Postpartum depression is not the same as what is colloquially known as the “baby blues”. But that doesn’t mean that the baby blues aren’t as real as postpartum depression. The birth of a child is a life-changing moment. It’s also overwhelming, incredibly grueling, and corresponds with a rapid shift in parental hormone levels. All of these things can contribute to feelings of high emotion, frustration, and irritability. But understanding how the underlying emotions are connected to postpartum depression and the baby blues can lead to much better mental health outcomes for everybody in the family.
“Baby blues are very common, and occur in approximately 80 percent of postpartum periods,” explains Crystal Clancy, the executive director of community engagement for Pregnancy and Postpartum Support Minnesota, and the co-coordinator of the Minnesota Chapter of Postpartum Support International. “It can be helpful to let people know that this is ‘normal’ so that they can expect it.”
Postpartum Depression or Baby Blues?
- The baby blues are common – 80% women experience postpartum blues, usually corresponding to changes in hormone levels during milk production.
- The baby blues are not postpartum depression – although they may have similar symptoms, the baby blues usually fade after two to five days, though can last up to two weeks. Postpartum depression lasts at least two weeks, and sometimes months.
- Postpartum depression symptoms – sufferers experience loss of enjoyment, isolation, a sense of detachment from the baby, and violent or intrusive thoughts, as well as milder symptoms shared with the baby blues, like mood swings, sorrow, anger, anxiety, loss of appetite, and trouble sleeping.
- Dads can get it, too – dads also experience hormone shifts and postpartum depression.
- It can be treated – Not every episode of depression is dangerous for the baby, but professional care is worth it for the parent’s sake as well as the child’s.
The baby blues manifest as mood swings, feelings of sadness, anxiety, or being overwhelmed, loss of appetite, and trouble sleeping. The symptoms are tricky considering they mimic postpartum depression, but the key difference, Clancy says, is the length of time.
“The baby blues are distinctly different in that it lasts for a brief period of time, and generally coincides with the hormonal drop that occurs when milk production begins. For most women, the symptoms subside within 2-5 days,” she explains. “While postpartum depression can start at any time during postpartum, and even during pregnancy, the key differences are duration (with postpartum depression symptoms occurring for at least two weeks) and, for the most part, “baby blues” symptoms do not contain thoughts about death or suicide, or bizarre thoughts, like you would see as part of postpartum psychosis.”
Postpartum depression also manifests as loss of enjoyment, isolation, and a sense of detachment or disinterest in the baby. This doesn’t make the sufferer a horrible person – this is a matter of disrupted brain chemistry. But that doesn’t stop sufferers from feeling guilty or disgusted at their own thoughts or behavior.
“What many don’t know is that sometimes depression does not manifest as sadness, but rather anger or rage. This leads to guilt about snapping at the baby, other children, or family members,” Clancy says. “These fuels thoughts like ‘I’m a bad mom’ and sometimes ‘this baby would be better off without me’. Sometimes moms think about dying or running away (called ‘escapist fantasies’), but don’t necessarily want to hurt themselves. However, this is still a serious sign that she could be depressed, and needs help.”
This self-recrimination make it complicated, because often these reactions, or these thoughts of harming self or the child, are extremely upsetting to the people who experience them – so upsetting they don’t talk about it. Another more serious risk is that these thoughts are not upsetting at all. This is an indication of postpartum psychosis, a rare and severe form of postpartum depression.
“In the case of psychosis, the danger is that having thoughts about harming the baby or themselves is not upsetting,” Clancy cautions. “In the moment, it makes sense to them, and the research shows they are often altruistic- that they believe they are helping the baby or saving their family from harm. They can often have a religious component, but not always.”
Experiencing these kinds of thoughts doesn’t necessarily mean postpartum psychosis, for both moms and dads – who also undergo postpartum hormone shifts and suffer from postpartum depression. Just having the thoughts does not mean they will be acted out.
That doesn’t mean that parents need to manage it alone. There’s a lot at stake, for individuals and families. Therapy can provide tools for coping with these thoughts, medication can reduce their frequency and intensity, and seeking professional help can help avert a tragedy.
“If you are concerned, or have concerns about your partner, it’s always OK to ask — especially if the thoughts are about suicide, harming the baby, or thoughts that seem bizarre or out of character,” Clancy advises. “If that occurs, even if it hasn’t been two weeks, it would be important to seek help.”