Postpartum Depression or the Baby Blues?

I gave birth six weeks ago, and am very irritable with everyone. I even get upset when the baby cries. Is this normal postpartum hormone adjustment, or postpartum depression?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Postpartum depression, beginning in the first two to three months after giving birth, occurs in about 8 to 20 percent of women. The baby blues, on the other hand, occur within a few days to a month after birth.

Usually "the blues" last a few days to a few weeks, but may recur during the first year postpartum due to stress or loss of sleep. After the initial excitement a new mom can experience a let down, a sense of vulnerability and even loss. She may feel an incredible responsibility and may mourn the loss of freedom. She may feel unloved and unlovable. Fatigue and sleep deprivation may play a major role in these sensations. She may feel sore, weak, and if there have been complications with her own health or that of the baby, the sense of sadness can become overwhelming.

Sometimes women experience the blues when their support systems become less available after the first few days or weeks. The new mom, especially a single mom or a mom who has had a cesarean, can feel that she has no time to care for her own physical and emotional needs.

Some mothers wonder how they are going to get everything done and if they can protect and care for such a vulnerable little creature. They become frightened at the strong contradictory emotions they feel.

Support and assistance from your partner, family or friends is vital. It can mean the difference between significant improvement and sliding deeper into true depression.

Signs of Postpartum Depression

Postpartum depression is very similar to the types of minor and major depression that may occur at any time of life. If it begins within the first three to six months after childbirth, it is considered postpartum depression. Some experts agree that this can be extended to one year postpartum.

Criteria for this type of depression include "depressed moods or loss of interest or pleasure in life nearly every day." This must be present with at least five of the following signs:

  • Markedly diminished interest or pleasure in all or almost all activities.
  • Significant weight loss or weight gain when not dieting, or a decrease or increase in appetite.
  • Insomnia or excessive sleepiness most of the day.
  • Agitation or slowness when handling daily activities.
  • Fatigue or loss of energy.
  • Feelings of worthlessness, or excessive or inappropriate guilt.
  • Diminished ability to think or concentrate.
  • Suicide attempt or recurrent thoughts of death.

    Some women are at higher risk than others for the development of postpartum depression such as women with a previous history of any type of depression, women with a family history of depression, adolescents and single mothers or mothers with little or no emotional or physical support.

What to Do for the Baby Blues

When you feel the blues setting in, remember the three keys to prevention and treatment: rest, exercise and nutrition.

Women who engage in a regular program of activity every day, eat a healthy diet and rest when their baby is resting have a reduced incidence of the postpartum blues.

Obtaining a good support system is essential. Family or partner support is crucial to giving the mother time for herself.

Join or start a mother's support/play group on a weekly or twice weekly basis. Start the search at a local school, your place of worship or the local community center. Women who support each other in discussions, childcare and empathy have an outlet for their feelings and will suffer less with the postpartum blues.

For Additional Information:
Depression after Delivery

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