Eager to learn where we're opening next? Join our growing community.
Back to articles

Warning Signs & Symptoms: the Difference Between Postpartum Blues, Depression, Anxiety, and Psychosis

October 9, 2023
Isabelle Pope
Image Credit: Cottonbro

As a new mom, you are often expected to be ecstatic about your new role and head-over-heels in love with your newborn, even as you're navigating your own recovery; but the reality is that it’s common for new moms to feel overwhelmed, tired, anxious, sad, and frustrated. These feelings are normal, considering that you have just experienced a massive life change that was made more difficult with hormonal imbalances, physical challenges, and oftentimes a lack of proper social support. This can lead to a shift in mental health, increasing the risk for development of potentially debilitating conditions.

The holidays call for additional attention, as mothers are put under tremendous pressure with social obligations and may feel even more vulnerable. In this article, we cover the symptoms of the baby blues, postpartum depression, postpartum anxiety, and postpartum psychosis, and outline the differences.

The Baby Blues

As much as 80% of new mothers are affected by the baby blues: feelings of sadness that begin 2 to 3 days after giving birth and can last up to two weeks. The baby blues are usually caused by a combination of factors, such as hormonal changes (your levels of progesterone and estrogen drop significantly while prolactin and oxytocin surge) along with emotional distress that comes with having to take care of a new baby, lack of sleep, and worries about being a good mom. Common symptoms of the baby blues include:

  • Weepiness or crying for no apparent reason
  • Impatience and irritability
  • Restlessness
  • Anxiety
  • Insomnia, though you feel fatigued
  • Sadness
  • Mood changes
  • Poor concentration

While the baby blues are considered "normal," it can feel isolating for a new mother to deal with the symptoms alone. It's crucial that you show yourself compassion and recognize that you're not alone, nor are you a bad mother for not being able to intuitively "figure it out." Seek support from friends, family, or a mommy group, and openly share how you're feeling - the key to overcoming this tough phase is to draw on relationships in which you feel safe and seen.

*We also have an article dedicated to the baby blues that you can check out here

Postpartum Depression

The signs of postpartum depression are similar to those of the baby blues, except they are more intense, and continue longer than two weeks after childbirth and can eventually impact your ability to complete daily tasks or care for your newborn. Also like the baby blues, hormonal changes play a part in the development of postpartum depression, but more factors are typically at play such as family mental health history, pregnancy complications, and limited social support; it usually develops within the first 6 weeks and is more common in adolescents, mothers who deliver prematurely, and women living in urban areas. Symptoms include:

  • Constant crying that feels uncontrollable
  • Continuation of depressed moods or severe mood swings
  • Difficulty bonding with your baby
  • Insomnia or oversleeping, though you feel overwhelming fatigue
  • Trouble with finding joy as you did before
  • Feelings of worthlessness, shame, guilt, or inadequacy
  • Lack of energy to concentrate/focus
  • Thoughts of harming yourself or your baby
  • Thoughts of suicide

There is no shame in seeking help for postpartum depression. Contrary to belief, PPD is fairly common: studies show that 1 in 7 new mothers are diagnosed with PPD, but the actual number is estimated to be higher, given that as many as half of PPD go undiagnosed due to mothers' tendency to avoid disclosing due to the stigma surrounding the issue. The good news is that there is a wide range of treatment options available which are usually effective, such as psychotherapy and medication. If you or your partner is noticing any of the signs of PPD, you should not hesitate to reach out to your care provider as soon as possible for diagnosis and appropriate treatment. If you are thinking of harming yourself, your baby, or others, reach out to 988 (the Suicide & Crisis Lifeline) via phone or text message to connect with a trained counselor who will be available 24/7 to help.

Postpartum Anxiety

Some anxiety is due after introducing a newborn into the world, but if you have postpartum anxiety, you may be feeling consumed with excessive worrying and fear day and night. Though hormonal changes and family mental health history could contribute to postpartum anxiety, the pressure to be the perfect parent, stressful events such as trouble with breastfeeding or a risky pregnancy, can also be responsible. Usually, mothers with “type A” personalities are more likely to develop this condition. Symptoms postpartum anxiety include: 

  • Inability to relax or keep calm
  • Racing thoughts, especially regarding worst-case scenarios
  • Having irrational fears (i.e. feeling terrified that your baby will be hurt if you leave it alone for a few moments, even with a trusted adult like your partner)
  • Continued sense of danger, without a clear cause
  • Loss of appetite and nausea
  • Disrupted sleep due to anxiety (i.e. staying awake all night because you're worrying about your baby)

Studies estimate that between 11 to 21% of mothers are affected by postpartum anxiety, though the exact number is up for debate due to no official screening or diagnostic being in place for postpartum anxiety. It's usually identified during a screening for postpartum depression, though the two conditions are diverge in that PPD's main symptom involves excessive feelings of sadness while postpartum anxiety's main symptoms involves excessive worrying. Similar to PPD, postpartum anxiety is unlikely to go away on its own - seeking help from your care provider to assess the options for treatment, which could involve a combination of cognitive behavioral therapy, support from friends and family, exercise, and medication will be essential to addressing the condition and taking a step towards your and your newborn's long-term wellbeing.

Postpartum Psychosis

Postpartum psychosis is much less common, only affecting 1 to 2 out of 1000 mothers after childbirth, but is considered a serious mental health emergency. Of all the postpartum related mental health conditions, postpartum psychosis is the most severe because, in addition to symptoms that are very similar to postpartum depression, there are additional notable symptoms that put mothers at a much higher risk of hurting harming themselves or their children or dying by suicide:

  • Hallucinations
  • Delusions
  • Manic/low moods, or a mixture of both
  • Loss of inhibitions
  • Behaving in a way that's out of character

Hallucinations involve the inability to distinguish between false perception and reality; delusions are beliefs that are so strong they cannot be changed despite evidence otherwise presented. Though experts are still identifying the causes of postpartum psychosis, they suspect that it involves a combination of factors, including a personal or family history of mental health conditions (such as bipolar disorder, major depressive disorder, and schizophrenia), as well as hormonal changes, sleep deprivation or the number of pregnancies you have experienced. You should immediately seek the help of a mental health provider for an official diagnosis through a physical and neurological exam, and seek inpatient care for treatment, which ranges from medication to electroconvulsive therapy. It's important to note that due to the nature and danger of the condition, it is usually the friends and family members of the mothers who seek care on their behalf, as it's very rare that they can recognize their own symptoms early on. If you are pregnant and believe that you may be at risk due to your profile or history, it's crucial that you speak with your care provider and your family and friends to help you plan ahead. Though postpartum psychosis is considered to be extremely dangerous, it is also considered to be reversible with the appropriate treatment.

Discussing mental health conditions, particularly during a time when you're expected to love being a mother, can seem taboo, but it is necessary nonetheless. The postpartum period can often be a vulnerable time for new mothers. Amongst the holiday excitement, a struggling mom can easily be missed and her symptoms exacerbated due to the increased weight of obligations - it is important to check in with yourself frequently to assess how you are feeling, and ask your loved ones to do the same for you to ensure that the first warning signs can be sensed so that you can seek the support you need.

Related Posts