The Difference Between the Baby Blues and Postpartum Depression

What 70 percent of new moms need to know.


When TV personality/actress Vanessa Lachey revealed that she struggled with the "baby blues" after giving birth to her son Camden, a lot of people were confused — so much so that she issued a "clarification" a few days later:

"Several of you have asked about the difference between Baby Blues (what I had after having Cam) and Postpartum Depression," she wrote on her website, before going on to explain that 70-80 percent of new moms are affected by the baby blues, while only 10-20 percent suffer from postpartum depression, which, as she puts it, usually "lasts much longer than a few weeks with much more intense emotions."

So if at least 70 percent of new moms suffer from the baby blues—a normal, short-lived period of feeling sad, weepy or otherwise moody that is triggered by hormonal changes after giving birth—why do we hear so little about them?

Samantha Meltzer-Brody, M.D., Associate Professor and Director of the Perinatal Psychiatry Program, UNC Center for Women's Mood Disorders, thinks there's still a stigma attached to admitting that you're feeling sad after you've just given birth to a beautiful baby.

"There's societal pressure to feel happy and blissful, so women don't talk about [the baby blues]. There's enormous guilt and shame," attached to the experience, Meltzer-Brody says.

But there shouldn't be. Levels of the hormones estrogen and progesterone are sky-high during pregnancy—higher than they will ever be at any other time in a woman's life—and after delivery of the baby and the placenta, they plummet. This neurobiological process triggers the baby blues.

Plus, especially for first-time moms, you've just been through the birth process, which is both profound and exhausting—and you've just been handed a brand-new baby to take care of, manual not included, Meltzer-Brody explains. Other factors could make you even more likely to experience postpartum mood changes, such as a traumatic birth, if you didn't go into labor (as in a planned c-section or induction), if you're having difficulty breastfeeding, sleep deprivation, whether you have a personal/family history depression and how much social support you have (or don't have) at home.

But isn't being a new mom supposed to be a joyful state like no other? In fact, isn't it supposed to be the happiest time of your life? While there's no doubt that giving birth and meeting your newborn is one of the most special and amazing times in a woman's life, Meltzer-Brody thinks these claims of being "blissed out" are exaggerated for most people.

"The vast majority of women find both the birth and the transition to motherhood to be challenging. Certainly there's lots of joy and it's a time of great happiness, but it's really difficult the first few weeks," she says.

Count Jennifer Lopez in that "vast majority." The superstar revealed last year that she suffered from the baby blues about a week after giving birth to her twins, Max and Emme, in 2008.

Meltzer-Brody thinks it's important for women to know the signs and symptoms of both the baby blues and postpartum depression before giving birth, so they'll know what to expect if they're among the majority of women who experience short-lived mood changes (the baby blues), or whether they might need to seek treatment for something more severe and persistent (postpartum depression). Here's a cheat sheet you can pack in your hospital bag:

Baby Blues

1. You feel weepy (crying "all the time"), emotional and/or profoundly vulnerable. Some women describe it as "very bad PMS," Meltzer-Brody says.

2. Your symptoms last about two weeks after giving birth.

3. You also might experience mood instability, depressed mood, sadness, irritability, anxiety, lack of concentration and/or feelings of dependency.

Postpartum Depression

1. Your symptoms last longer than two weeks after giving birth, are much more severe than baby blues symptoms and interfere with functioning.

2. You might experience feelings of anxiety, sadness (crying a lot), depression, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, thoughts of hopelessness and sometimes even thoughts of harming the baby or yourself, rumination, obsessions, loss of interest in usual activities, feeling worthless, incompetent or inadequate to cope with your baby, fatigue and/or excessive worry about the baby's health.

3. Postpartum depression typically emerges over the first 2-3 months after childbirth but may occur at any point after delivery.

"Generally I tell people if two weeks go by and the symptoms of anxiety and depression persist, the woman needs to contact her doctor for an evaluation by her ob-gyn," Meltzer-Brody says. Your doctor will then follow you or refer you to a specialist for possible treatment, which most commonly can include psychotherapy, medication therapy, some combination or other types of treatment. Women experiencing the baby blues can also find some relief early on by obtaining extra sleep and adding more social support and help if possible, she adds.

Meltzer-Brody thinks it's terrific that celebs like Lachey and Lopez are coming forward to talk honestly about their experiences with the baby blues.

"I would like people to understand is that it's just common, to really try to help people remove the stigma of this. They should not be embarrassed in any way about asking for help," she says.