Baby blues vs postnatal depression – we explain the difference between the two

Yes, there is a difference between feeling a little blue post birth, and the more serious concern of post- or perinatal depression. Here is what you need to know. By Kim Bell

During pregnancy, we eagerly anticipate the arrival of our baby and dream of all the time we will enjoy with them. After the birth, while this dream may become reality for many, it’s not quite so simple for others who experience this time as one filled with anxiety and stress.

American TV personality, beauty queen, model and actress, Vanessa Lachey, describes her experiences after the birth of her first son Camden (now 4) on her blog by saying: “I remember that first night in the hospital, after 14 hours of labour and three hours of pushing, how it was all worth it. I couldn’t understand how anyone could ever feel anything less than this enormous amount of pure love.”

She shares how she felt at peace. “I knew this was what I was meant to be: a wife, and a mother to these two amazing people. Nothing in the world was ever going to change that or take that away from me…”

But then, tiredness and hormones kicked in, and Vanessa faced what up to 80% of new mothers experience: baby blues.

She writes: “I was feeding Camden and crying my eyes out. I felt like I had officially come undone. I imagined blissful days and tired nights, but quiet, loving moments. I imagined family dinners with the 12 casseroles I had prepared ahead of time, and a beautiful post-pregnancy glow that embodied me 24/7. But this was none of that. I didn’t feel like myself. Where was the super woman who always thought and knew she could do it all?”

ALSO SEE: Adele talks about her experience of postnatal depression

What are baby blues?

These feelings of irritability, of being completely overwhelmed and losing yourself that set in after birth are completely normal, due to ping-ponging hormone levels, very little sleep, recovering from pregnancy and birth and the realisation that this little person is completely dependent on you. The good news is that baby blues last only a couple of weeks post birth.

However, if dark feelings of hopelessness linger longer, you may be experiencing perinatal depression. According to Dr Lavinia Lumu, a specialist psychiatrist at Akeso Clinic in Randburg, the prevalence of perinatal depression (pre- and post-childbirth) is as high as around 20% in South Africa, while postnatal depression sits at around 34.5%. And, while research on antenatal depression is limited, studies suggest that this is as high as 39%.

What is perinatal depression?

This refers to depression that occurs during the perinatal period, starting during pregnancy and persisting for up to 12 months post birth. Dr Lumu explains that in the past, the focus was more on postnatal depression. However, research reveals that, quite often, depression starts during pregnancy itself. The term perinatal depression (PD) encompasses both antenatal and postnatal depression. Dr Lumu adds that women who have experienced PD in their past pregnancies, are at risk of having PD in their next pregnancies. “If a mother has had a previous history of PD, it is essential that they inform their healthcare provider. This will ensure close monitoring and early intervention in the next pregnancy.”

ALSO SEE: What you need to know about depression during pregnancy

Symptoms of perinatal depression

Symptoms include:

  • The inability or lack of desire to take care of yourself and/or your baby
  • Low appetite
  • Extreme fatigue
  • Memory problems
  • Persistent feelings of sadness
  • Hopelessness
  • Helplessness
  • Insomnia
  • Feelings of panic.

In severe cases, there may even be suicidal thoughts. “Psychotic features and thoughts of infanticide can also occur in severe cases,” Dr Lumu adds.

Actress Lena Headey, who plays Cersei on Game of Thrones, recently admitted that she was diagnosed with PD while filming the intense first season of the popular show. “I saw a great guy and he sorted me out, but I did the first year in that space, figuring out motherhood and going through a weird time personally. It was tricky,” she said in a recent interview with The Edit.

Brooke Shields is another celebrity who has famously tackled postnatal depression. In her book, Down Came the Rain: My Journey With Postpartum Depression, which was released in 2006, she wrote: “At first I thought what I was feeling was just exhaustion, but with it came an overriding sense of panic that I had never felt before … I started to experience a sick sensation in my stomach; it was as if a vise were tightening around my chest. Instead of the nervous anxiety that often accompanies panic, a feeling of devastation overcame me.”


Mild depression can be managed with counselling. Moderate to severe PD would usually require medication.

Bad mothers?

Importantly, being depressed does not mean that you are not a good mother, says Dr Lumu. However, if the depression is untreated, the neonatal outcomes may be harmful. “Depressed mothers are more likely to not want to nurture or spend time with their babies. It is essential that depressed mothers are identified and treated effectively so that they are able to care for their babies as well.”

Family assistance

Your partner can assist by helping with household duties or other duties that would usually be conducted by the new mother, advises Dr Lumu. “Family may assist with attending to the other childrens’ needs. It is essential that support is provided with the care of the newborn and that the partner, above all, provides the necessary emotional support to the new mother. Interestingly, perinatal depression is not just limited to women, with research showing that there is a phenomenon of fathers also developing postnatal depression. It is, therefore, vital that new fathers are also supported by family and friends, to prevent this outcome, concludes Dr Lumu.

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