Baby blues and depression: what’s normal?

Dear Doctor Column

1-15-18.    Dear Doc, I just had my first baby and now I’m moody and tearful all the time.  The doctors say I have the “postpartum blues” and that it’ll get better on its own.  What are post-partum blues, and how do I know I don’t have something more serious?

Congratulations on your new baby!  It can be both exciting and scary to bring another human into this world, especially when it’s your first child.

Despite the excitement of having a new child, the “postpartum” period (a big way for saying anything that happens after the baby is born) can be a rough time for the mother.  She’s trying to adjust to the changes in her life.  She’s just lived through the birth process, which is special and amazing and exhausting, and now there’s a new baby to take care of, handed over after delivery without an instruction manual.  Even more significant, hormones are plummeting rapidly, and the mother’s probably not sleeping a tenth of what she needs.

This is all a set up for the post-partum blues, also called the “baby blues,” a normal, short-lived period of:

• mood swings
• crying spells
• sadness
• mixed feelings about having had a baby at all

Because of social pressures to feel happy after having a child, there’s also often a sense of shame that comes with having the blues.  There shouldn’t be reason for shame: according to some reports, about 70% of new mothers get the blues.  These symptoms last no longer than two weeks after birth, and they go away on their own.  They don’t usually interfere with the mother’s ability to take care of her child.

Sometimes the emotional changes are so overwhelming that they go beyond the post-partum blues, developing into what psychiatrists call post-partum depression.  This is a type of clinical depression.  The symptoms last longer than two weeks and are far more severe.  In this case, the mother experiences:

• profound sadness
• crying spells
• loss of interest in usual activities
• irritability
• guilt
• changes in eating and sleeping habits
• thoughts of hopelessness, helplessness
• profound fatigue
• problems thinking and concentrating.
• feelings of inadequacy taking care of the infant & need help to keep going
• thoughts of harming themselves or the baby

Post-partum depression usually starts within the first few months after delivery, but can kick-in anytime.  You’re more likely to experience post-partum depression if you’ve had it in the past.

Here’s a quick run-down on the differences between baby blues and postpartum depression:

A few words about treatment: Studies show that infants raised by untreated depressed mothers don’t fare as well as those raised by mothers who are under treatment, so psychiatric care is vital to the health of both mom and child. People with mild depression do well with talk-therapy and support groups.  For severe cases, doctors recommend medications.  If the melancholy brings the mother to a halt, causing utter break-down, hospitalization should be considered.

I hope this information helps.  If the baby blues don’t disappear after two weeks, or your symptoms are debilitating, consider contacting your doctor for an evaluation for depression.  Post-partum depression is considered an urgent problem and needs prompt treatment.

If you’re having thoughts of suicide or injuring your baby, please reach out for help immediately by calling 911 or going to the nearest emergency room!