Telling the first two apart

The thing that separates the first two is not how bad it feels on the worst afternoon. It is time, and it is whether life still works.

The first one arrives in the first week, peaks quickly, and lifts on its own inside about a fortnight without anyone treating it. Tearful over nothing, irritable, flooded, and then it goes.

The second is still there after those two weeks. Low mood most of the day, most days. Nothing gives pleasure any more, including things that used to. Guilt that is out of all proportion to anything you have done. Sleep that is wrong in a way the baby does not explain, so you lie awake in the gap when you could be sleeping. Appetite changed. And often, thoughts about harm coming to the baby that horrify you.

Two more things worth knowing. It does not always start after the birth. For a meaningful share of women it began in pregnancy, or before it, which is why the field increasingly says perinatal rather than postnatal. And it is common. Not rare, not unusual, and not a comment on the kind of mother you are.