Baby blues, postnatal depression and postpartum psychosis

Feeling low after a birth can be part of the baby blues, but worsening mood, difficulty coping or a sudden loss of contact with reality need different kinds of help. Baby blues, postnatal depression and postpartum psychosis are different conditions.

When baby blues linger

Feeling low, anxious or irritable for a few days after a birth is common. The NHS says baby blues usually settle within 2 weeks. If symptoms continue, worsen or leave you struggling to cope, ask for help. You can contact someone before then.

Tell someone what would help today. You could ask for company, help with a meal or someone to take over a household task. You can ask for practical support alongside professional care.

Depression can look like anxiety or disconnection

Postnatal depression, called postpartum depression in the US, can involve persistent low mood, loss of enjoyment, guilt, anxiety, irritability or trouble concentrating. Some people struggle to sleep even when they have the opportunity, or find it hard to feel connected to their baby.

Symptoms can begin during pregnancy, soon after birth or up to a year afterwards. Fathers and partners can also experience depression after a baby arrives. Ask for help even if only some of these signs sound familiar.

Contact your GP, midwife or health visitor in the UK, or your doctor or a mental health professional in the US and elsewhere. They can ask how you have been feeling and discuss treatment. You could start with, “I am finding it difficult to cope, and it is not getting easier.”

Treatment can fit around feeding and family life

Treatment may include talking therapies, antidepressants or both. Many antidepressants can be used while breastfeeding; tell your doctor that you are feeding so they can discuss a suitable option. Do not stop a prescribed medicine without talking to your doctor.

A partner, relative or friend can help with appointments, childcare and household tasks. Ask the care team what support is available locally and how to contact them if symptoms change. Someone close to you can share what they have noticed at an appointment. You can describe how things feel to you too.

Postpartum psychosis needs immediate help

Postpartum psychosis often starts suddenly within the first 2 weeks after birth, although it can begin later. Signs can include hearing or seeing things that are not there, beliefs that are unlikely to be true, severe confusion, very high or overactive mood, or rapidly changing moods. The person affected may not recognise that they are unwell.

Seek immediate assessment for these symptoms. In the UK, contact a GP immediately and request assessment the same day; call NHS 111 if you cannot reach a GP. If you already have a crisis-team plan, use it. In the US, NIMH advises calling 911 or going to the nearest emergency department. Elsewhere, contact your emergency mental health service now. Do not leave this until a scheduled postnatal appointment.

This is a medical emergency. Hospital treatment is usually needed, and recovery is possible with appropriate care. A friend or relative may need to recognise the signs and make the call.

Crisis support and immediate danger

Call 999 now in the UK, 911 in the US or your local emergency number if you cannot keep yourself or your baby safe. Do not wait for a routine appointment or a listening service.

Get urgent mental health help now for thoughts of suicide or harming yourself or your baby. In England, call NHS 111 and select the mental health option. In the US, call or text 988. Elsewhere, use your local crisis service; use emergency services if there is immediate danger.

In the UK, Samaritans is available free, day or night, on 116 123. In the US, the 988 Lifeline also offers someone to talk to during emotional distress.