A few days after bringing your baby home, you find yourself crying in the shower and you're not sure why. You love your baby. You're also exhausted, on edge, and wondering whether this is normal.
For most new mothers, it is. But for some, those feelings are the start of something that needs more support. As a perinatal psychologist, this is one of the questions I hear most often from new parents and their partners. Here's how to tell the difference.
What are the baby blues?
The baby blues are very common. As many as 4 in 5 new mothers experience them. They usually start two to three days after birth, as hormone levels drop sharply and sleep disappears.
With the baby blues, you might:
Cry easily, sometimes for no clear reason
Feel irritable, anxious, or overwhelmed
Have mood swings, from happy to tearful within the same hour
Feel unsure of yourself as a parent
The key feature of the baby blues is that they pass on their own, usually within about two weeks. Rest, food, help with night feeds, and someone to talk to make a real difference. You still feel like yourself underneath it all.
What is postpartum depression?
Postpartum depression is more than a rough couple of weeks. It affects about 1 in 8 new mothers, according to the CDC, and it can begin during pregnancy or at any point in the first year after birth, not only in the first days.
Signs of postpartum depression can include:
Sadness, emptiness, or hopelessness that lasts most of the day, most days
Exhaustion beyond what you'd expect with a newborn, or trouble getting out of bed
Losing interest in things you used to enjoy
Feeling disconnected from your baby, or having little interest in them
Intense guilt, or feeling worthless or like a bad mother
Trouble sleeping even when the baby sleeps, or changes in appetite
Pulling away from your partner, family, or friends
Thoughts of harming yourself or your baby, or that your family would be better off without you
Many women also experience postpartum anxiety: constant worry, racing thoughts, or a sense that something bad is about to happen. Anxiety and depression often show up together, and both are treatable.
How can I tell which one I have?
Three questions can help:
How long has it lasted? The baby blues fade within about two weeks. Symptoms that last longer, or that get worse instead of better, are a reason to reach out.
How strong is it? The blues come and go. Depression tends to color most of the day and make ordinary tasks feel impossible.
Can you still function and connect? If you're struggling to care for yourself or your baby, or you feel numb and far away from the people you love, that's more than the blues.
You don't need to be sure before asking for help. If you're wondering, that alone is a good reason to talk to someone.
Why does postpartum depression happen?
There's no single cause, and it is never a sign of weakness or of not loving your baby. Hormonal shifts, sleep loss, a difficult birth, a personal or family history of depression, mood changes around your period, a high-risk pregnancy (such as preeclampsia, gestational diabetes or twins), infertility or pregnancy loss, and limited support at home can all raise the risk. Postpartum depression can happen after a first baby or a fourth, and to mothers who were thrilled to be pregnant.
What helps?
Postpartum depression responds well to treatment. Therapy with a clinician trained in perinatal mental health can help you understand what you're feeling, cope with intrusive or anxious thoughts, and feel like yourself again. For some women, medication is also part of the plan, and many options are compatible with breastfeeding. Your OB or primary care doctor can talk this through with you.
Practical support matters too: protected stretches of sleep, help with feeds, meals, and people who check in without judgment.
When to get help right away
If you have thoughts of harming yourself or your baby, call 911 or 988 (the Suicide & Crisis Lifeline) now. For support any time of day, you can call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262), or call the Postpartum Support International HelpLine at 1-800-944-4773.
You don't have to wait it out
At River Psychology Group, our perinatal team works with women through pregnancy, after birth, and beyond, in person in Scarsdale and Park Slope and online across New York. Learn more about our postpartum therapy and perinatal mental health care, or book a free 15-minute call to talk about what you're going through.
Shira Danzig, PhD, PMH-C is a clinical psychologist and co-founder of River Psychology Group, certified in perinatal mental health.
This article is for general information and isn't a substitute for professional care.
