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Postpartum Depression

The Difference Between Baby Blues and Postpartum Depression

Beyond Baby Blues

Two weeks ago, I met a pregnant woman who described experiencing depression after her first pregnancy but received no help or support. Her family physician said she was just going through the baby blues, but this was five months after she had given birth. She did her best to carry on as if nothing was wrong.

Nearly two years later and pregnant with her second child, she was admitted to a hospital with suicidal ideation. Her postpartum depression went undiagnosed and, therefore, untreated. Everyone missed it and this young mother was left alone wondering what was wrong with her, feeling guilty and ashamed of her inability to “snap out of it.”

“I just thought, well, this is what it was like to be a mother,” she said to me.

A new mom may experience mood swings ranging from extreme happiness to weepiness. During pregnancy and postpartum, a woman obviously goes through tremendous physical, hormonal, and emotional changes. It is not uncommon to experience feelings of sadness during the first few days or weeks of motherhood as the body and emotions adjust to new circumstances. Baby blues last two to three weeks at the most and resolve on their own. In fact, up to 80% of new moms experience baby blues to some degree, but they do not last for several months nor do they leave a mother feeling sad, worthless, helpless, hopeless, and unable to feel any joy.

Baby blues is not postpartum depression and postpartum depression is not the same as baby blues! It might seem that the line between the baby blues and postpartum depression is not a clear one because so much is changing so quickly. In addition, people - including a new mom herself - often have unrealistic expectations about what a mother should feel and do.

While it is normal and expected to feel exhausted, sleep-deprived, irritable, overwhelmed with new and never-ending responsibilities, (and, at times, even angry and resentful of the baby and those around), it is not normal to believe that you are hopeless and worthless, feel perpetually guilty and profoundly sad, and believe that you are a bad mother. Sometimes, new moms begin having thoughts that the baby would be better off without them. Experiences are subjective, so how is a mom and those around her supposed to know when the baby blues are no longer the baby blues? What should partners, parents, and friends be aware of?

Motherhood is overwhelming and scary at times, but not all of the time. Postpartum depression is a different experience. Up to 15-20% of new moms experience the condition. It interferes with a mother’s daily functioning: she can’t shower (which is different from not having time nor energy to do so), can’t sleep even when exhausted, eat, have a conversation, may have difficulty breastfeeding, withdraw or isolate herself, etc. Though this can be said about any new mom some of the time it does not describe her all of the time, especially, not past two to three weeks postpartum. If a mom seems to be getting worse and symptoms become more severe, frequent, and don’t abate, it’s time to reach out for help.

It is also important to mention that anxiety is, in fact, more common than depression during pregnancy and postpartum. Often, anxiety and depression co-occur. However, anxiety is less talked about and acknowledged, perhaps because some anxiety is expected when preparing for the birth of a new baby. It is also more accepted to exhibit signs of anxiety as opposed to depression during the period in a woman’s life when she is expected to be experiencing only happy thoughts and emotions. Some levels of anxiety are not only healthy but also necessary at any point in our lives, especially when there is a new baby to take care of.

However, when worry becomes so intrusive and incessant that it interferes with daily life, and restlessness and hypervigilance take over, do not wait – reach out for help as soon as possible. If you don’t feel like yourself and feel that something is wrong – listen to yourself! No one knows you better than you do. If your doctor brushes it off as the baby blues when you are past your second month after giving birth, ask more questions, and mention it to your child’s pediatrician – moms often report that pediatricians are more receptive to hear about how they feel.

There are so many resources available, you just need to reach out or ask your partner or a family member to reach out because often your loved ones feel helpless not knowing what to do. Do not worry about appearing weak, ungrateful, or incompetent – there are many amazing physicians who do listen and can help. There are many online resources available. Postpartum Support International is an excellent place to start. It has evidence-based up-to-date information for moms, partners, family, friends and helps find local resources.