Baby Blues vs. Postpartum Depression: What’s the Difference?

Content medically reviewed by Jennifer Janke, APRN, CNM

Being a new mother can feel like riding a rollercoaster of emotions. Joyful highs may give way, without warning, to weepy lows, known as the baby blues. The symptoms of baby blues affect many moms after giving birth, and they usually go away on their own. How can you tell whether you're dealing with the baby blues vs. postpartum depression? Let's explore the differences.

Baby Blues vs. Postpartum Depression: Different Timelines

The baby blues tend to appear two or three days after giving birth, according to The American College of Obstetricians and Gynecologists (ACOG), and clear up within two weeks.

"Pregnancy and postpartum are exciting," said Jennifer Janke, certified nurse-midwife at Essentia Health. "As with all new things, however, there may be feelings of worry, disconnection, sadness, and a struggle to figure out how to handle this new role."

"It's expected to be tearful and feel overwhelmed in the first few weeks postpartum — it happens to almost all women," Janke said. "When these feelings last longer than two weeks, something more serious may be going on."

Postpartum depression occurs when you experience more intense feelings of sadness, anxiety or hopelessness for more than two weeks. This type of depression usually starts within three weeks after childbirth, although it can occur months later. Postpartum anxiety affects one out of eight new mothers, according to the Office on Women's Health.

Fueled by Hormone Changes?

Experts don't fully understand why many new mothers develop the baby blues or postpartum depression, but typical, post-pregnancy changes in hormone levels may play an important role. During pregnancy, your estrogen and progesterone levels surge. Once you have your baby, these hormones swiftly return to their pre-pregnancy levels. This drop may lead to the baby blues or depression.

More than changing hormone levels may be at work. Other factors can increase your risk of postpartum depression, including:

• Negative emotions, such as fear of childbirth or concern about being a good parent.
• Personal or family history of anxiety, depression or another mood disorder.
• Post-pregnancy fatigue.
• Socioeconomic factors, such as a lack of support or childcare.
• Stress.

Spotting the Symptoms of the Baby Blues vs. Postpartum Depression

The baby blues bring emotional ups and downs, sometimes seemingly out of nowhere. Crying or feeling impatient, irritable, anxious or restless are common baby blues symptoms. You may also experience fatigue or difficulty sleeping or concentrating.

"Compared with postpartum depression, baby blues symptoms are milder and self-limiting," Janke said. "They don't affect your ability to perform daily tasks or care for your baby."

The symptoms of postpartum depression, on the other hand, are more severe and long-lasting than those of the baby blues, and they can have major effects on your daily functioning. Signs of this type of depression include:

• Avoiding friends, family members or favorite activities.
• Changes in appetite.
• Feelings of anger, hopelessness, sadness or guilt.
• Frequent crying.
• Over- or under-sleeping.
• Thoughts of harming your baby or yourself.

Other mood disorders may affect new mothers. These include postpartum anxiety, which is abnormal worrying that interferes with daily activities and may lead to a variety of symptoms, such as panic attacks.

Another condition, postpartum psychosis, is rare but serious.

"Postpartum psychosis is a medical emergency requiring immediate treatment and hospitalization," Janke said. "The symptoms include a rapid onset of hallucinations, delusions, bizarre behavior, confusion and disorganization. Women with postpartum psychosis may go days without sleeping."

Self-Care Steps

Many of the pillars of planning for a healthy pregnancy can also help you manage mental health symptoms that may occur after childbirth. Things you can do include:

• Ask friends and family members to help with everyday chores, such as grocery shopping.
• Exercise regularly, which may help prevent postpartum depression, the ACOG reports.
• Follow a balanced, nutritious diet.
• Get as much rest as possible.
• Seek support from other new moms who can empathize with what you're going through and share their own coping tips.

Knowledge is power, so learn all you can about being a new parent. On the Real Talk on Women's Health podcast, for example, you can listen to an Essentia Health expert discuss adjusting to new motherhood.

In addition, make time to nurture your health. If, for example, you experience urinary incontinence or another pelvic floor problem after having a baby, as many women do, a specialized type of physical therapy called pelvic rehabilitation can help.

Treating Postpartum Depression

Developing postpartum mental health symptoms doesn't mean you're weak or a bad mother, or that you just need to work through them on your own. Seeking help, especially if you suspect postpartum depression, is an act of love — for yourself and your baby.

"The longer you wait, the harder postpartum depression is to treat," Janke said. "Several treatment options are available. We develop a plan that works for each mother and her family."

Start by seeing your primary care provider or women’s health provider. To treat depression, they may recommend:

• Medication. An antidepressant or anti-anxiety medication, such as a selective serotonin reuptake inhibitor, may help you feel better by bringing mood-controlling chemicals in your brain into balance. Worrying comes with being a parent, but medication can help stop it from interfering with all aspects of your life.
• Talk therapy. Your primary care provider may refer you to a mental health professional for outpatient counseling to help you better understand the emotions you're feeling and how to manage them.

Self-care steps can complement medication and mental health counseling.

"As with all health conditions, getting good nutrition and moving your body daily will assist the postpartum depression treatments in helping you feel better," Janke said. "Taking time every day just for you is extremely important. I like to recommend 30 minutes of 'you time,' but if 10 minutes is all that's available, it's still helpful."

Helping a Friend or Loved One

If you think a friend or loved one may have postpartum depression, encourage them to share how they're feeling and listen without judgment. Offer your support and help them seek medical attention. Free, confidential, 24/7 mental health support is also available through the National Maternal Mental Health Hotline.