Mental health

What's the difference between baby blues and postnatal depression (PND)?

August 6, 2021
Close up of woman's face partially covered by hair - baby blues PND - Naytal

Short on time? Then the key things to know are:

  • Firstly, pregnancy, birth and transitioning to parenthood is hard - neither baby blues or PND is a sign of your inabilities as a mother

  • Baby blues is a natural response to the change of hormones immediately after birth - it is completely normal and tends to pass within 2 weeks

  • Symptoms of postnatal depression (PND) can start in pregnancy, or in the weeks and months following birth, and persist over time, getting in the way of your daily life

  • PND is highly treatable - it is important to reach out early and talk to your NHS GP or health visitor as soon as possible

 

Many women imagine new motherhood as a time of total fulfilment, days filled with baby bonding and abundant joy. This may well in part be true but we do need a hard reality check.

Pregnancy, giving birth and parenthood is hard, really hard. Transitioning into parenthood is a period of monumental change and spans all areas of life including social life, relationships, physical, emotional, career etc. Becoming a new mother (or father) is not instinctive. We don’t get trained up for what is a full-time 24/7 job. Oh, and you start this new job completely sleep-deprived and overwhelmed! The postnatal period is full of promise but it can involve a lot more than new parents bargained for.

Historically and even today in other cultures, rituals and community offerings would provide women with support for several months in order to recover. The culture we live in today has very different expectations of an individual compared to the times of community approach. Is it such a surprise that it may not all be plain sailing?

If you’ve come to this post, chances are you’re experiencing a form of ‘baby blues’ or postnatal depression (PND). Don’t worry, there is support out there for you. Read on to find out the difference between these two very common feelings and how you can get help.

What is baby blues?

The baby blues is a natural response to the sudden and rapid drop of hormone levels after birth combined with sleep deprivation and changes in routine/identity. Women experience baby blues in their own unique way but common symptoms include fluctuating mood, tearfulness, irritability and anxiety.

How long do baby blues last?

Up to 85% of new mothers experience baby blues and at most, it will last around 2 weeks.

Baby blues is a completely normal response and one which is not your fault. It’s certainly not a sign of your inability to cope as a mother! This may be hard to believe given the idealistic picture that modern-day society, social media and Hollywood presents us with; images of women after giving birth like it is a ‘non-event’. Baby blues can take women by surprise and they may question what it means for them, fuelling shame and comparison.

So, what’s the difference between baby blues and PND?

The main difference comes down to persistence and severity of symptoms as well as the impact on life in general. Baby blues are transient and do not tend to get in the way of your daily functioning.

What is postnatal depression (PND)?

First off, let’s bust a few myths:

Myth 1: It is caused by hormone imbalance or chemical imbalance

Myth 2: If you try hard enough you can snap out of it

Myth 3: A depressed person is not stressed

Myth 4: PND only affects women

Myth 5: It is not as serious as a physical problem

Myth 6: It stops you from loving your baby

Myth 7: There is no cure

Myth 8: It doesn’t affect normal, healthy, successful people

Myth 9: If you have PND you are somehow weaker than others

Myth 10: If you have PND you will damage your baby

None of the above is true!

When the joy we hope for is tempered with and despair endures we may be experiencing PND. Around 10-15% of women experience PND and for most, symptoms begin within pregnancy; thus, perinatal depression may be more fitting.

PND can sometimes start weeks or months after birth. PND is like depression at any other time in life and common symptoms include sleep disruption, despair, crying, obsessive thinking, anxiety, panic, hopelessness, irritability, negative ruminations, withdrawal and lack of interest / pleasure in activities previously enjoyed.

Some people may feel disconnected from their baby and have thoughts about harming themselves or their baby. A hallmark of depression is rumination and harsh self-critical thinking. Pressure and expectations from self as well as family, friends, society can perpetuate feelings of shame and inadequacy.

Why does postnatal depression happen?

Although some debate exists around PND it can broadly be explained in terms of a biological, psychological and social adjustment. Pregnancy leads to changes in feelings of control, routine and roles. For example, changing from a career role into a mother role. There are multiple simultaneous adjustments including relationships, body, mobility, emotional, responsibility, pace of life, loss of routine, identity, not putting yourself first, lack of focus to name a few.

In addition, it is important to understand the context of the pregnancy when we consider adjustments. Pregnancy may be unexpected and unplanned or a result of multiple rounds of IVF. Added to that is our previous experiences of being human that have led us here.

We also have a brain that is wired to be efficient for cavemen days, not our current glitzy fast-paced society. When we consider evolution, symptoms of depression like shutting down and withdrawal may have been helpful at one point in our history signalling a call for help to our surrounding community.

Self-criticism may also have an evolutionary role to motivate us and protect us from failure. Thus, PND is a human condition and should be viewed as a natural consequence of being human combined with a series of factors including our previous experiences, our tricky brains, birth experience, social support, relationships, societal expectations. Remember, you didn’t choose any of this; PND is not your fault and is not in any way a reflection of your capacity as a mother.

Getting help for postnatal depression

The key things to remember are:

  • Reach out and connect with others, tell someone how you feel
  • Mindfulness, gratitude, acts of kindness
  • Take care of your relationships
  • Make time for things that matter to you
  • Watch out for your harsh judgements and self-criticism – practice compassion
  • Gentle movement and activity (if you are able)
  • Rest/sleep when your baby is napping & maintain a healthy diet
  • Speak to a professional to get expert support
  • Accept help & support when possible

We know PND is highly treatable and there are many approaches shown to significantly improve women's functioning and well-being. It is important to reach out early and talk to your NHS GP, health visitor or as soon as possible; remember, you are not alone and it is their job to help you feel better. They will discuss your options – a number of talking therapies (CBT, CFT, MBCT) are available as well as other options including medication.

Unfortunately, mother and father’s experiences are too often clouded by stigma, shame and guilt which can get in the way of seeking support. Getting the right help firstly requires a system change and society to recognise and celebrate pregnancy, birth and parenting for what it is. This involves providing understanding, care and support as early as the first trimester.

Looking for support with baby blues or postnatal depression? Book a consultation with our expert psychologists who offer online therapy and counselling from the comfort of your home.

References:

Cree, M. (2015). The compassionate mind approach to postnatal depression: Using compassion focused therapy to enhance mood, confidence and bonding. Hachette UK.

Wenzel, A., & Kleiman, K. (2014). Cognitive behavioural therapy for perinatal distress. Routledge.

Bardacke, N. (2012). Mindful birthing: training the mind, body, and heart for childbirth and beyond. Harper Collins.

Scotland, M. (2019). Why Post Natal Depression Matters (Vol. 15). Pinter & Martin Ltd.

Dr Victoria, Naytal Psychologist

Dr Victoria has over 10 years experience working with people who have a wide range of psychological difficulties. She holds honorary clinical lecturer status and has worked within a range of settings both within and outside of the NHS.

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