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Baby Blues vs Postpartum (Postnatal) Depression

Common feelings after birth and when to ask for professional help.

Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.

Feeling tearful, anxious or overwhelmed in the first days after birth is very common. It is often called the baby blues, and it affects many new mothers. It is not a sign that you are failing. Postnatal depression is different, and it is more serious and longer lasting, but it is common and treatable.

Baby blues

• They usually start two to three days after birth, when hormone levels drop.
• You may feel weepy, irritable, anxious or oversensitive, and have mood swings.
• They usually settle within about two weeks, without treatment.
• Rest, reassurance and support from people close to you help most.

When it may be more than the blues

If low mood, anxiety, loss of interest, trouble sleeping when baby sleeps, or difficulty bonding last longer than two weeks, or are getting worse, you may have postnatal depression. It can begin at any time in the first year, and sometimes during pregnancy. More than one in ten mothers are affected. It is not your fault, and it is not a sign of weakness. Partners and fathers can develop it as well.

Possible signs

• Feeling low, empty or hopeless most of the day, most days
• Losing interest or pleasure in things you usually enjoy
• Feeling worthless, or like a bad parent, or guilty without a clear reason
• Constant tiredness, or being unable to sleep even when your baby sleeps
• Changes in appetite
• Trouble concentrating or making decisions
• Feeling anxious, panicky or on edge, or having unwanted, frightening thoughts
• Feeling detached from your baby, or withdrawing from family and friends
• Irritability or anger that feels out of character

Anxiety is common, often together with depression. Some women also have frightening intrusive thoughts, such as images of harm coming to the baby. These are common, they are not the same as wanting to harm your baby and they do not mean you are dangerous. Still, tell your doctor, because they can be treated.

Who is more likely to be affected?

Postnatal depression can happen to anyone, including mothers with a healthy baby and plenty of support. It is more likely if you have had depression or anxiety before, or if you have little support, a stressful or traumatic birth, a baby with health problems, relationship difficulties or severe sleep deprivation. Having risk factors does not mean you will have it, and not having them does not protect you.

What helps

• Tell your partner, family or a friend how you feel, and ask them for specific help.
• Speak to your doctor, midwife or health visitor as soon as you can. You do not have to wait for your six-week check. Doctors and nurses often use a short questionnaire, such as the Edinburgh Postnatal Depression Scale, to understand how you are.
• Talking therapies, such as cognitive behavioural therapy (CBT), are effective. Many areas have perinatal mental health services.
• Antidepressant medicines may be recommended. Some are suitable during breastfeeding, so ask your doctor, and do not stop medication suddenly without advice.
• Support groups, in person or online, connect you with parents who understand.
• Protect your sleep where you can. Ask a partner or relative to do a night feed or take your baby for a few hours.
• Eat regular meals, drink water and get outside for a short walk each day.
• Lower your standards for housework and visitors for a while.

Most women recover fully with the right help. The earlier you get support, the sooner you are likely to feel better.

How partners and family can help

• Listen without trying to fix or judge.
• Take over practical tasks such as meals, laundry and shopping.
• Take the baby so she can sleep or have time to herself.
• Encourage her to see a doctor and offer to go with her.
• Look after your own wellbeing too, and watch for signs in yourself.

Postnatal psychosis: an emergency

Rarely, usually in the first few weeks after birth, a woman can develop postnatal psychosis. Signs include confusion, seeing or hearing things that are not there, strange or paranoid beliefs, rapid mood swings, feeling very high or agitated, and needing very little sleep. This is a medical emergency. Call emergency services or go to the nearest emergency department straight away. With treatment, women recover.

Get help immediately

If you have thoughts of harming yourself or your baby, or feel unable to cope, contact your doctor or your local emergency or crisis service right away. If you are in immediate danger, call your emergency number: 911 in the US and Canada, 999 in the UK and Ireland (112 also works in Ireland), or 000 in Australia. You can also reach a crisis line at any time:

• US: call or text 988, or call the National Maternal Mental Health Hotline on 1-833-852-6262
• Canada: call or text 988
• UK and Ireland: Samaritans, 116 123 (free)
• Australia: Lifeline, 13 11 14

Telling someone is not a sign of failure. It is the first step to feeling better. Our guide to the six-week postnatal check explains how doctors check on your recovery and mood.

Where to find more support

Organisations that offer information and support include Postpartum Support International in the US, PANDAS Foundation in the UK, Perinatal Anxiety and Depression Australia (PANDA), and your local health service.

This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.