After-pregnancy blues: Cause for concern?

Up to 80 percent of all new moms feel sad, anxious, crabby or just plain tired after giving birth. It is no wonder so many new mothers get the “baby blues.” Even if delivery went well and their newborn is adorable, mothers are bound to be short on sleep and long on responsibilities, and their hormones are shifting.

The baby blues typically begin three to four days after delivery and tend to disappear by the 10th day.

When the blues stick around

“If a new mother’s blues persist or worsen, she may have a more serious condition called postpartum depression (PPD),” says Sheryl Kingsberg, PhD, Chief of Behavioral Medicine at University Hospitals MacDonald Women’s Hospital. “The same may be true if she begins to suffer several weeks or months after childbirth.”

Dr. Kingsberg says the following signs, if present beyond the first few weeks after childbirth, may indicate PPD:

  • Depressed mood
  • Loss of interest or pleasure in life
  • Unexplained weight loss or gain
  • Loss of appetite
  • Intense fatigue
  • Decreased energy and motivation
  • Unexplained difficulty falling or staying asleep
  • Intense worry about the baby or lack of interest in the baby
  • Extreme indecisiveness
  • Feelings of worthlessness, hopelessness or guilt
  • Agitation, irritability or anxiety
  • Thoughts about hurting oneself or the baby

“PPD affects about 10 percent of childbearing women,” says Dr. Kingsberg. It can make women miserable and undermine the confidence they need to care for their babies. Untreated, PPD could even interfere with the baby’s development.

Pinpointing PPD

PPD can be easy to ignore. After all, tiredness and other symptoms may result from sleep loss. And postpartum weight loss is a natural occurrence.

A doctor can determine whether symptoms are from another medical condition. Anemia, for example, can make sufferers very tired. Thyroid disorders also can cause symptoms similar to PPD.

Who is at risk?

Any new mother, especially a first-timer, can get PPD. “Who will develop PPD is hard to predict,” explains Dr. Kingsberg, “but a woman’s medical history and current circumstances can influence her odds.”

According to Dr. Kingsberg, factors that increase the risk for PPD include having:

  • Extreme mood swings right after giving birth
  • A previous depressive disorder
  • A history of severe PMS
  • Marital problems
  • Stressful life events
  • Little social support

What to do about PPD

PPD can be effectively treated with psychotherapy and/or antidepressant medications. In one study, women who received either treatment felt better within four weeks.

If you suffer from PPD, Dr. Kingsberg says the following coping strategies also may help:

  • Get sleep during the night. “Even if you are breast-feeding, let your partner, a family member or a friend help in the middle of the night. The brain chemistry related to mood requires sleep,” says Dr. Kingsberg.
  • Speak with a trusted friend.
  • Take at least 15 minutes each day to do something for yourself, such as exercise or even something as basic as taking a shower or a bath.
  • Keep a diary to record your progress toward recovery.
  • Join a support group for mothers with PPD.

Meet with one of our specialists

To schedule an appointment with a women’s behavioral medicine specialist, call 1-866-UH4-CARE (844-2273) or visit

Sheryl Kingsberg

Chief, Behavioral Medicine, UH MacDonald Women’s Hospital
Professor, Case Western Reserve University School of Medicine

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