Baby Blues vs Postnatal Depression – what’s the difference?

Parental transition coach Amanda Sasada clarifies the difference between these two postnatal conditions and what symptoms to look out for.

As mere mortals we apparently need to idealise when we go through massive life transitions like childbirth (or dare I say marriage) hence the plethora of perfect images around mother and newborn baby that we see online or in countless mags. This idealisation helps us to manage what might otherwise be too overwhelming an experience.

There is also a modern acceptance that it’s ok to talk about mental ill health but somehow this jars when it comes to early parenthood. It’s supposed to be amazing & life-affirming - isn’t it?

Baby Blues

The first shock can come just a few days in when the combination of lack of sleep and hormonal swing and a baby deciding it is very, very hungry leads to a coming down to earth with a bump ... think a post-holiday low with knobs on and crying a river. I have read stats that suggest 50% of women suffer the baby blues - as it’s often referred to. Personally, I think it’s 99.9%... but the good news is that it rarely lasts long. Perhaps a few days max….and chocolate really does help.

Postnatal Depression

This is a different beast. Any type of mental ill health that occurs in the first year after the birth is given this label. Postnatal illness is perhaps a more helpful description as this could manifest itself as anxiety or even mania. It is surprisingly common - with approximately 1 in 7 women and 1 in 10 men being affected.

It often creeps up, rather than coming on suddenly and, contrary to popular belief, is rarely linked to hormones at all in women. The biggest triggers are isolation and fatigue and for men, in particular, a response to navigating what is an all too often unacknowledged huge life transition.

Fatigue: how about a babymoon?

Of course, fatigue pretty much goes with the territory! But there are some very practical things we can do to counter this. The idea of a ‘confinement’ after birth is thought of by many to be old fashioned (although not in all cultures). I am going to call it a babymoon instead. It’s not the idea of a pre-baby trip to the Bahamas but a post-birth resting up period. The idea of this is to spend time with your baby and wallow in the love/bonding hormone oxytocin which is apparently at its highest immediately after birth and recovery period. I don’t have any research to draw on here but observationally, I have seen and personally experienced a huge benefit to doing almost nothing for the first couple of weeks post birth. I would highly recommend staying in the bedroom (Guests don’t stay long and usually bring you food and drink…it works a treat). It makes sense to give our bodies a chance to regain strength after birth and also gain some resilience for managing the sleepless nights ahead.

Secondly, it is very important to sleep when the baby sleeps. I have rarely met anyone who does this but I am going to suggest it anyway.

Isolation: the importance of talking

It is extremely important that isolation is avoided and for any new parent to link up with others in the community.... so engaging a key network but at home. It has been proven that meeting up with other parents once a week significantly reduces the chances of becoming depressed, as by talking to others we can ‘normalise’ the challenges of new parenting and this helps.

It’s not even a ‘modern day Costa thing’... it is part of our DNA that we should seek others for support at this time. Think the opposite of fight-flight, it’s more like hunker-down and huddle. After all, there’s support and safety in numbers. The modern part hasn’t helped in that family support networks are less likely to be present or local at least.

To dig a bit deeper, there is also some significant psychological processing (often subconscious) that we do around the time of birth and this may throw up unresolved past issues.

All of this can be the perfect storm when it comes to tipping the balance of mental wellness.

How do I know when to seek help?

It is not difficult to google the symptoms of postnatal depression but the most helpful two questions to ask are:

• Over a period of a few weeks... am I having more bad days than good?
• And am I not enjoying things I would normally enjoy?

If the answer to either or both of these questions is yes, it is time to visit the GP who is likely to suggest a combination of talking therapy and a short course of antidepressants. (These are the NICE guidelines). Exercise can also help hugely. The only good news is that it is treatable but by its very nature depression can be an isolating affair as shame and a feeling of simply failing can be a common thread. So not forgetting that having a baby can be the most wonderful experience, the general message is to keep talking.

It doesn’t matter who to... your partner if you have one, your friends or health professionals or even online forums. Share and be honest about your struggles or worries.

Almost certainly there will be others that are experiencing similar difficulties. Talking may be as a preventative effort to stay sane or as an honest reaching out. It doesn’t matter. In any event this is the key.

Baby Blues vs Postnatal Depression

Baby Blues

Timing: This typically kicks in around day three and lasts for a few days to a maximum of around a couple of weeks. Baby blues are thought to be due to sudden hormonal changes that take place after childbirth.

Symptoms:

•Feeling and being very tearful – almost for no apparent reason

•Feelings of overwhelm and low mood

•Anxiety and restlessness

Treatment: If it doesn’t resolve in within a couple of weeks or gets worse then it’s time to go to a doctor.

Postnatal Depression

Timing: This can kick in at any time and is not connected to, nor does it necessarily feed on from Baby Blues. It can start randomly a few months after giving birth. It’s worth noting that any mental illness experienced within the first year of a baby’s life is considered to be some form of postnatal depression.

Symptoms:

•Waking early and being unable to get back to sleep (although this can be hard to qualify given you will probably be rising early to look after your baby)

•Feeling at your lowest at the beginning of the day

•Feelings of hopelessness

•Unable to stop crying

•Not finding enjoyment especially in things you would normally

•Feeling unable to cope

•Panic attacks

•Sleeplessness

•Feeling unwell generally

•Anxiety

Treatment: Milder cases of postnatal depression are often helped with counselling. More severe depression may be treated with a combination of talking therapy and antidepressants.

Article credits: Leadership and Parental Transition Coach, Amanda Sasada