Having a baby is a big change in your life. You probably expect to feel happy, but you may feel moody and overwhelmed instead.
It’s normal to feel this way for a little while. After you give birth, your hormone levels drop, which impacts your mood. How do you know, though, whether you're having common mood swings know as the "baby blues" or a more serious condition, postpartum depression?
Postpartum Depression vs. Baby Blues
Up to 80% of those who've just given birth get what’s called the "baby blues" — short-term dips in mood caused by all the changes that come with a new baby. It's also called "postpartum blues."
These feelings often begin when your newborn is just 2 or 3 days old, but you’re likely to feel better by the time your baby is 1 or 2 weeks old.
If your feelings of sadness last longer than that, or become worse instead of better, you may have what’s called postpartum depression, or PPD. It’s more severe and lasts longer than the baby blues, and about 10% of those who've just given birth get it. You’re more likely to have postpartum depression if you’ve already had bouts of depression or if depression runs in your family. You're also more at risk of postpartum depression if you've had PPD after previous pregnancies.
Other things that put you at a higher risk of postpartum depression include:
- You have bipolar disorder.
- Your baby has health problems or is especially fussy.
- You had a difficult pregnancy.
- You've had a lot of stress in your life, such as problems at work.
- Your pregnancy was unplanned or unwanted.
- You're having relationship troubles with your partner.
- You're worried about money.
- You had twins, triplets, or other multiples.
- You don't have a strong support network.
- You have trouble breastfeeding.
- You're younger than 20, single, or both.
- You're already a caregiver for a parent or other relative.
- You're in a relationship that's abusive or violent.
How can you tell if you have the baby blues or postpartum depression?
Postpartum depression
Signs that you may have postpartum depression include:
- You feel hopeless, sad, worthless, or alone all the time, and you cry often.
- You don’t feel like you’re doing a good job as a new parent.
- You’re not bonding with your baby.
- You can’t eat, sleep, or take care of your baby because of your overwhelming despair.
- You have anxiety and panic attacks.
- You withdraw from family members.
- You're very angry or irritated.
- You're not interested in things you used to enjoy.
- You're restless.
- You have overwhelming fatigue and lack energy.
- You feel guilty.
- You have thoughts of harming yourself or your baby.
- You have recurring thoughts of death or suicide.
- You have trouble thinking and focusing.
Postpartum depression in non-birth parents
Postpartum depression can also occur in the parent who didn't give birth. Partners also may feel tired and overwhelmed. Their eating and sleeping patterns can be disrupted. Factors that increase the risk include:
- Being young
- A history of depression
- Financial worries
Adoptive and surrogate parents can have these symptoms, too.
Baby blues
When you have the baby blues, your mood symptoms come and go, and they don't last as long as postpartum depression. Signs of baby blues include:
- You experience mood swings.
- You don’t feel like eating or taking care of yourself because you’re exhausted.
- You feel irritable, overwhelmed, and anxious.
- You feel sad and cry.
- You can't concentrate.
- You have trouble sleeping.
Peripartum depression
For some people, depression begins during pregnancy. That's called peripartum depression. Like postpartum depression, it's longer-lasting and more serious than the baby blues. Experts sometimes use the term "perinatal depression" to include both peripartum and postpartum depression.
Postpartum Depression Treatment
You might not want to tell anyone you feel depressed after your baby’s birth. But treatment can help you feel like yourself again, so it’s important to seek help quickly.
If you have symptoms of postpartum depression or if the baby blues don’t ease up after 2 weeks, get in touch with your doctor right away. Don’t wait for your 6-week checkup. Other signs that should prompt you to call your doctor include:
- Your moods make it hard for you to care for your baby.
- You're having trouble completing normal daily tasks.
- You have thoughts of harming yourself or your baby.
Treatment for postpartum depression can involve several approaches.
Talk therapy
A psychiatrist, psychologist, or other mental health professionals can help you. In therapy, you can learn ways to deal with your feelings and set goals. Cognitive-behavioral therapy is one type used to treat postpartum depression.
Joining a discussion group for new parents might give you a safe forum to express your feelings and help you build a support network.
Antidepressants
Your doctor might prescribe an antidepressant. These drugs can pass to your baby if you breastfeed, so you should discuss the pros and cons of medication with your doctor. Most antidepressants for postpartum depression don't have much risk of side effects for your baby.
Antidepressants take a few weeks to be effective, so you'll have to be patient. Don't stop taking the medication just because you think it's not working.
Antidepressants prescribed for postpartum depression include:
- Selective serotonin reuptake inhibitors (SSRIs) including sertraline (Zoloft) and fluoxetine (Prozac)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), including duloxetine (Cymbalta) and desvenlafaxine (Pristiq)
- Norepinephrine-dopamine reuptake inhibitors (NDRIs) including bupropion (Wellbutrin or Zyban)
- Tricyclic antidepressants (TCAs), including amitriptyline (Elavil) or imipramine (Tofranil)
Other medicines
You might get a prescription for an anti-anxiety drug. These medicines also can pass to your baby through breastmilk, so discuss your options with your doctor.
Another possibility is an estrogen patch that you wear. Studies suggest it may improve the symptoms of postpartum depression.
Your doctor might prescribe brexanolone (Zulresso), a new synthetic version of the hormone allopregnanolone, which has been found effective in relieving symptoms of postpartum depression. The FDA approved it in 2019, and it's the first treatment specifically for postpartum depression. You get the drug through an IV, and you'll have to stay in the hospital for a few days to be monitored for side effects. Research shows that it keeps hormone levels from dropping quickly after your baby's birth.
Baby Blues Treatment
You should start to feel better and your baby blues should ease if you do what your body and mind need during this stressful time.
- Sleep as much as you can, and rest when your baby is napping.
- Eat foods that are good for you. You’ll feel better with healthy fuel in your system.
- Go for a walk. Exercise, fresh air, and sunshine can do wonders.
- Accept help when people offer it.
- Relax. Don’t worry about chores. Just focus on you and your baby.
- Connect with other new parents.
- Avoid alcohol and recreational drugs, which can make your mood swings worse.
- If you're having trouble breastfeeding, ask your health care provider to suggest resources.
- Try to see friends or talk to them on the phone. Don't isolate yourself.
Takeaways
Many people have complicated feelings when they have a new baby. You might feel sad, discouraged, overwhelmed, and exhausted. When these symptoms last just a week or two, they're commonly called the baby blues. Mood problems that last longer are known as postpartum depression. You're more likely to have postpartum depression if you or someone in your family has a history of depression. Treatment -- including counseling and medication -- can help ease postpartum depression. If you believe you have postpartum depression, it's important to contact your doctor right away and begin treatment. Don't wait until your 6-week checkup.
Postpartum Depression and Baby Blues FAQs
Can you have postpartum depression and still love your baby?
Postpartum depression is a mental health condition. It has nothing to do with how much you love your baby. But it's important to get treatment because postpartum depression can interfere with your ability to bond with your baby. It also can make it hard for you to respond to your baby's needs and parent the way you want to.
What is the baby blue period?
Baby blues generally come on within a couple of days of your baby's arrival. They typically last 2 weeks.
When does postpartum depression start?
If your symptoms last longer than 2 weeks, you may have postpartum depression rather than a simple case of the baby blues. If you don't feel better by the 2-week mark, see your doctor. The sooner you start treatment, the sooner your symptoms will improve.
