Postpartum Blues vs. Postpartum Depression: How to Recognise the Difference

Author: Oke Ikpekpe, MSc (PH)

Medical Reviewer: Dr Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

• Postpartum blues (baby blues) are common, temporary, mild mood changes that affect up to 85% of new mothers.
• Postpartum depression (PPD) is a serious mood disorder that affects about 1 in 10 moms
• PPD is more severe and lasts longer than the blues. 
• PPD symptoms include constant sadness,  anxiety, guilt, no interest in things or even suicidal thoughts. 
• Untreated PPD can affect both the mother and baby, causing emotional problems for the child later on.
• There is treatment for PPD, and it includes emotional support, self-care, therapy (like CBT), and safe medication, which can help mothers to recover fully. 

INTRODUCTION

A new baby arrival is wonderful! But you feel everything from excitement, love, joy, and it can sometimes mix with frustration and exhaustion. So, if you feel overwhelmed, down, or you're crying easily right after birth, know this is common. You're not alone! A lot of new moms have ups and downs early on. Your body and mind are adjusting to huge changes. Caring for a newborn is not easy work. Still, you need to know what's normal and what's not. This article will help you know the difference between the common postpartum blues and the more serious postpartum depression (PPD). That way, you'll know when it's time to reach out for support.

What Are Postpartum Blues?

Postpartum blues, also called the baby blues or maternal blues, are just a temporary mood shift. They happen a few days after birth.This is the most common and mildest mood swing. It's self-limiting. That means it just fades away. No meds or therapy are needed for this.Studies show that about 85% of new mothers experience baby blues. This happens partly because of the sudden hormonal shifts after childbirth, particularly the sharp drop in estrogen and progesterone, which are the hormones that help stabilise mood and emotions. 

When these hormone levels drop rapidly after childbirth, they can significantly influence your mood. At the same time, your body is undergoing physical recovery, adjusting to disrupted sleep patterns, and responding to the new demands of caring for a newborn.

These changes are natural, and they actually help you bond. But stress makes you vulnerable to big mood swings. Postpartum blues happen because of hormonal, physical, and emotional stress [1].

Symptoms of Postpartum Blues

If you're dealing with the baby blues, you might notice this:

• You're crying way more than usual.
• You get irritated easily.
• Unexpected mood swings. One minute you're fine, the next you're not.
• You're restless and have trouble sleeping.
• Headaches, forgetfulness, or you can't concentrate.
• You feel overwhelmed, anxious, or just lack confidence.
• You get brief moments of real sadness or frustration.

These are normal reactions. It's because of the hormonal and emotional shifts after birth. It may feel intense, but these feelings are short-lived [1,2].

Duration

Postpartum blues usually start quickly, a few days after delivery. They peak around days 3 to 5. The great news is they fade away on their own within two weeks. Most moms feel much better as they settle into their new routine.

What Is Postpartum Depression (PPD)?

PPD is serious. It's a major type of depression. Sometimes people call it postnatal or peripartum depression. It can start when you're pregnant, or any time in that first year after birth.According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), postpartum depression is defined as a major depressive episode that occurs during pregnancy or within four weeks after childbirth [3].  Lots of women get this months after the baby is born. It's not just the first few weeks. This is a real illness. It is not like the baby blues.Any new mom can get it, despite their age or background. Research shows that about 1 in 10 women get PPD [4].]Over 50% of mothers with PPD go undiagnosed and untreated [5]. So you have to know the signs so you can protect your family and yourself.

Symptoms of Postpartum Depression

PPD is way tougher than normal ups and downs. If these feelings last more than two weeks, please get help [2,4,6].You might notice:

• You cry constantly. 
• You get angry so easily.
• Persistent sadness. 
• You feel empty.
• Nothing is fun. You can't enjoy things you used to love.
• You can't sleep. Even when the baby is asleep, you're awake.
• You're tired, hopeless, and anxious. Focus is impossible.
• You pull back. You stop calling friends. You isolate yourself.
• You feel disconnected from your child. You doubt yourself as a mom.
• Appetite changes. Sex drive drops.
• You have thoughts about hurting yourself or the baby

If this sounds like you, and it's been over two weeks, call someone. You need and deserve support. 

Harm or Effect of Postpartum Depression on the Child

When PPD isn't treated, it's not just the mom who struggles. Children whose moms are struggling are more likely to face these problems later on:

• Learning Difficulties: Issues with poor concentration or cognitive functioning. 
• Emotional & Behavioural Issues: Problems like behavioural difficulties, violent behaviour, emotional struggles, and a higher risk of developing anxiety or other psychiatric disorders later in adolescence [6,7]
• While the majority of mothers with PPD do not harm their children, in rare cases, untreated PPD can progress to postpartum psychosis [8]. which is a psychiatric emergency associated with thoughts of self-harm (suicidal ideation) and, in very rare cases, harm to the baby (infanticide). 

The solution is early treatment for the mom. You get better, and your bond with your baby gets stronger.

Duration 

PPD lasts way longer than postpartum blues. It usually starts two to eight weeks after giving birth, but it can happen any time in that first year.Without help, PPD can last for months, even years. But with the right care, most moms recover completely. You will feel confident and happy again.

What are the risk factors for postpartum depression

These  are  conditions that make PPD more likely to occur [2,4,6]:

• You had anxiety or depression before.
• Mood disorders run in your family.
• No support from your partner or family.
• Relationship stress or domestic violence.
• Pregnancy was unplanned.
• Difficult delivery (preterm, baby needed Neonatal Intensive Care Unit [NICU]).
• Chronic illness or financial stress.
• Substance or alcohol use. It makes everything harder.

Key Differences Between Postpartum Blues and PPD

When to Seek Help

Your well-being is very important. You need to call your doctor, midwife, or someone you trust right away if [2,4]:

• Your feelings of sadness, anxiety, or emptiness persist for more than two weeks and do not seem to improve with rest or support.
  
  
• You feel emotionally detached from your baby, as though you are unable to connect or feel affection.
  
  
• You find it difficult to function in daily life, for example, you cannot sleep, eat, or manage routine activities.
  
  
• You have thoughts of harming yourself or your baby. This is a medical emergency and requires urgent professional help.
  
  

The earlier you recognise these signs and seek prompt support, the better your chances of preventing your symptoms from worsening and ensuring a faster recovery. For further guidance, refer to trusted resources such as the United Nations Children’s Fund (UNICEF) library or your local health authority.

Treatment and Support Options

PPD is serious, but treatment absolutely works! You do not have to struggle alone [9,10].

• Talk Therapy (psychotherapy): This is essential. Therapies like CBT (Cognitive Behavioural Therapy) and IPT(Interpersonal Therapy) help a lot. They're proven to work by fixing those heavy, negative thoughts.
• Counselling: It is slightly different from talk therapy. It focuses more on helping you manage current challenges and emotions in a supportive space. It’s a safe way to talk through what you’re feeling, gain reassurance, and find new coping tools.
• Medication: If symptoms are moderate or severe, your doctor can prescribe antidepressants. Common options include Selective Serotonin Reuptake Inhibitors (SSRIs) such as sertraline (Zoloft), fluoxetine (Prozac), or paroxetine (Paxil), which are generally considered safe for breastfeeding under medical supervision. In more serious cases, newer medications like brexanolone (an IV treatment) or zuranolone, the first oral drug approved by the U.S. FDA specifically for postpartum depression, may be recommended by a psychiatrist.
• Who Can Help: You can reach out to a psychiatrist (for medication), clinical psychologist (for therapy), or counsellor (for emotional support). Your doctor or midwife can also help you find the right specialist.
• Practical Help: You need this. Family support is vital. Let your partner or friends bring meals or watch the baby for an hour. This practical help makes healing faster.
• Peer Support: Join a group. Online or in-person. Connecting with other moms reminds you: You're not the only one.
• Others: Bright Light Therapy might be recommended, along with relaxation exercises or a simple massage to ease stress.

With the right help, recovery is totally expected. Most moms feel better within weeks or a couple of months.

Conclusion

The first few weeks with a baby are a bit rough with ups and downs. But if the sadness is constant, or you feel alone, that's a signal for you to get help.PPD and the blues are common. You're adjusting to motherhood, and your feelings are NOT your fault .If symptoms last over two weeks or just feel too much, please reach out. Asking for help is the strongest thing you can do. It shows huge love for yourself and your baby. 

Frequently Asked Questions (FAQs)

1. I cry all the time, but I still love the baby. Is that normal? 

Yes, usually. That's the baby blues mixed up. But if the sadness is really heavy or lasts more than two weeks, call your doctor. Could be PPD.

2. When should I call my doctor? 

If your mood is the same after two weeks or if you have any thoughts of harming yourself and the baby, call now.

3. Will PPD hurt my baby? 

Yes, untreated PPD can impact bonding and your baby's emotional development. But early treatment can prevent this.

4. Can I take medicine and still breastfeed? 

Yes. Some antidepressants are safe for breastfeeding. Your doctor will pick the absolute best for you both.

5. I feel guilty for needing help. What should I do?

 Stop feeling guilty. Getting help is the most responsible and loving thing you can do for your family. Healing starts the second you ask.

References

1. Okunola T, Awoleke J, Olofinbiyi B, Rosiji B, Omoya S, Olubiyi D. Postnatal blues: A mirage or reality. J Affect Disord Rep. 2021;6:100237. doi:10.1016/j.ja100237dr.2021.
   
   
2. UNICEF. What is postpartum depression? [Internet]. 2024 [cited 2025 Oct 17]. Available from: https://www.unicef.org/parenting/mental-health/what-postpartum-depression
   
   
3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington (VA): American Psychiatric Association; 2013. Available from: https://www.psychiatry.org/psychiatrists/practice/dsm
   
   
4. NHS. Postnatal depression (postpartum depression): Overview [Internet]. 2024 [cited 2025 Oct 17]. Available from: https://www.nhs.uk/mental-health/conditions/post-natal-depression/overview/
   
   
5. Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, Xiao X, et al. Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021;11(1):543. doi:10.1038/s41398-021-01663-6
   
   
6. Amer SA, Zaitoun NA, Abdelsalam HA, et al. Exploring predictors and prevalence of postpartum depression among mothers: Multinational study. BMC Public Health. 2024;24:1308. doi:10.1186/s12889-024-18502-0. Available from: https://www.researchgate.net/publication/380055846_Postpartum_Depression_Etiology_Tr…
   
   
7. Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health (Lond). 2019;15:1745506519844044. doi:10.1177/1745506519844044
   
   
8. Atuhaire, C., Rukundo, G.Z., Nambozi, G. et al. Prevalence of postpartum depression and associated factors among women in Mbarara and Rwampara districts of south-western Uganda. BMC Pregnancy Childbirth 21, 503 (2021). https://doi.org/10.1186/s12884-021-03967-3
9. Dimcea D, Petca RC, Dumitrașcu M, Șandru F, Mehedințu C, Petca A. Postpartum depression: Etiology, treatment, and consequences for maternal care. Diagnostics. 2024;14(9):865. doi:10.3390/diagnostics14090865. Available from: https://www.researchgate.net/publication/380055846_Postpartum_Depression_Etiology_Tr…
10. Centre for Addiction and Mental Health (CAMH). Postpartum depression [Internet]. 2024 [cited 2025 Oct 17]. Available from: https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/postpartum-depression
    
    

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published October 24, 2025