Depression after birth – more than the baby blues
How postnatal depression differs from the baby blues, what it looks like, why it is not a failure of love, and how to get help in South Africa.
Baby blues and postnatal depression are different
In the first days after birth most women feel tearful, irritable and overwhelmed. That is the baby blues, it is very common, and it lifts on its own within about two weeks. Postnatal depression is different: it lasts longer, it is heavier, and it does not lift by itself.
- Persistent low mood, or feeling numb and flat rather than sad.
- Not enjoying anything, including the baby, and feeling guilty about that.
- Exhaustion beyond what the broken nights explain, or being unable to sleep even when the baby sleeps.
- Anxiety, frightening intrusive thoughts, or constant fear that something will happen to the baby.
- Feeling that you are a bad mother, or that your family would be better off without you.
- Difficulty bonding with the baby.
Getting help
Every routine visit after birth — yours or the baby's — is a chance to raise it. Nurses and doctors ask about mood as part of maternal care in South Africa, and saying "I am not coping" is enough. The South African Depression and Anxiety Group also runs a support line specifically for postnatal depression.
- Talking therapy and counselling help, and are the usual first step for milder depression.
- Antidepressants are used for moderate to severe depression, and several are compatible with breastfeeding — tell the prescriber you are breastfeeding and it will be taken into account.
- Practical support counts as treatment: someone taking the baby so you can sleep a full stretch, help with food, help with older children.
- Bring your partner or a family member to the appointment if you can.
Antidepressants commonly used after birth in South Africa, chosen with breastfeeding in mind:
Sertraline — Zoloft, Serdep, Adco-Sertraline, Lustral
Major depressive disorder; OCD; PTSD; social anxiety disorder; panic disorder
Fluoxetine — Prozac, Lorien, Adco-Fluoxetine, Nuzak
Major depressive disorder; anxiety disorders; PTSD; OCD; bulimia nervosa
When it is urgent
Common questions
- How long do the baby blues last?
- Usually up to about two weeks after birth, and they lift on their own. Low mood that lasts longer than that, or that is heavy enough to stop you functioning, is more likely postnatal depression and needs help.
- Can I take antidepressants while breastfeeding?
- Several antidepressants are used while breastfeeding. Tell the prescriber you are breastfeeding so the choice takes it into account, and do not stop a prescribed antidepressant on your own.
- Can fathers get postnatal depression?
- Yes. Fathers and partners can develop depression after a birth too, and it is treatable in the same ways. It is worth raising with a clinician rather than waiting it out.
Sources
- Guidelines for Maternity Care in South AfricaNational Department of Health, South Africa
- Mental health support and crisis resourcesSouth African Depression and Anxiety Group (SADAG)
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
Last reviewed 11 August 2026.