Your body and mind go through many changes during and after pregnancy. If you feel sad, anxious, or overwhelmed or feel like you don’t love or care for your baby and these feelings last longer than 2 weeks during or after pregnancy, you may have postpartum depression. Treatment for depression, such as therapy or medicine, works and can help you and your baby be as healthy as possible in the future.
What is postpartum depression?
“Postpartum” means the time after having a baby. Some women get the “baby blues,” or feel sad, worried, or tired within a few days of giving birth. For many women, the baby blues go away in a few days. If these feelings don’t go away or you feel sad, hopeless, or anxious for longer than 2 weeks, you may have postpartum depression. Feeling hopeless after childbirth is not a regular or expected part of being a mother.
Postpartum depression is a serious mental health condition that involves the brain and affects your behavior and physical health. If you have depression, then sad and hopeless feelings don’t go away and can interfere with your day-to-day life. You might not feel connected to your baby, as if you are not the baby’s mother, or you might not love or care for the baby. These feelings can be mild to severe.
Mothers can also experience anxiety disorders during or after pregnancy.
How do I know if I have postpartum depression?
Some normal changes after pregnancy can cause symptoms similar to those of depression. Many mothers feel overwhelmed when a new baby comes home. But if you have any of the following symptoms of depression for more than 2 weeks, call your doctor, nurse, or midwife:
- Feeling angry or moody
- Feeling sad or hopeless
- Feeling guilty, shameful, or worthless
- Eating more or less than usual
- Sleeping more or less than usual
- Unusual crying or sadness
- Loss of interest, joy, or pleasure in thing you used to enjoy
- Withdrawing from friends and family
- Possible thoughts of harming the baby or yourself
Some women don’t tell anyone about their symptoms. New mothers may feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They may also worry they will be seen as bad mothers. Any woman can become depressed during pregnancy or after having a baby. It doesn’t mean you are a bad mom. You don’t have to suffer. There is help. Your doctor can help you figure out whether your symptoms are caused by depression or something else.
What causes postpartum depression?
The exact cause of PPD is not known and many different factors are likely to contribute to someone developing PPD. Hormonal changes may trigger symptoms of postpartum depression. When you are pregnant, levels of the female hormones estrogen and progesterone are the highest they’ll ever be. In the first 24 hours after childbirth, hormone levels quickly drop back to normal, pre-pregnancy levels. Researchers think this sudden change in hormone levels may lead to depression.2 This is similar to hormone changes before a woman’s period but involves much more extreme swings in hormone levels.
Levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps regulate how your body uses and stores energy from food. Low levels of thyroid hormones can cause symptoms of depression. A simple blood test can tell whether this condition is causing your symptoms. If so, your doctor can prescribe thyroid medicine.
Are some women more at risk of postpartum depression?
Yes. You may be more at risk of postpartum depression if you:
- Had depression before or during pregnancy
- Have a family history of depression
- Experienced abuse or adversity as a child
- Had a difficult or traumatic birth
- Had problems with a previous pregnancy or birth
- Have little or no support from family, friends, or partners
- If you are now or have experienced domestic violence
- Have relationship struggles, money problems, or experience other stressful life events
- Are under the age of 20
- Have a hard time breastfeeding
- Have a baby that was born prematurely and/or has special health care needs
- Had an unplanned pregnancy
The U.S. Preventive Services Task Force recommends that doctors look for and ask about symptoms of depression during and after pregnancy, regardless of a woman’s risk of depression.4
What is the difference between “baby blues” and postpartum depression?
Many women have the baby blues in the days after childbirth. If you have the baby blues, you may:
- Have mood swings
- Feel sad, anxious, or overwhelmed
- Have crying spells
- Lose your appetite
- Have trouble sleeping
The baby blues usually go away within a few days. The symptoms of postpartum depression last longer, are more severe, and may require treatment by a health care professional. Postpartum depression usually begins within the first month after birth.
What should I do if I have symptoms of postpartum depression?
Call your doctor, nurse, midwife, or pediatrician if:
- Your baby blues symptoms don’t go away after 2 weeks or are very intense
- Symptoms of depression begin within 1 year of delivery and last more than 2 weeks
- It is difficult to work or get things done at home
- You cannot care for yourself or your baby (e.g., eating, sleeping, bathing)
- You have thoughts about hurting yourself or your baby
Ask your partner or a loved one to call for you if necessary. Your doctor, nurse, or midwife can ask you questions to test for depression. They can also refer you to a mental health professional for help and treatment.
What can I do at home to feel better while seeing a doctor for postpartum depression?
Here are some ways to begin feeling better or getting more rest, in addition to talking to a health care professional:
- Rest as much as you can. Sleep when the baby is sleeping.
- Don’t try to do too much or to do everything by yourself. Ask your partner, family, and friends for help.
- Make time to go out, visit friends, or spend time alone with your partner.
- Talk about your feelings with your partner, supportive family members, and friends.
- Talk with other mothers so that you can learn from their experiences.
- Join a support group. Ask your doctor or nurse about groups in your area.
- Don’t make any major life changes right after giving birth. More major life changes in addition to a new baby can cause unneeded stress. Sometimes big changes can’t be avoided. When that happens, try to arrange support and help in your new situation ahead of time.
It can also help to have a partner, a friend, or another caregiver who can help take care of the baby while you are depressed. If you are feeling depressed during pregnancy or after having a baby, don’t suffer alone. Tell a loved one and call your doctor right away.
How is postpartum depression treated?
Working with a health care professional is a good way to create a plan that will work for you. Here are some ways to get help—they can be used alone or together:
- Therapy: Counseling or therapy sessions with a mental health professional can help you understand and cope with your emotions and challenges.
- Support groups: Joining a support group of others experiencing PPD can provide comfort and understanding.
- Self-care: Taking care of yourself is important. Do your best to get enough rest, eat food with a lot of nutrients like fresh produce and whole grains, be physically active, and ask for help when needed.
- Social support: Reach out to family, friends, or other people you trust who can offer advice or support.
- Medication: In some cases, medicine may be prescribed to help manage symptoms. The most common type is antidepressants. Antidepressants can help relieve symptoms of depression and some can be taken while you're breastfeeding. Antidepressants may take several weeks to start working.
- The Food and Drug Administration (FDA) has also approved a medicine called brexanolone to treat postpartum depression in adult women.6 Brexanolone is given by a doctor or nurse through an IV for 2½ days (60 hours). Because of the risk of side effects, this medicine can only be given in a clinic or office while you are under the care of a doctor or nurse. Brexanolone may not be safe to take while pregnant or breastfeeding. Zuranolone, the first oral medication approved to treat postpartum depression may be another option.
These treatments can be used alone or together. Talk with your doctor or nurse about the benefits and risks of taking medicine to treat depression when you are pregnant or breastfeeding.
Having depression can affect your baby. Getting treatment is important for you and your baby. Getting help is a sign of strength.
What can happen if postpartum depression is not treated?
Untreated postpartum depression can affect your ability to parent. You may:
- Not have enough energy
- Have trouble focusing on the baby's needs and your own needs
- Feel moody
- Not be able to care for your baby
- Have a higher risk of attempting suicide
Feeling bad about yourself can make depression worse. It is important to reach out for help if you feel depressed.
Researchers believe postpartum depression in a mother can affect the healthy development of her child which can cause:7
Did we answer your question about postpartum depression?
The resources below can help you learn more about PPD and can guide you in finding additional help.
- Call or text the Suicide and Crisis Lifeline at 988 for free access to a trained crisis counselor who can provide you with support and connect you with additional help and resources. If you’re deaf or hard of hearing, use your preferred relay service or dial 711 then 988.
- Call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) for 24/7 free access to professional counselors. If you’re deaf or hard of hearing, use your preferred relay service or dial 711 then 1-833-852-6262.
- Call or text “Help” to the Postpartum Support International helpline at 1-800-944-4773 for PPD information, resources, and support groups for women, partners, and supporters.
- Local resources can be identified in many ways:
- Ask a health care professional or find a local health center.
- Reach out to local organizations like social service agencies, family resource centers, libraries, community centers, or places of worship.
- Look for support groups in your area, such as new moms’ groups, breastfeeding support groups, or a baby café. See if there are mother/baby exercise programs in your community.
- Centers for Disease Control and Prevention, Division of Reproductive Health. (2020). Pregnancy Risk Assessment Monitoring System (PRAMS). Washington, DC: Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/prams/prams-data/mch-indicators/states/pdf/2020/All-Sites-PRAMS-MCH-Indicators-508.pdf. Accessed on June 5th, 2023.
- Schiller, C.E., Meltzer-Brody, S., Rubinow, D.R. (2014). The Role of Reproductive Hormones in Postpartum Depression. CNS Spectrums; 20(1): 48–59.
- Sit, D.K., Wisner, K.L. (2009). The Identification of Postpartum Depression. Clinical Obstetrics and Gynecology; 52(3): 456–468.
- U.S. Preventive Services Task Force. (2016). Depression in Adults: Screening .
- Alhusen, J.L., Alvarez, C. (2016). Perinatal depression. The Nurse Practitioner; 41(5): 50–55.
- U.S. Food and Drug Administration. (2019). FDA approves first treatment for post-partum depression.
- Stein, A., Perason, R.M., Goodman, S.H., Rapa, E., Rahman, A., McCallum, M., et al. (2014). Effects of perinatal mental disorders on the fetus and child. Lancet; 384(9956): 1800–1819.
- Surkan, P.J., Ettinger, A.K., Hock, R.S., Ahmed, S., Strobino, D.M., Minkovitz, C.S. (2014). Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort . BMC Pediatrics; 14: 185.
- Benton, P.M., Skouteris, H., Hayden, M. (2015). Does maternal psychopathology increase the risk of pre-schooler obesity? A systematic review . Appetite; 87(1): 259–282.
- Korhonen, M., Luoma, I., Salmelin, R., Tamminen, T. (2014). Maternal depressive symptoms: Associations with adolescents' internalizing and externalizing problems and social competence. Nordic Journal of Psychiatry; 68(5): 323–332.