Is it “baby blues” or postpartum depression?

It’s not unusual for a new mom to feel happy one minute and sad the next and to cry for no apparent reason. The “baby blues” often appear 3–4 days after birth and can last for several days or weeks. But if your symptoms persist or worsen, you may have a more serious illness called “postpartum depression” (PPD). Sometimes PPD occurs even before delivery: especially if the mother is under stress, symptoms may begin during pregnancy.

What are signs of PPD? 

PPD is a treatable illness that many women experience because of the physiological changes that occur during pregnancy. Symptoms can develop shortly after birth or weeks or months later and can include the following:

  • feeling sad most of the time 
  • feeling numb or disconnected from your baby 
  • feeling bad about yourself, your partner, or your baby 
  • having negative or scary thoughts about the baby (such as that he will be hurt or taken away) 
  •  having thoughts of hurting yourself or your baby
  • not wanting to care for yourself or your baby 
  • feeling nervous or afraid 
  • feeling angry 
  • feeling a lack of energy 
  • feeling worthless, shameful, guilty, or unable to be a good mother 
  • feeling hopeless, or thinking that life is not worth living 
  • crying or feeling tearful  
  • having mood swings
  • losing interest in fun activities 
  • experiencing changes in sleep patterns (such as excessive sleepiness, insomnia, or trouble sleeping when your baby sleeps) 
  • feeling loss of appetite 
  • having problems in thinking, concentrating, or making decisions 
  • having problems completing daily tasks (such as cleaning, making meals, or showering) 

If you think you’re suffering from PPD, it’s important to know you’re not alone. Data suggest that 10–15 percent of mothers experience PPD, but in some groups of mothers the rate is much higher. And PPD doesn’t affect only mothers but fathers and babies too. 

What risk factors are associated with PPD? 

These are factors that increase a mother’s risk for PPD:

  • severe childbirth or childcare-related stress
  • physical pain
  • exhaustion
  • lack of support
  • past infertility
  • anxiety during pregnancy
  • an unintended pregnancy
  • a complicated pregnancy or delivery
  • premature labor and delivery
  • miscarriage or stillbirth
  • having twins or triplets
  • caring for a baby born ill, premature, or with a disability
  • having a sick or hospitalized baby
  • a history of abuse (physical, mental, or emotional)
  • a history of previous depression

What problems can PPD lead to? 

PPD can interfere with parent-child bonding, lead to behavioral problems and language delays, and impact physical growth. The Mayo Clinic warns that if left untreated, PPD can lead to:

  • For mothers. Untreated postpartum depression can last for months or longer, sometimes becoming a chronic depressive disorder. Even when treated, postpartum depression increases a woman's risk of future episodes of major depression.
  • For fathers. Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby's father may also increase. And new dads are already at increased risk of depression, whether or not their partner is affected.
  • For children. Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, excessive crying, and attention-deficit/hyperactivity disorder (ADHD). Delays in language development are more common as well.

What should you do if you think you have PPD? 

PPD is an illness, not a weakness. Its symptoms can last for a few weeks or for many months.

Fortunately, treatment can help. Therapy, medication, or both, under the guidance of a health care provider experienced with PPD, can help you recover much sooner. Contact your health care provider if your symptoms last more than 2 weeks or if they worsen. The sooner you get help, the sooner you—and your baby—will start to feel better.

Last updated July 12, 2018

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