Postpartum Depression or Baby Blues? Understanding the Difference

So many emotions come with giving birth to a child and bringing them home.  On television shows, often, the woman experiences an inexplicable pain followed by a flood of happy tears that their little bundle has finally arrived.  Many women cite forgetting the pain and just feeling pure bliss.  However, people rarely discuss the aftermath of postpartum and the changes the woman’s body endures.  Many women struggle with this process and the hormonal changes that come with it.  This blog explains the symptoms and indications of baby blues, postpartum depression, and postpartum psychosis.  This blog provides insight with hopes of normalizing these experiences without shame, providing psychoeducation and resources.  But first, understand the key differences.

The Baby Blues

After giving birth, the woman’s body experiences many hormonal changes, especially in the first two weeks.  These hormones can cause restlessness and mood changes, such as crying and anxiety.  According to John Hopkins Medical Center, eighty-five percent of women experience the postpartum blues.  Baby blues usually happen because of a sudden decrease in estrogen and progesterone after delivery.  In some cases, the thyroid can also drop in hormone production, leaving new moms tired and depressed, which worsens by insufficient sleep or eating well.  Emotionally, it is common for new moms to feel nervous about how to care for a baby and think about how this might change their life.  The intensity of the baby blues typically doesn’t require medical treatment and resolves independently in a few weeks.

Postpartum Depression

Postpartum depression, or PPD, is different from baby blues because symptoms are more severe, for more extended periods, and can be dangerous if not treated.  Postpartum depression affects one in seven women (approximately fifteen percent), and symptoms can begin before the baby is born.  For many new mothers, depression is their first experience which can make it even scarier.  To meet the criteria for postpartum depression, you must meet five or more of the following symptoms that are present for longer than two weeks:

  • Feeling depressed daily for most of the day
  • Feelings of failure, guilt, fear, or shame
  • Severe agitation and mood swings
  • Loss of interest in typical interests
  • Exhaustion and feeling tired all of the time
  • Changes in appetite or weight
  • Trouble sleeping or sleeping most of the day
  • The problem with decision-making and concentration
  • Feeling disconnected from your baby
  • Thoughts of hurting yourself or the baby

While we are still learning all the definitive causes of postpartum depression, there are several risk factors and possible causes that heighten the risk of PPD, such as:

  • Genetics family history of mental illness or depression increases the likelihood of depression and depressive-related disorders.
  • Rapid hormone changes– drops in estrogen and progesterone after pregnancy and low thyroid hormone levels
  • Mental health history Trauma, intimate partner violence, sexual or physical abuse, depression, or other mental health treatment and diagnosis in history
  • High levels of stress including but not limited to family illnesses, poverty, unemployment, lack of resources, lack of support from loved ones
  • Health issues including diabetes, complications in pregnancy, previous pregnancy loss
  • Substance use including drinking or other harmful drugs

Postpartum Psychosis

Unlike baby blues and PPD, which occur more frequently, postpartum psychosis is a severe and rare condition affecting only approximately 1 in 2,000 women.  Symptoms typically begin in the first two weeks after giving birth and are more likely in new moms with mental health conditions such as schizoaffective disorder or bipolar disorder.  Symptoms of postpartum psychosis include:

  • Visual or auditory hallucinations
  • Paranoia
  • Confusion
  • Rapid mood swings
  • Restlessness
  • Hopelessness
  • Trouble sleeping even when exhausted
  • Thoughts about hurting others, the baby, or self

It is imperative to recognize that each of these experiences is not the mother’s fault and warrants a great deal of support and empathy.  Many women experience shame that their symptoms reflect poorly on their abilities as a mother.  PPD can last months or even years without treatment and interfere with bonding and caring for the baby and the mother.  While PPD is severe, it is highly treatable.  There are several supportive strategies listed below that can help cope with these different diagnoses:

  • Sleep Getting enough sleep or as much as you can.
  • Seek help- Reach out to your partner/support for help with clear things they can do to help (ex., food shopping, cooking, taking a shower while someone else watches the baby).
  • Get outside- walking and sunshine are good for relieving stress and releasing endorphins.
  • Support- find other new parents or support groups. It normalizes the struggle and provides resources for others going through something similar.
  • Stay away from substances- alcohol or other substances can alter and worsen your mood, making you feel worse.
  • When to seek additional support- if symptoms last longer than two weeks, contact your medical provider.
    • Antidepressants and estrogen are common medications used to treat PPD
    • Research shows that interpersonal therapy and cognitive behavioral therapy before and after birth have been effective at prevention and treatment alongside medication.

Call 911 if you feel scared or paranoid or think about hurting yourself or your baby.  Also, reach out to the following resources for more information or help:

Becoming a mother is one of the most rewarding and challenging life events a woman can endure in their lifetime, with so many emotions along the way.  If you are struggling, it is okay and imperative to reach out for help.

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