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Postpartum depression is having a depressed mood and other symptoms of depression during the postpartum period (up to 12 months after childbirth). It can be severe and affect your own wellbeing and your bonding with your infant and other children. Talk to a doctor as soon as possible.
What is postpartum depression?
Postpartum depression is a type of depression that occurs at any point during the postpartum period, which is the 12 months after childbirth. The depression lasts for more than 2 weeks. It includes symptoms like depressed mood, mood swings, changes in activity and sleep patterns, poor concentration, fatigue, guilt, and sometimes thoughts of death or self-harm.
Postpartum depression can also affect mother-infant bonding, and cause problems for the rest of the family.
Perinatal mood disorders, which include both prenatal and postpartum depression, affect up to 1 in 5 women during pregnancy or in the first year after childbirth. These disorders can involve symptoms like persistent sadness, anxiety, fatigue, and difficulty bonding with the baby. While the "baby blues" are common in the first couple weeks after giving birth, perinatal mood disorders last longer and can significantly impact a woman's ability to function and care for herself and her baby. It's important for pregnant women and new mothers to be aware of the signs and to seek help if they are struggling, as effective treatments are available. Healthcare providers play a key role in screening for these conditions and connecting women to appropriate mental health resources and support.
Recent studies suggest that about 12-15% of women may get postpartum depression. It may be related to genetic factors, hormonal changes, or a stressful home environment, according to a study in the Journal of Clinical Nursing.Unfortunately, women may not get help because they feel ashamed of being depressed during what is supposed to be a joyful time in a woman’s life. They may also be afraid that having postpartum depression means they’re a bad mother.
It is a real illness and not a reflection of who you are or your love for your baby. There are many safe treatment options, including talk therapy and medication.
Pro Tip
Having a child is one of the most important milestones in life and there are often a lot of expectations for how that experience will feel and what it will be like. Just like a person cannot change their body temperature at will, they cannot control their mood or emotional state after pregnancy. —Dr. Nikhil Nadkarni
Signs of postpartum depression
It’s important to know that postpartum depression is different from postpartum blues, also called “baby blues.” The baby blues are mild symptoms of depression that begin a few days after delivery and go away on their own within the first 2 weeks. They’re a normal part of the postpartum period for most mothers.
Postpartum depression lasts longer than the baby blues, and it can be severe in some cases. Symptoms often develop in the first few weeks after giving birth, but they can happen any time during the postpartum period. In some cases, symptoms may begin before or during pregnancy.
Symptoms of postpartum depression include:
- Low mood most of the time
- Decreased interest in activities that you used to enjoy
- Sleeping too much or too little
- Eating too much or too little
- Feeling restless
- Poor concentration
- Low energy
- Feelings of guilt or low self-esteem
- Thoughts of hurting oneself or suicide
You may also experience:
- Intrusive negative thoughts and feelings about the infant
- Fear about not being a good mother
- Reduced interest in the infant or other family members
- An inability to be consoled or comforted
Pro Tip
Women with postpartum depression often express feelings of inadequacy, guilt, shame, and disappointment because the way that they feel after the baby is born does not match their expectations for this important event. —Dr. Nadkarni
Causes
The exact cause of postpartum depression is not well understood, but it’s believed to be related to a chemical imbalance in the brain. Risk factors include:
- Family history of depression, postpartum depression, or other mental health disorders
- You’ve had postpartum depression after a previous childbirth
- A past diagnosis of depression (unrelated to pregnancy) or other mental health disorders
- Limited social support or being a single parent
- Financial stress
- History of domestic, physical, or sexual abuse
- Pregnancy complications
- Infant health problems or difficulty with breastfeeding
Next steps
If you feel depressed for 2 weeks or more in the year after delivery, see your doctor. Many different types of doctors can diagnose and treat the condition, including ob/gyns, your primary care provider, family medicine doctors, therapists, and psychiatrists. When postpartum depression is untreated, there can be harmful consequences for the mother, infant, and family. These include:
- Poor mother-infant bonding
- Difficulty breastfeeding
- Relationship strain
- Increased risk of medical and mental health problems for the infant
- Reduced ability to care for other children in the household
- Suicidal thoughts or thoughts of harming yourself or your infant
- In severe cases, psychotic symptoms such as delusions or hallucinations
Dr. Rx
Having postpartum depression does not make anyone a bad mother or mean that they aren’t an excellent caregiver. However, when depressive symptoms are weighing heavily on you, it can be hard to be the best caregiver that you can be. This is why seeking help is important. —Dr. Nadkarni
Postpartum depression treatment
There are a range of treatments, depending on how bad your symptoms are and other factors. Your doctor may give you a questionnaire to help diagnose whether you have mild, moderate, or severe postpartum depression.
Talk therapy
Talking with a trained therapist, social worker, or psychologist can be a great way to help symptoms of mild to moderate postpartum depression. Therapy teaches you ways to change how depression makes you think, act, and feel. It can also be helpful as part of a treatment plan that includes medications.
Antidepressant medications
Antidepressants can also help postpartum women. Since trace amounts of the medications can go into the breastmilk, the risks of exposing the baby to these medications must be weighed against the benefits for the mother.
When mothers are not breastfeeding, antidepressant medications are not a risk to the infant and can be very effective treatments. Your doctor can prescribe them for most mild or moderate cases, though sometimes you’ll also be referred to a psychiatrist.
Hospitalization
For severe cases of postpartum depression—especially those that involve thoughts of suicide or self-injury or thoughts of harming the infant—it’s important that it is determined whether there may be any imminent risk to the mother or any family member. If so, psychiatric hospitalization is often needed. In these situations, treatment includes both talk therapy and medication management by a psychiatrist.
Preventing postpartum depression
The best way to prevent any harmful consequences of postpartum depression is to be aware of your own risk factors and see a doctor if you or your family notice symptoms of depression.
If you are at high risk of postpartum depression, discuss it with your doctors and therapists, and monitor yourself for the symptoms of depression.
It is also very important to make sure you have enough support during the postpartum period for you, the baby, and any other children.
Remember that immediately after the pregnancy, most mothers have up to 2 weeks of postpartum blues with mild to moderate depressive symptoms. If this lasts for more than 2 weeks, or if the symptoms are severe, see your doctor right away.
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References
- Perinatal Depression - National Institute of Mental Health (NIMH). (n.d.). https://www.nimh.nih.gov/health/publications/perinatal-depression
- Prevalence of perinatal depression among Japanese women: a meta-analysis | Annals of General Psychiatry | Full Text. (2020). https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-020-00290-7