve on their own with little or even no intervention. While it can be difficult to get through the baby blues, most of the time it resolves on its own.
Sometimes, however, the symptoms do not resolve on their own. If symptoms last beyond 2 weeks postpartum or start outside the first 2 weeks, there is a concern for postpartum depression.
Postpartum depression is a constellation of symptoms that can include some of the following:
changes in sleep with difficulty falling asleep even when everyone else is asleep or sleeping more than normal
decreased interest in the things you previously liked to do or lack of interest in the baby
feelings of worthlessness or guilt
lack of energy or motivation, or motivation to care for yourself or the baby
changes in concentration
loss of pleasure, inability to feel joy
eating more or less than usual
worrying about harming the baby
thoughts about death, dying or suicide
Some of these symptoms can overlap a lot with new parenthood. It is normal to sleep less, you have an infant to care for who wakes up a lot. It is normal to feel tired when you’re not sleeping much. It is important to consider how difficult it is to get through each day. There will be a lot of unknowns and figuring things out, but most people don’t feel completely overturned by their new responsibilities. Is the day extremely difficult? Does it take significant energy to get up and take care of things? Do you feel joy at times? Do you feel like you’re connecting with your baby on any level?
If some of these symptoms sound familiar or you notice things are feeling really difficult, it might be a good idea to talk to your clinician about what you’re experiencing. It is important to know that if you are experiencing postpartum depression you’re not alone. About 1 in 7 people who give birth experience postpartum depression. A lot of people delay or never seek treatment for fear of judgement or belief that these symptoms are just part of being a parent. Postpartum depression can rob them of some of the joy of parenthood and leave them with feelings of guilt and inadequacy. This absolutely does not need to be the case.
When you’re likely to only get one postpartum OBGYN visit, it can feel daunting to think about bringing up any symptoms you might be experiencing.. I hope you do! You can also talk to your baby’s pediatrician. You’re likely to have more visits to check-in on the baby so there will be more opportunities to bring up your concerns at the pediatrician visits. They absolutely care about postpartum depression too.
There is absolutely high-quality treatment for postpartum depression. If symptoms of baby blues last longer then about two weeks, there is concern for postpartum depression. The treatment options vary based on situation, but are largely based on lifestyle modifications like leaning on support and getting improved sleep, therapy and medications. If you’re struggling with symptoms of postpartum depression, please reach out to your doctor or someone you trust. There is always hope in feeling better and enjoying your new role.
For more information here are some great resources: postpartum.net and womensmentalhealth.org
If you’re looking for a perinatal psychiatrist here in Austin, we have several wonderful options at our practice. See our website, RPCAustin.com, for more information.
I’ve also helped develop Aluma, a self-discovery workbook with immersive audio and exercises designed to fit into your busy mom-life. You can learn more about Aluma at explorealuma.com.
Wishing you the best!
This post by guest writer, Perinatal Psychiatrist Nichelle Haynes, DO.
Nichelle Haynes is a perinatal psychiatrist with special interest in pregnancy and early parenting. She works as a psychiatrist at Reproductive Psychiatry Clinic of Austin where she also serves as CEO. She is a wife and mother of 2 energetic young boys who keep her busy. She has also recently co-founded Aluma, a self-discovery workbook for moms.
You can find Dr. Haynes on Instagram at @dr.nichellehaynes, @explorealuma and @rpcaustin