Three mood disorders can occur in new mothers: ‘baby blues’, postnatal depression, and postnatal psychosis.

‘Baby Blues’

‘Baby blues’, which most researchers’ think is caused by post-birth hormonal changes, affects up to 80% of new mothers between the third day and the tenth day after giving birth. Women with ‘baby blues’ are often tearful, irritable, and anxious, lack confidence in looking after their baby, and may worry about how they will cope at home. Typically, ‘baby blues’ lasts only a few days. No treatment is needed, but support and understanding from family and friends is helpful.

Postnatal depression (PND)

PND is a common problem, affecting at least one in ten new mothers. Symptoms usually appear in the first six months after childbirth, either gradually, over several months, or suddenly, but symptoms can appear at any time in the first year. In the effect it has on a woman, PND can range from mild to severe. Some women have few symptoms, which have little impact on their lives, while others are severely affected. A new mother of any age can develop PND. PND can happen to a woman who has had a natural childbirth or a caesarean. PND can occur after the birth of a woman’s first or any subsequent baby. A small number of women will experience PND after each pregnancy. PND occurs in all cultures, and was first documented 4,000 years ago, although what we now call PND has been described under various names (for example, two generations ago, ‘a nervous breakdown’). Early diagnosis of PND is vital, but with appropriate help most women who have it can expect to fully recover. If untreated, though, PND can persist through subsequent pregnancies, and can result in chronic depression.

Postnatal psychosis

Postnatal psychosis is a rare but serious illness. It affects 1-2 in every 1,000 new mothers, usually in the four weeks after giving birth. Symptoms include severe mood disturbance, confused thoughts, bizarre behaviour, insomnia, hallucinations (seeing, hearing, and feeling things that aren’t there), delusions (believing things that aren’t true), and inappropriate responses to a baby. In most cases, it is so obvious that something is very wrong with her that a woman who has postnatal psychosis will be diagnosed early and treated in hospital. New mothers who have a personal or family history of bipolar disorder or schizophrenia are at greater-than-average risk of developing postnatal psychosis, and pregnant women who have such a history should inform the health professional who is monitoring their pregnancy.

Don’t confuse them!

‘Baby blues’, postnatal depression (PND) and postnatal psychosis are separate conditions. In radio, TV, newspapers and magazines, though, they are often confused. PND is often described in the media as ‘baby blues’, with programs and articles about PND titled, ‘Birth of the blues’, or ‘Beating the blues’. PND is not ‘baby blues’ or ‘the blues’, and should not be confused with it. Similarly, the media often confuse PND and postnatal psychosis. Stories about new mothers who have tried to harm themselves or their baby have been labelled ‘PND’, when they are probably cases of postnatal psychosis. The media has also labelled instances of new mothers who have rejected their babies as cases of ‘PND’. Some new mothers with PND, being depressed and anxious, do find it difficult to bond with their baby, for a time, but most new mothers who have PND have a close, even over-protective, bond with their child. Because the media so often confuse the three disorders, many new mothers have an inaccurate understanding of what PND is, are afraid to admit they feel depressed, and are reluctant to seek professional help.