Baby Blues vs. Postpartum Depression

According to Depression after Delivery, a national Postpartum Depression support organization, baby blues are a biological response to a woman’s rapidly changing hormone levels after pregnancy. Yet sometimes the blues turn into postpartum depression. Learn the difference and where to find support if you’re struggling with a postpartum mood disorder.

Sarah recalls crying uncontrollably for no apparent reason one day after the birth of her son almost five years ago. “I just felt completely overwhelmed and scared, because suddenly the life of this little being was all my responsibility. I had to feed him, make sure he got enough food, make sure that he didn’t suffocate at night or swallow something and choke, or even drop from my hands…. I felt extremely restricted, imprisoned by his feeding schedule.” Looking back, Sarah believes she suffered from the baby blues, a short-lived but often distressing condition that affects between 50 and 75 percent of all new mothers within the week after the birth of their baby.

Baby Blues 101

According to Depression after Delivery, a national postpartum depression support organization, baby blues is a biological response to a woman’s rapidly changing hormone levels after pregnancy. Symptoms include tearfulness, irritability, impatience, restlessness, and anxiety. Of course, the overwhelming responsibilities of a new baby, around the clock feedings, diaper changes, inconsolable crying, spitting up, and too many sleepless nights, aggravate this state.

My husband would call, and I would hear his voice, and I would just start to cry for no reason, recalls Stephanie, whose baby blues were gone within three weeks. She describes being on a high her first days home, but her mood quickly dampened as she began week two. “I’m not very good with change,” she confesses. “I felt weird, anxious, really tired, a little overwhelmed—just out of sorts.”

Dr. Silvia Olarté, MD, senior attending at New York’s Lenox Hill Hospital, explains that women experiencing the baby blues “feel life through loudspeakers.” These exhausted moms find themselves in an emotional state they just don’t recognize. Usually the women’s hormones self-adjust within 21 days, and by then routine sets in and they find themselves feeling more and more at ease with their new situation.

Signs of Baby Blues

Baby Blues Symptoms Chart
(Source: Postpartum Support International):
Physical Symptoms:
Lack of sleep
No energy
Food cravings or loss of appetite
Feeling tired even after sleeping

Mental States:
Anxiety and excessive worry
Great concern over physical changes
Confusion and nervousness
Feeling, “I’m not myself; this isn’t me”
Lack of confidence
Feeling overwhelmed
Behavioral Reactions:
Crying more than usual
Hyperactivity or excitability
Over sensitivity
Feelings hurt easily
Lack of feeling for the baby

Postpartum Mood Disorders

Sometimes though, this emotional state lasts beyond a few weeks. After four weeks, Dr. Olarté explains, some moms begin to feel like they cannot do anything right. They are filled with self-doubt, are agitated and exhausted, but suffer from insomnia. Their thoughts darken and they find themselves in a clinically depressed state. These women may be suffering from postpartum depression.

Michelle’s daughter is now almost four months old, but Michelle still battles the effects of her postpartum depression. A successful and respected professional, she admits that she was completely unprepared for life with her infant. By the third week with her new child, Michelle was beside herself. The baby cried incessantly, and nothing would stop it. By week five, unable to eat, Michelle lost every ounce of weight she had gained during her pregnancy. “One night my husband tried to spoon feed me chocolate ice cream. I could barely get four teaspoons down,” she recalls. At first, Michelle assumed that she was simply suffering from the baby blues and that all she needed was a good night’s sleep. “I thought everyone goes through this and I’m just being a wimp,” she said. Further conversations with relatives and friends led her to believe she was experiencing something different. At one point Michelle even contemplated taking her own life. “I lost all my coping skills,” she reflects.

Michelle is not alone. Experts believe that at least one in 10 new mothers will experience a postpartum mood disorder. Sonia Murdock, president of Postpartum Support International, explains that postpartum depression is just one condition in this family of disorders. Women also suffer from postpartum panic/anxiety, postpartum obsessive/compulsive syndrome, and in the worst cases, postpartum psychosis. These mood disorders can appear within days of delivery, slowly over a few months, or even after a year. Symptoms of postpartum depression may include mood swings, anxiety, disturbances with sleep, feeling helpless and disconnected from the baby, a fear of losing control, and even suicidal thoughts.

Treatment for Postpartum Mood Disorders

If you suspect that you may be suffering from more than the baby blues, rest assured that there are professionals, support groups, and resources out there to help you through what may feel like a hopeless time. You may find comfort knowing that many of the individuals who support or treat postpartum mood disorders have either experienced or had a loved one experience a mood disorder in some form. The first person you should contact is your OB/GYN or midwife. Express your concerns and ask for a medical evaluation. Ms. Murdock warns that there are other medical conditions, such as a thyroid problem, which can be mistaken for postpartum mood disorders. Once you and your doctor have ruled out other medical conditions, ask for a referral to see a postpartum specialist. If your primary health provider does not know one, contact the organizations listed below and individuals there will provide you with a list of specialists in your community.

Dr. Michelle Friedman, MD, a New York City-based psychiatrist, urges women suffering from postpartum mood disorders to seek help and know there is absolutely no cause for shame. They worry there may be something inherently wrong with them, or that they are “bad” because they have given birth to a beautiful baby but feel so miserable inside. Michelle certainly felt that way. “I looked at my baby and thought, ‘I don’t want to see this baby, I don’t want to hold this baby, I don’t want to be with this baby.’ I just wanted to get out of the house, and I felt guilty.” Postpartum mood disorders are simply biochemical, medical conditions exacerbated or caused by hormones after delivery. And suffering from one of these mood disorders “in no way means that a woman won’t be a competent mom,” reassures Dr. Friedman. A woman battling a postpartum mood disorder should feel confident that with proper treatment, usually a combination of psychotherapy and antidepressants, she will be a wonderful mother to not only her baby, but if she so chooses, to more in the future.

Postpartum Depression Symptoms

Post Partum Depression Symptoms Chart
(Source: Postpartum Support International):
Physical Symptoms:
Numbness, tingling in limbs
Chest pains, heart palpitations
Mental States:
Despondency or despair
Feelings of inadequacy
Inability to cope
Over concern for baby’s health
Impaired concentration or memory
Loss of normal interests
Thoughts of suicide
Bizarre or strange thoughts
Behavioral Reactions:
Extreme behavior
Panic attacks
New fears or phobias
Extreme guilt
No feelings for baby
Over concern for baby
Feeling “out of control”
Feeling like “you are going crazy”

More Postpartum Resources

Depression After Delivery, Inc.

Postpartum Support International

Postpartum Resource Center (631-422-2255)

Women’s Moods: What Every Woman Must Know About Hormones, the Brain, and Emotional Health by Deborah Sichel and Jeanne Watson Driscoll (December 1999).

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