What's the difference between baby blues and postnatal depression (PND)?
First published by Naytal in August 2021.
In brief:
Firstly, pregnancy, birth and transitioning to parenthood is hard - neither baby blues or Postnatal Depression is a sign of your inabilities as a mother
Baby blues is a natural response to the change of hormones immediately after birth - it is completely normal and tends to pass within 2 weeks
Symptoms of postnatal depression (PND) can start in pregnancy, or in the weeks and months following birth, and persist over time, getting in the way of your daily life
PND is highly treatable - it is important to reach out early and talk to your NHS GP or health visitor as soon as possible
Many women imagine new motherhood as a time of total fulfilment, days filled with baby bonding and abundant joy. This may well in part be true but we do need a hard reality check.
Pregnancy, giving birth and parenthood is hard, really hard. Transitioning into parenthood is a period of monumental change and spans all areas of life including social life, relationships, physical, emotional, career etc. Becoming a new mother (or father) is not instinctive. We don’t get trained up for what is a full-time 24/7 job. Oh, and you start this new job completely sleep-deprived and overwhelmed! The postnatal period is full of promise but it can involve a lot more than new parents bargained for.
Historically and even today in other cultures, rituals and community offerings would provide women with support for several months in order to recover. The culture we live in today has very different expectations of an individual compared to the times of community approach. Is it such a surprise that it may not all be plain sailing?
If you’ve come to this post, chances are you’re experiencing a form of ‘baby blues’ or postnatal depression (PND). Don’t worry, there is support out there for you. Read on to find out the difference between these two very common feelings and how you can get help.
What are the baby blues?
The baby blues is a natural response to the sudden and rapid drop of hormone levels after birth combined with sleep deprivation and changes in routine/identity. Women experience baby blues in their own unique way but common symptoms include fluctuating mood, tearfulness, irritability and anxiety.
When do baby blues start and how long do they last?
Up to 85% of new mothers experience baby blues and at most, it will last around 2 weeks.
Baby blues is a completely normal response and one which is not your fault. It’s certainly not a sign of your inability to cope as a mother! This may be hard to believe given the idealistic picture that modern-day society, social media and Hollywood presents us with; images of women after giving birth like it is a ‘non-event’. Baby blues can take women by surprise and they may question what it means for them, fuelling shame and comparison
So, what’s the difference between baby blues and postnatal depression?
The main difference between baby blues and postpartum depression comes down to persistence and severity of symptoms as well as the impact on life in general. Baby blues are transient and do not tend to get in the way of your daily functioning.
What postnatal depression (PND) is NOT - Myth Busting
Myth 1: It is caused by hormone imbalance or chemical imbalance Myth 6: It stops you from loving your baby
Myth 2: If you try hard enough you can snap out of it Myth 7: There is no cure
Myth 3: A depressed person is not stressed Myth 8: It doesn’t affect normal, healthy, successful people
Myth 4: PND only affects women Myth 9: If you have PND you are somehow weaker than others
Myth 5: It is not as serious as a physical problem Myth 10: If you have PND you will damage your baby
How common is PND?
Around 10-15% of mothers experience PND and for most, symptoms begin within pregnancy; thus, perinatal /antenatal depression may be more fitting.
What are PND symptoms?
When the joy we hope for is tempered with and despair endures we may be experiencing PND. Postnatal depression can sometimes start weeks or months after birth. The feelings an individual may have when experiencing PND are like those of depression at any other time in life.
Common PND symptoms include:
sleep disruption
feelings of despair and hopelessness
crying
obsessive thinking
anxiety and panic
irritability
negative ruminations
withdrawal and lack of interest / pleasure in activities previously enjoyed
Some women feel disconnected from their baby and have thoughts about harming themselves or their baby. A hallmark of depression is rumination and harsh self-critical thinking. Pressure and expectations from self as well as family, friends, society can perpetuate feelings of shame and inadequacy.
NOTE: If you are experiencing, severe symptoms such as hallucinations, delusions, mania, confusion, extreme low mood or other out of character symptoms, this could be a side of postpartum psychosis. This is a serious mental illness that affects around 1 in 500 mothers after giving birth and should be treated as a medical emergency.
Why does postnatal depression happen?
Although some debate exists around PND it can broadly be explained in terms of a biological, psychological and social adjustment. Compared to other life events, pregnancy can lead to extreme changes in feelings of control, routine and roles. For example, changing from a career role into a mother role. There are multiple simultaneous adjustments including relationships, body, mobility, emotional, responsibility, pace of life, loss of routine, identity, not putting yourself first, lack of focus to name a few.
In addition, it is important to understand the context of the pregnancy when we consider adjustments. Pregnancy may be unexpected and unplanned or a result of multiple rounds of IVF. Added to that is our previous experiences of being human that have led us here.
We also have a brain that is wired to be efficient for cavemen days, not our current glitzy fast-paced society. When we consider evolution, symptoms of depression like shutting down and withdrawal may have been helpful at one point in our history signalling a call for help to our surrounding community.
Self-criticism may also have an evolutionary role to motivate us and protect us from failure. Thus, postpartum depression is a human condition and should be viewed as a natural consequence of being human combined with a series of factors including our previous experiences, our tricky brains, birth experience, social support, relationships, societal expectations. Remember, you didn’t choose any of this; PND is not your fault and is not in any way a reflection of your capacity as a mother.
Getting help for postnatal depression
The key things to remember are:
Reach out and connect with others, tell someone how you feel
Mindfulness, gratitude, acts of kindness
Take care of your relationships
Make time for things that matter to you
Watch out for your harsh judgements and self-criticism – practice compassion
Gentle movement and activity (if you are able)
Rest/sleep when your baby is napping & maintain a healthy diet
Speak to a mental illness professional to get expert support
Accept help & support to care for your baby and you when possible
We know PND is highly treatable and there are many approaches shown to significantly improve women's functioning and well-being. It is important to reach out early and talk to your NHS GP, midwife or health visitor or as soon as possible; remember, you are not alone and it is their job to help you feel better. They will discuss your options – a number of support groups and talking therapies (CBT, CFT, MBCT) are available as well as other options including medication.
Unfortunately, mother and father’s experiences are too often clouded by stigma, shame and guilt which can get in the way of seeking support. Getting the right help firstly requires a system change and society to recognise and celebrate pregnancy, birth and parenting for what it is. This involves providing understanding, care and support as early as the first trimester.
References:
Cree, M. (2015). The compassionate mind approach to postnatal depression: Using compassion focused therapy to enhance mood, confidence and bonding. Hachette UK.
Wenzel, A., & Kleiman, K. (2014). Cognitive behavioural therapy for perinatal distress. Routledge.
Bardacke, N. (2012). Mindful birthing: training the mind, body, and heart for childbirth and beyond. Harper Collins.
Scotland, M. (2019). Why Post Natal Depression Matters (Vol. 15). Pinter & Martin Ltd.
