Postpartum depression or baby blues? How to tell the difference and get support

What are the baby blues?

Most new mothers experience the baby blues. In the first few days after giving birth you might feel weepy, irritable, anxious or overwhelmed, and your mood can swing from happy to tearful quickly. Big hormone changes, exhaustion and adjusting to life with a newborn all play a part.

The baby blues usually start within the first week and fade within about two weeks. Rest, food, practical help and being able to talk about how you feel are often enough. If the feelings last longer than two weeks, or get worse, it may be postpartum depression.

Signs of postpartum depression

Postpartum depression (also called postnatal depression) is more than feeling a bit low. Signs include:

• Persistent sadness or low mood most of the time
• Losing interest in things you used to enjoy
• Feeling unable to cope, or feeling hopeless
• Difficulty bonding with your baby, or feeling numb
• Feeling guilty, worthless or like a bad mother
• Trouble sleeping even when your baby sleeps, or sleeping much more
• Lack of energy and feeling exhausted all the time
• Changes in appetite
• Withdrawing from partner, family or friends
• Frightening, unwanted thoughts, for example about something bad happening to your baby

It can start any time in the first year after birth, not just in the early weeks. Anxiety is also common, either on its own or alongside depression, and can show up as constant worry, racing thoughts or panic.

Baby blues vs postpartum depression at a glance

• Timing: baby blues start in the first days and usually go within two weeks. Postpartum depression lasts longer and can begin weeks or months after birth.
• Intensity: baby blues come and go. Postpartum depression is more persistent and makes daily life harder.
• Coping: with the baby blues you can usually still look after yourself and your baby. Postpartum depression can make that feel very difficult.

If you're not sure which it is, that's reason enough to talk to someone.

It's not your fault — and it's treatable

Postpartum depression can happen to anyone. You're more likely to experience it if you've had depression before, had a difficult pregnancy or birth, lack support, or are going through other stress, but often there's no clear reason.

Having postpartum depression doesn't mean you're a bad mother or that you don't love your baby. Many people worry their baby will be taken away if they speak up; health professionals' aim is to support you and your family to get well.

Treatment can include:

• Self-help and support — rest, help with night feeds, gentle activity and connecting with other parents
• Talking therapies, such as CBT or counselling
• Antidepressants, if recommended — some can be taken while breastfeeding, so discuss options with your doctor

Partners can experience depression after a new baby too, and deserve support as well.

How to get help

Tell your doctor, midwife or health visitor how you've been feeling. It can help to write down your symptoms beforehand or bring your partner or a friend. Be honest — they hear these feelings often, and you won't shock them.

If you're supporting someone, gently tell them what you've noticed, offer practical help, and encourage them to talk to a professional.

When to get help urgently

Get urgent help straight away — contact emergency services, go to an emergency department or call a crisis line — if you or someone you know:

• has thoughts of harming themselves or ending their life
• has thoughts of harming the baby
• sees or hears things that aren't there, or has beliefs that seem out of touch with reality
• seems confused, very agitated or unusually energetic and not sleeping
• feels unable to keep themselves or their baby safe

The last three can be signs of postpartum psychosis, a rare but serious condition that usually starts in the first weeks after birth. It is a medical emergency, but with prompt treatment most people recover fully.