Baby Blues vs. Perinatal Depression and Anxiety

The Perinatal Period  

Being pregnant or having a new baby, also called the perinatal period, is a time full of emotional ups and downs. Many factors can influence your mood including lack of sleep, hormone fluctuations and day-to-day stressors. Usually, these mood swings are normal, but many women experience severe depression or anxiety during the perinatal period. It is important to know what is normal and what is not, and how to get help for yourself or someone you love.

What is normal?  

Up to 80 percent of women experience mood swings and other symptoms that are frequently called postpartum blues or “baby blues.”[1]

Symptoms may include:

• Rapid mood swings
• Irritability
• Crying spells
• Difficulty sleeping
• Difficulty concentrating
• Feeling overwhelmed

These symptoms typically start within two to three days after delivery and end within two weeks. [2] Women with postpartum blues may experience drastic mood swings, but are able to enjoy their new baby. These feelings are thought to be related to changes in hormones after delivery. Postpartum blues is not considered a mental health issue and treatment is not necessary unless the symptoms persist past two weeks after delivery.[3]

What is not normal?

Up to 20 percent of women experience a depressive or anxiety disorder in the perinatal period.[4] This can occur during pregnancy and up to one year postpartum.[5] Postpartum depression or anxiety and postpartum blues have similar symptoms. The difference is postpartum depression or anxiety symptoms are more severe and last longer. Additional symptoms to watch out for include:

• Significant changes in appetite or weight
• Lack of interest in self-care – showering, brushing teeth, getting dressed, etc.
• Feelings of being overwhelmed, hopelessness or sadness that don’t go away
• Uncontrolled worry or intrusive, scary thoughts
• Panic attacks
• Isolation

When is there an immediate danger?

Depression or anxiety may increase to the point of being a medical emergency. If any of the following occur, call 911 or go to the nearest emergency department:

• Suicidal thoughts – thoughts of wanting to hurt yourself
• Homicidal thoughts – thoughts of wanting to hurt your baby or someone else
• Hallucinations – seeing or hearing things that others cannot
• Delusions – believing things that are not true, such as feeling that others are out to get you

When should I get help?

• If symptoms start affecting your ability to do your normal day-to-day routine
• If you continue to have these symptoms for two weeks or longer
• If you have thoughts of hurting yourself or others, have hallucinations or delusions, seek immediate help

How do I get help?

Getting help starts by letting someone know how you’re feeling. Reach out to someone you trust: your partner, family member, friend or clergy member. There are also many caring professionals who can help, including your primary care provider, OB-GYN, a psychiatrist or a counselor.

If you need help in taking that next step, call Seton Behavioral Health Care’s Resource Navigation Department at 512-324-2039 during business hours to speak with a licensed mental health professional. In emergencies, call 911 or Psychiatric Emergency Services at 512-472-4357.

Each pregnancy and baby is different and knowing what is normal as a mom can be hard.  If you find yourself struggling with depression or anxiety, ask for help and be vocal about how you’re feeling.

[1] https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml

[2] http://www.acog.org/-/media/For-Patients/faq091.pdf?dmc=1

[3] http://www.acog.org/-/media/For-Patients/faq091.pdf?dmc=1

[4] http://onlinelibrary.wiley.com/doi/10.1111/1552-6909.12734/full

[5] http://www.acog.org/-/media/For-Patients/faq091.pdf?dmc=1

Co-contributor:

Dr. Nix is Chair of the Seton Women’s Health and Perinatal Network Clinical Care Council and a member of the Perinatal Steering Committee for Ascension Health. As an assistant professor for the Dell Medical School Department of Women’s Health, he is involved with clinical care, teaching, and patient safety. He has served on local, state, and national committees to promote patient safety in health care. For more information, visit:

Michael Nix, MD, FACOG
Assistant Professor, Department of Women’s Health
Dell Medical School
Seton Family of Doctors — Women’s Health
7900 FM 1826
Seton Southwest Health Plaza II, Ste. 205
Austin, TX 78737
512-324-9290