Which symptom differentiates peripartum blues from major depressive disorder?

• A. Inability to enjoy the baby
• B. Excessive crying
• C. Weight gain
• D. Improved appetite

Answer: (A)

The key idea is that postpartum blues are short-lived mood changes after delivery, with tearfulness and mood swings that usually resolve within a couple of weeks. Major depressive disorder in the postpartum period, however, involves persistent depressed mood with a clear loss of pleasure in activities, including the inability to enjoy the baby (anhedonia), lasting at least two weeks and causing significant impairment. The symptom of not being able to enjoy the baby points to anhedonia, which is characteristic of major depressive disorder rather than the transient blues. Excessive crying can occur with blues, while weight or appetite changes are non-specific and can appear in different states, so they don’t differentiate as clearly.