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

If you’ve recently given birth, but you aren’t sure if what you’re feeling is Postpartum Depression or just ‘baby blues,’  it’s extremely helpful to learn the key differences, common symptoms, and treatment options so you can ask for the right help.

To describe the multitude of postpartum feelings would take up so much internet space, there wouldn’t be room for anything else: joy, sadness, elation, resentment, pride, guilt, relief, regret, gratitude, loneliness, selflessness, unconditional and unending love … along with unconditional and unending exhaustion. And guess what – all of those feelings are totally normal and expected. Every parent feels these things, often all at the same time. 

But at what point are postpartum feelings no longer “normal?” When is it time to be concerned and think about treatment?

We are a team of Newborn Care Specialists and Postpartum Doulas who work in new parents’ homes [typically overnight]. We are often the first ones who see signs that what parents are working through is more than the “normal” sadness and tiredness that comes with welcoming home a new baby. The line can often feel blurry and hard to distinguish. It’s our mission to not only educate parents, but also to help them know that it’s okay to ask for help.

What Are the Baby Blues?

Postpartum Blues or “Baby Blues” is a period of emotional sensitivity that many parents experience after their baby is born. About 80% of new parents report feeling sad, tearful, or irritable, especially around day three or four after birth. [and not just birthing moms!]

Symptoms of the baby blues are usually mild, though they may appear suddenly and shift quickly. Examples of Baby Blues symptoms include:

• Feeling emotionally fragile and easily upset (for example, crying at a what someone else might call a “minor inconvenience”)
• Feeling irritable or short-tempered
• Difficulty sleeping (not just because the baby is waking up a lot)
• Feeling overwhelmed

In short, Postpartum Blues can look like any of us having a really, really rough day. This is common, and unfortunately normal.

What causes the Baby Blues?

This increased sensitivity is caused by a combination of chemical and situational factors.

For birthing parents, hormones like estrogen and progesterone decline sharply after birth, while other chemicals like oxytocin and prolactin start surging in order to promote lactation and bonding.

While hormones can be a big part of the equation, it’s important that to note that for all parents, this new little baby has completely upended the new parent’s world! Add a few sleepless nights, and it’s no wonder a new parent could feel a little fragile. 

We see parents of adopted babies, parents who welcomed their baby through surrogacy, and moms and dads who didn’t give birth also go through this. The responsibility, the not knowing how to care for their newborn and the sleep deprivation combined can be a difficult combination.

What helps Postpartum Blues?

The good news is that these symptoms tend to pass quickly [usually within a week or two] and don’t impact the parent’s daily life or their ability to care for themselves or their baby. Typically, the ‘baby blues” don’t require medical professionals. Often, some uninterrupted sleep, nutritious food, and positive social interactions can help a parent feel calmer and more stable. Asking for help [and accepting the help that’s offered] is the number one way a new parent can help themselves.

When we’re in parents homes at night, we focus on making sure that parents have periods of uninterrupted rest. This can be challenging [but not impossible] if the struggling parent is breastfeeding. *Read more about how overnight newborn care can be helpful even for nursing parents.*

We also make sure that parents are feeding themselves, that they understand what they are feeling is normal, and that we’re helping them understand their newborn. Getting babies into rhythms and routines can often help parents feel more grounded.

What Is Postpartum Depression (PPD)?

Postpartum Depression (sometimes called Perinatal Depression or PPD) is a mental health condition that can cause deep, ongoing sadness and loss of interest, affecting a new parent’s thoughts, emotions, and daily activities. Between 10 and 20% of new parents (moms, dads, and adopting parents too!) experience Postpartum Depression sometime in the 12 months after birth.

Symptoms of Postpartum Depression can include:

• Crying and persistent sadness
• Feelings of anger, irritability, and/or rage
• Feelings of apathy or numbness
• An inability to sleep or sleeping too much
• Significant decrease or increase in appetite
• Feelings of guilt, shame, worthlessness, or hopelessness
• Difficulty concentrating, remembering things, or making decisions
• Loss of interest or pleasure in things once enjoyed
• Lack of interest in the baby and/or in self-care
• Physical symptoms like headaches, chest pains, heart palpitations, numbness, and hyperventilation
• Possible thoughts of harming the baby or oneself

All these symptoms can range from mild to severe, but will somehow impact the new parent’s ability to function in their daily life. This could look like difficulty interacting with others or participating in social events, problems with school or job responsibilities, or the ability to care for themselves and their baby. It’s important to know that a deep level of despair is not normal, and it’s always best to reach out for help if you’re unsure.

What causes Postpartum Depression?

Postpartum Depression typically develops just like Postpartum Blues, due to sudden hormone shifts and the drastic changes that come from caring for a newborn. A parent’s personal or family history or mental health concerns can also play a role in whether a new parent develops Postpartum Depression. 

According to a 2023 study reported in the journal BMC Psychiatry, isolation and loneliness are major risk factors for depression. Rates of PPD also go up when there are other stressors on the family, like financial instability, violence at home, and pregnancy and birth complications. Don’t forget that every parent and every pregnancy is different – just because someone had PPD with one pregnancy doesn’t mean it is guaranteed to happen again.

4-5 hours of uninterrupted sleep a night is a big protective factor for Postpartum Depression. Unfortunately, newborns didn’t get the memo. New babies typically need to eat every 2-3 hours around the clock. Having a partner or family member help with part of the night shift, or hiring professional in-home support is highly effective in preventing Postpartum Depression. When we work with families overnight, we often work on a plan to ensure that everyone is getting rest, even on the nights that we aren’t providing care.

Treatment for Postpartum Depression

Treatments for Postpartum Depression can vary depending on the severity of the symptoms. 

• Just like the treatments for Postpartum Blues, caring for your basic needs – getting more sleep, eating nutritious food, getting outside, or exercising – can help a new parent feel more stable.
• Talking about your feelings with people who care about you can also keep negative thoughts from spiraling out of control. 
• If those techniques are not enough, the next step is calling your doctor or midwife. They can help you decide if medical treatment is needed.
• Speaking with a professional therapist can help you learn new coping skills, change negative thinking patterns, and improve communication with your support people. Many of our clients secure a therapist before pregnancy, so they have support in place if/when they need it.
• Antidepressant or anti-anxiety medication may also help alleviate symptoms and make it easier for the new parent to take care of their own needs. Many medications are perfectly fine to take while breastfeeding, so it’s important to talk to your doctor. 

Some new parents may worry that others will judge them, or worse, say they are an unfit parent and try to take their baby away if they admit to being depressed. Thankfully, we understand depression much better today than we used to in years past. PPD is the most common postpartum complication, and it is NOT caused by someone being a bad or uncaring parent. Every parent deserves to enjoy the days with their new baby, and if depression is getting in the way, it is OK to ask for help (and to KEEP asking for help until you get it).

We work with many parents who call us when they are experiencing Postpartum Depression to catch up on some sleep so they can start feeling better, faster. If this is you, know that we are here.

How do I know if it’s Postpartum Depression or something else, like Postpartum Anxiety or Psychosis?

Sometimes people dealing with Postpartum Depression also have Postpartum Anxiety, which can show up as nervousness, unwanted scary thoughts, or compulsive behaviors. Postpartum Anxiety requires similar treatment steps as Postpartum Depression, so make sure to share all your symptoms with your care provider.

We find that Postpartum Anxiety often slips through the cracks. New parents are understandably worried. Why is their baby not gaining fast enough? Why does their baby cry for what feels like no reason? Are they not doing enough? Are they not caring for their baby the “right” way? It’s hard to understand the line between what is normal worry about your new little being that relies on you for everything, and when it’s crossed over into anxiety that needs treatment.

When our providers are in homes, it’s hard for us to understand if it’s a parent’s personality to be anxious, or if it is a symptom. Also, many of parent’s anxieties they are feeling inside vs expressing out loud. It’s important for those close to new parents to keep an eye out for any personality changes or excessive worry. Especially those who have had babies themselves and know what is “normal”

Postpartum Psychosis, however, is much more serious (but thankfully much MUCH less common). Symptoms can include hallucinations, intense delusions, or actual plans to harm the baby or oneself. If a new parent is showing these symptoms, they require immediate help from a professional. Do not leave them alone, and call 9-1-1 or go to the emergency room immediately.

It can be scary for the parent and for those around the parent to experience this, but help and treatment are extremely effective. In the cases we’ve worked with, intense monitoring, medication, uninterrupted rest and sometimes hospitalization are necessary.

Key Differences at a Glance:

The three key differences between Postpartum Blues and Postpartum Depression are:

 1. How long the symptoms last

Postpartum Blues usually peaks around day 3 or 4 [some professionals even call it the “third-day syndrome”] and goes away by 2 weeks after birth. If the symptoms are still around after 2 weeks, it might be Postpartum Depression.

Postpartum Depression, Anxiety and Psychosis can sometimes kick in months after birth and, if left untreated, can continue for years.

2. How severe the symptoms are

Symptoms of Baby Blues tend to be mild and come on as mood swings, and usually go away on their own without a lot of outside help. Symptoms of Postpartum Depression, however, can range from mild to moderate to severe, and may last all day. Depression doesn’t go away on its own – one can’t just “think” their way to feeling better. 

3. How much the symptoms impact a parent’s life

Finally, while a Postpartum Blues mood swing can be alarming, the parent can usually still take care of the baby and themselves without an issue. PPD symptoms are different – they make it hard for the parent to function.

	Postpartum Blues / Baby Blues	Postpartum Depression
Timing	3-5 days after birth → 2 weeks after birth	2 weeks after birth → 1 year after birth
Severity	Symptoms are mild, temporary, and subside on their own	Symptoms are mild, moderate, or severe, persistent, and require treatment to go away
Impact	Parents are able to function normally.	Parents have significant difficulty functioning in social situations, with work or school responsibilities, or with caring for themselves and the baby.

When to Get Help

If symptoms are lasting longer than two weeks or the symptoms are getting worse despite the parent’s best efforts to deal with it on their own, it’s time to call in reinforcements. At this point, a new parent needs their support network [which includes medical professionals] in order to feel better. And if a support person notices signs that the parent is not thinking clearly, as in they are saying things that don’t make sense, seeing or hearing things that aren’t there, or talking about harming themselves or the baby, it’s time for immediate help. 

How Postpartum Doulas Can Help

All new parents can benefit from a network of support people after they have a baby, and this support is crucial if the parent is dealing with a mental health concern. This can be friends, family and even online communities. However, many parents choose to hire support specifically for them.

A Postpartum Doula provides valuable support for parents facing Postpartum Blues or Depression by offering practical assistance, emotional reassurance, and education and connection to resources. While they don’t diagnose or treat depression, they help prevent some of those situations that can make it worse. 

Both Baby Blues and PPD can be magnified by lack of sleep – a Postpartum Doula or Newborn Care Specialist ensures the parents get the best sleep possible. That extra set of hands allows many parents to take a moment to eat, drink, and shower, which goes a long way in making a parent feel human again. A doula can be a wonderful source of emotional support for a new parent, preventing isolation and validating these sometimes overwhelming feelings. Doulas and Newborn Care Specialists are also highly trained and well-educated in all aspects of postpartum care. If a parent needs resources or help finding more support, a professional is a great place to start. 

There are a lot of unknowns when it comes to bringing home a new baby. If you’re not sure whether your feelings are “normal” or something to worry about, the first step is to ask for help. A Newborn Care Specialist or Postpartum Doula can be an invaluable member of your support team.

If you’re overwhelmed and need immediate support, our team offers in-home overnight newborn care so you can finally get some rest and daytime support if you need a nap, some education, someone to talk to or some baby laundry taken off your plate. Book a call today to get support for you and your baby.

If you are feeling helpless, hopeless or are in a place where you feel like you might harm your baby or yourself, don’t hold it inside. Call the National Maternal Health Hotline to talk to a trained therapist and talk through options at: 1-833-TLC-MAMA