Learn the difference between normal stress, ‘baby blues’ and something more serious
My daughter was preterm and spent some time in the neonatal intensive care unit. I remember being completely unprepared for the emotional challenge of a sick baby. In my mind, my house was unkempt, my older son neglected, and I was a blubbering mess. Mind you, my lovely husband was there, holding down the fort and taking great care of our son, but I wanted to be able to do it all.
My insightful obstetrician recognized my stress level and gave my husband some concrete advice on what to look for with postpartum depression. She knew my type A personality. Along with all the other advice she gave us, she said that if I skipped my shower for a day or so to not worry — but if I skipped for a week then my hubby should call her. He totally related to that message, and while that was a cheeky way to talk about a serious subject, it points out how exhausting it is to be a new mom and how the village around her needs to make sure she is doing well.
Fortunately, our daughter was discharged and my stress level dropped dramatically when we went home. (I confess my “neglected” son thought the baby needed a breathing machine to blow her ears up because they were stuck to her head. Maybe too many cartoons while I was gone?)
But what if all had not been well? What is the difference between stress, “baby blues” and postpartum depression?
It can be hard for the most experienced doctor, midwife or nurse practitioner to tell the difference.
It comes down to how extreme the symptoms are and how long they persist. In our clinics, we use a questionnaire called the Edinburgh Postpartum Depression scale to identify moms who are at risk. We use this screening tool because research has shown that you can’t tell by outward appearance or a quick “how are you doing?” When we recognize that a mom is having more than typical symptoms, we are able to have our social work team step in to assist in identifying appropriate resources for help.
If you are a new mom or have one in your life, then you should know the signs of postpartum depression.
Warning Signs
- Low energy and refusal to do things she normally enjoys
- Not sleeping because she is sad
- Not feeling happy even with happy moments
- Feeling guilty and blaming herself even when small things go wrong
- Anxious and nervous about things out of her control (such as the health of her baby)
- Thoughts of harming herself or her baby
If you think that someone you love is suffering, offer to help. Make that meal, keep the older child and offer reassurance. Help her reach out to her OB provider or the baby’s pediatric provider and find out what resources are near her. These online resources may also be helpful. Postpartum depression is a serious mental health concern that shouldn’t be ignored. Awareness of the problem is a good place to start.
This post was written by pediatrician Anna Morad, M.D., director of the Newborn Nursery at Monroe Carell Jr. Children’s Hospital at Vanderbilt and assistant professor of Pediatrics at Vanderbilt University School of Medicine.

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Vanderbilt Women’s Health provides care for women at all stages of their lives at locations across Middle Tennessee. Learn more here or call 615-343-5700.