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Recognising Persistent Low Mood After Birth And What It Means For You

by Samaira Farid,
Dr Jade Thomas
Medically reviewed by Dr Jade Thomas
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There is a particular kind of flatness that can settle in after birth. It does not feel like the tearfulness of the early days, and it does not quite line up with the descriptions of postnatal depression you may have read. You are functioning and getting through the days, but there is a heaviness underneath, a tiredness that sleep does not fix, and a sense that something is off. Low mood after birth that does not fit neatly into the usual categories is common enough to deserve its own attention.1

Why mood shifts so dramatically after birth

In the first few days after birth, you may feel low, tearful, and anxious in a way that catches you off guard. This is often called the baby blues. A big hormonal shift happens across your brain and body after you give birth, and alongside the physical recovery and broken sleep, it helps explain that early wave of feeling. These feelings usually start around three to four days after birth and ease within about two weeks.210

When that low mood carries on past the early weeks, something else may be feeding into how you feel. The reasons behind persistent low mood after birth are not fully understood, though ongoing hormonal adjustment, the demands of caring for a newborn, and broken sleep all play a part. Sometimes the shift is gradual enough that it is hard to pinpoint when things started to feel different.311

Low mood postpartum and where postnatal depression fits

Postnatal depression, often shortened to PND, can build slowly. It tends to bring a persistent low mood, less enjoyment in things, fatigue, and difficulty bonding with your baby. It affects more than 1 in 10 women in the first year after giving birth, and it can start at any point in that year, not only in the weeks right after delivery.12

PND runs along a spectrum, from mild to more severe. At the milder end you may still be getting daily tasks done, but the effort it takes can feel out of proportion, and any sense of enjoyment or connection can feel muted. If you have felt this way for two weeks or more, it is worth raising with your GP or health visitor, even if your experience does not match the more severe descriptions you have come across.4

The thyroid connection that is often missed

One specific and treatable cause of persistent low mood after birth is postpartum thyroiditis. This is when your immune system causes inflammation of the thyroid gland, the small gland in your neck that helps set your energy levels. It usually develops between one and six months after delivery, and affects around 5 to 10 per cent of women.14

It often moves through phases. A spell of an overactive thyroid can be followed by an underactive phase, which tends to land around four to eight months after delivery. That underactive phase can leave you tired, low, anxious, and irritable, struggling to concentrate, and feeling cold a lot of the time. Because this overlaps so closely with baby blues or PND, the thyroid often goes unchecked.15

Your GP can check how your thyroid is working with a simple blood test. If you have symptoms but your first results come back in the normal range, it can be worth retesting later, since thyroid function can shift over the months after birth. Your GP can advise on the right timing based on how you are feeling.5

Recognising patterns in how you feel

When low mood is persistent but keeps shifting, it can be hard to describe accurately to a healthcare professional. Tracking how you feel over several days or weeks can help you spot patterns you might otherwise miss, and link how you feel to things like how well you slept or how much company you had.6

A mood diary does not need to be complicated. Each day, you might jot down your general mood, rate how strong the feeling is, and add a quick note about what you were doing or who you were with. Over a few weeks, that can show patterns worth noticing. It is also useful to bring to a GP or health visitor appointment, since it gives them a clearer picture than memory alone tends to.7

Taking the step to seek support for low mood postpartum

How you are doing emotionally is something healthcare professionals are meant to ask about during postnatal checks. Raising how you have been feeling is a routine and expected part of that care.16

In England, you can refer yourself straight to NHS Talking Therapies without needing a GP referral first. Access works differently across Scotland, Wales, and Northern Ireland, so if you are outside England it is worth checking what your local NHS services offer. Your GP or health visitor can also point you towards further support if you need it.8

Frequently Asked Questions

Sources

  • [1] What is maternal mental health?

    It does not feel like the tearfulness of the early days, and it does not quite line up with the descriptions of postnatal depression you may have read.

  • [2] What is the difference between postnatal depression and the baby blues?

    These feelings usually start around three to four days after birth and ease within about two weeks.

  • [3] Postnatal depression

    Ongoing hormonal adjustment, the demands of caring for a newborn, and broken sleep all play a part.

  • [4] Postnatal depression

    PND runs along a spectrum, from mild to more severe.

  • [5] Postpartum thyroiditis — Thyroid UK / British Thyroid Association

    Thyroid function can be checked with a blood test, and if symptoms are present but results are within normal range, retesting may be appropriate as thyroid function can shift over time in the postpartum months.

  • [6] Low mood and depression

    Mood tracking can help identify patterns that might otherwise go unnoticed, connecting emotional states to factors such as sleep quality and social interaction.

  • [7] Low mood and depression

    A mood diary can involve recording general mood each day, noting how strong the feeling is, and adding brief context about what you were doing or who you were with. Over time, this can reveal patterns.

  • [8] Find NHS talking therapies for anxiety and depression

    In England, you can refer yourself directly to NHS Talking Therapies without needing a GP referral. Provision and access routes differ across Scotland, Wales, and Northern Ireland.

  • [9] NHS Talking Therapies – NHS England

    If speaking to a GP feels hard, you can also refer yourself to NHS Talking Therapies in England, or check local NHS services if you are in Scotland, Wales, or Northern Ireland.

  • [10] NHS — Postnatal depression overview

    The baby blues typically starts around three to four days after birth and eases within two weeks.

  • [11] NHS — Postnatal depression overview

    The exact causes of persistent postpartum mood difficulties are not fully understood, but ongoing hormonal adjustment, the demands of caring for a new baby, and disrupted sleep are all considered contributing factors.

  • [12] nhsinform.scot

    Postnatal depression affects more than 1 in 10 women within the first year after giving birth. Its symptoms can develop gradually and include a persistent low mood, reduced enjoyment, fatigue, and difficulty bonding with the baby. It can start at any point in the first year.

  • [13] NHS — Postnatal depression overview

    If feelings of being down, anxious, or irritable have lasted longer than two weeks after the birth, speak to your GP or health visitor.

  • [14] Postpartum thyroiditis — Thyroid UK / British Thyroid Association

    Postpartum thyroiditis is an autoimmune condition that typically develops between one and six months after delivery, affecting approximately 5 to 10 per cent of women, and involves inflammation of the thyroid gland often causing a hyperthyroid phase followed by a hypothyroid phase.

  • [15] Postpartum thyroiditis — Thyroid UK / British Thyroid Association

    The underactive thyroid phase tends to occur around four to eight months after delivery and can bring tiredness, low mood, anxiety, moodiness, difficulty concentrating, and a persistent feeling of cold. These symptoms overlap closely with baby blues or PND.

  • [16] Postnatal care — NICE guideline NG194 (2021)

    Psychological and emotional wellbeing is something healthcare professionals are expected to check at every postnatal contact.