Postpartum Depression: Signs, and When It Is More Than the Baby Blues

The baby blues are very common. They start in the first few days after birth and settle within about two weeks. If low mood, anxiety or numbness lasts longer than that, keeps getting worse, or starts later in the first year, it may be postpartum depression, and that deserves treatment, not endurance.

Baby blues or postpartum depression#

The baby blues come with the huge shift in hormones, sleep and life after birth. You may cry without knowing why, feel touchy, anxious or overwhelmed, and swing between joy and sadness. It is uncomfortable but mild. Most new mothers have some of it, and it passes on its own within about two weeks.

Postpartum depression is heavier and lasts longer. It can begin during pregnancy, in the first weeks after birth, or at any time in the first year. It does not lift with rest or reassurance.

Signs to watch for#

Postpartum depression does not always look like sadness. Common signs include:

• Feeling low, empty or hopeless most of the day
• Strong anxiety, panic, or constant worry about the baby
• Feeling disconnected from your baby, or that you are a bad parent
• Not enjoying things, including the baby
• Being unable to sleep even when the baby sleeps, or sleeping all the time
• Changes in appetite, and feeling exhausted beyond normal tiredness
• Guilt, shame, or pulling away from family and friends
• Frightening thoughts that pop into your head about the baby coming to harm

Those unwanted thoughts are common and do not mean you will act on them. They are worth telling a doctor about, because they respond well to treatment.

Partners can get it too#

Fathers and partners can also become depressed after a baby arrives. Lost sleep, money pressure, relationship strain and a past history of depression all raise the risk. In partners it often shows up as irritability, drinking more, withdrawing, or working longer hours. It deserves the same attention and the same help.

Postpartum psychosis is an emergency#

Postpartum psychosis is rare, affecting around 1 in 1,000 mothers. It usually starts suddenly in the first two weeks after birth. Signs include confusion, seeing or hearing things others do not, strange or fixed beliefs, racing thoughts, extreme restlessness, or not sleeping at all. The person may not realize they are unwell, so family often notices first.

If you see these signs, call your local emergency number or go to the nearest emergency department now. With fast treatment, most people recover fully.

If you or someone you love has thoughts of suicide or self-harm, reach out now:

• If you might act on thoughts of suicide or self-harm: call your local emergency number now.
• US and Canada: call or text 988, any hour.
• UK and Ireland: Samaritans, 116 123, any hour.
• Anywhere else: findahelpline.com lists free lines by country.

Treatment works#

Postpartum depression is not a sign that you are a bad parent, and it is not your fault. It is one of the most treatable problems after birth. Talking therapies, such as cognitive behavioral therapy and interpersonal therapy, work well. Medicine is an option for some people.

If you are breastfeeding, many treatments are still possible. Talk through the options with your doctor, so you can weigh what is right for you and your baby together.

Practical help matters too. Ask someone to take a night feed so you can sleep a longer stretch. Accept meals, visits and errands. Get outside in daylight when you can.

In the US, the National Maternal Mental Health Hotline, 1-833-TLC-MAMA (1-833-852-6262), offers call or text support at any hour, in English and Spanish. Your obstetric clinician, midwife, or your baby's doctor can also start the conversation. If you want a specialist's view before an appointment, a psychiatrist on our team can answer one question in writing within 24 hours for $29.

Where to take this next#

Postpartum depression shares a lot with depression at other times of life, and the fuller guide to depression explains the signs, the treatments, and how to find the right place to start.