New mothers often face emotional challenges after childbirth, but not all postpartum emotions are the same. While the baby blues are a temporary phase, postpartum depression is a more serious condition that requires immediate attention. Here’s how to tell the difference and when to ask for help.

In the leadup to welcoming a new baby, everyone is focused on the new addition—especially the parents-to-be. It’s a frenzy of final doctor’s appointments, baby showers, setting up a nursery, washing tiny sleepers and socks and hats, debating and choosing a name, and so on. In this whirlwind of preparation, it’s easy to lose sight of what happens physically for new moms in the aftermath of childbirth. This is especially true for first-time parents who don’t know what to expect.

Childbirth is a major physical and emotional feat for women. The hormonal upheaval once the baby is born is often intense and unexpected. The person who has given birth may experience mood swings, tearfulness and irritability as their body starts to recover from nine months of pregnancy and the act of giving birth, and then readying to breastfeed a newborn. These symptoms are often referred to colloquially as “the baby blues.” But the fact is, this is completely normal for up to a couple of weeks.

For some women, however, these overwhelming emotions persist. When this emotional instability intensifies and even expands, it may be classified as postpartum depression (PPD). Read on to learn more about the baby blues and PPD, the key differences between the two and when to seek help.

What are the Baby Blues?

After delivery, the levels of estrogen and progesterone drop dramatically, triggering an emotional response. This begins soon after a baby is born—usually around day four or five. It often coincides with a woman’s milk production ramping up. This hormone drop coupled with the new demands of parenthood, sleep deprivation, a new routine, etc. can make for an emotionally messy time. Common symptoms include the following:

• Mood swings
• Episodes of crying
• Irritability
• Anxiety
• Insomnia or trouble sleeping

These symptoms are usually short-lived, often improving as new parents find their groove in the early days with their newborn. Women usually notice the rollercoaster of emotions tapering off within a couple of weeks.

What is Postpartum Depression?

Postpartum depression is a more serious and long-lasting mental health condition that occurs as a result of childbirth. The Government of Canada’s 2018-2019 Survey on Maternal Health showed that an average of 23 percent of Canadian women who recently gave birth experience PPD. That’s nearly one in four people. Unlike the baby blues, PPD doesn’t resolve within a couple of weeks of childbirth, and it can have a profound impact on a new mom and her ability to care for her infant. New moms usually start to show symptoms within a month of delivery, but the onset of symptoms can develop for up to a year after welcoming a new baby.

Common symptoms include the following:

• Persistent feelings of sadness or hopelessness
• Loss of interest in daily activities, including personal hygiene and caring for their child
• Severe mood swings, irritability or outbursts of anger
• Extreme fatigue or lack of energy
• Insomnia
• Appetite changes
• Feelings of worthlessness or guilt
• Thoughts of harming oneself or their infant, in severe cases

Postpartum depression often requires medical treatment, including therapy or medication.

How to Tell the Difference Between the Baby Blues and Postpartum Depression

While both conditions look similar to one another in the early days after childbirth, the differences lie in the severity, duration and impact on daily life. The baby blues are usually relatively mild and fleeting (though they don’t feel like that in the moment!), and women in this stage of postpartum can still look after themselves and their new baby. They are able to bond with their child, and they notice a steady improvement in their emotions as they settle into their new normal.

On the other hand, for women experiencing PPD, their symptoms can last for weeks or even months. They are disruptive to a mother’s ability to function, and they can impact how their interact with their child. If a mother is experiencing the symptoms we outlined above for more than two weeks, it’s time to seek immediate help.

How to Seek Help

The first step in getting help is speaking to a healthcare provider. Most obstetricians and midwives will do a mental health check at six-week follow-up appointments with their patients, but you can reach out to a family doctor sooner. In urgent situations, if you feel like you are going to harm yourself or someone else, you can even go to the emergency room.

Once you are diagnosed with PPD, your healthcare team will help to put a recovery plan in place. This may include psychotherapy, cognitive behavioural therapy (CBT), medication, support groups, and more. Rest, proper nutrition and quiet time for relaxation can also go a long way.

It’s imperative that women experiencing PPD feel supported by their family and friends, too. If someone you love is exhibiting symptoms, don’t be afraid to offer to help them get the care they need.