Postpartum depression occurs after giving birth, and it involves a persistent low mood. It is different from the “baby blues” that many new parents experience.
Having postpartum depression does not mean that a person does not love their baby. It is a mental health condition, and treatment can resolve it. Anyone with symptoms should see a doctor immediately.
Postpartum depression affects 1 in 9 new mothers, the Office on Women’s Health report.
Symptoms may arise within 1 month or 1 year of delivery. They include a persistently low mood that lasts for at least 2 weeks.
Also, according to an older study, 10% of new fathers experience similar depression, the highest rates of which occur 3–6 months after childbirth.
In this article, learn about effective treatments and self-care strategies for postpartum depression.
Postpartum depression can affect people differently, but below are some common signs and symptoms:
- a low or sad mood
- anxiety and irritability
- fatigue and lethargy
- feeling guilty, worthless, hopeless, or helpless
- pain, such as a headache or stomachache
- a lack of appetite
- difficulty thinking or focusing
- low motivation and a lack of interest in activities
- difficulty bonding with the baby
- feeling unable to care for the baby
- frequent or long bouts of crying
- feeling unable to make decisions
- withdrawing from friends and family
- having no interest in the baby or feeling as if they are another person’s responsibility
Some people experience postpartum psychosis, a severe mental health problem that needs immediate medical attention. Symptoms include hallucinations, delusions, mania, paranoia, and confusion.
Others experience baby blues. This is different from postpartum depression. It affects many new parents and usually disappears after 3–5 days.
A healthcare provider can help a person understand the cause of a low mood after childbirth, and they can provide effective treatments and self-care strategies, if necessary.
Postpartum depression can cause people to think about harming their child or themselves, including thoughts of suicide. If anyone has these thoughts, they or someone else should seek immediate help.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
Doctors do not know exactly what causes postpartum depression, but it can affect anyone. Genetic factors may play a role, and environmental factors may also contribute.
The following may increase the risk of developing postpartum depression:
- past trauma
- hormonal fluctuations
- a previous diagnosis or family history of depression or bipolar disorder
- the physical and emotional stress of delivery and childcare
- added stress at work or at home
- difficulty sleeping
- feeling overwhelmed
- feeling unattractive
- feeling the need to be a perfect parent but feeling unable to achieve this
- not having any free time
- having breastfeeding difficulties
- having a substance use disorder
- having a baby with special needs
- having had an unwanted pregnancy
- being younger than 20
- having a lack of support from family and friends
- having had complications during delivery
- the need for the infant to spend time in the hospital
- experiencing preterm birth
- having a baby with a low birth weight
Causes in transgender people
Some transgender men and other gender-nonconforming people face additional stress during and after pregnancy. This may lead to a higher risk of postpartum depression.
One study lists factors contributing to the added stress, including:
- a lack of understanding and provision from healthcare providers
- other forms of transphobia
- isolation and low access to social support
- hormonal factors
Stillbirth and pregnancy loss
In the United States, around 1 in 160 pregnancies end in stillbirth, after 20 weeks of pregnancy. This may increase the risk of postpartum depression.
Experts report that 14.8% of people who experience pregnancy loss have postpartum depression, compared with 8.3% of those with regular deliveries.
If symptoms of depression last 2 weeks or longer within 1 year of giving birth, a person should receive medical attention.
This is also crucial for anyone who is having trouble caring for themselves or their baby.
The doctor will ask questions about symptoms and medical histories. They may also request blood tests to rule out other causes of depression.
Treatment for postpartum depression is essential for the well-being of the parent and their newborn. The sooner a person receives it, the sooner they are likely to recover. Treatment is effective in most cases.
Once they have identified the issue, the doctor usually prescribes a combination of psychotherapy and medication.
Tips for helping to support recovery include:
- acknowledging the problem
- being open about any feelings
- getting help from friends and family
- joining a support group
Support groups can reduce the feelings of isolation and provide tools and helpful strategies.
These may be antidepressants, which can help manage symptoms and improve the mood. They may take 6–8 weeks to work, however.
Meanwhile, the hormonal medication brexanolone (Zulresso) can help relieve depression by restoring the hormonal balance.
If psychosis occurs, antipsychotic medications can help.
All medications can have adverse effects, and it is important to work with a doctor closely to find a treatment plan that works.
There is also a small risk that some medications can enter breast milk. The doctor will work with the person to find one that is likely to be safe and effective.
Cognitive behavioral therapy, sometimes called CBT, may help resolve moderate postpartum depression. Its aim is to find new ways to approach and interpret situations and to develop more positive ways of thinking.
Interpersonal therapy may also be a good option. Its goal is to improve communication skills and help develop social networks. This can help a person manage challenges that may otherwise lead to depression.
Treating severe postpartum depression
If symptoms are severe and other strategies are not effective, it may help to spend time in the hospital. In some cases, a doctor may recommend electroconvulsive therapy.
Some people may use the following therapies to help relieve postpartum depression:
There is limited evidence that any of these work, however. Check with a doctor first. Anyone interested in acupuncture should be sure to find a qualified practitioner.
During and after pregnancy, a person can take some steps to help prevent or manage postpartum depression. Strategies include:
- having a healthful diet and getting regular exercise
- keeping all medical appointments and following up about health concerns
- eating small meals regularly to maintain blood sugar levels
- getting at least 7–8 hours of sleep each night
- planning ahead, during pregnancy, to reduce stress after delivery
- speaking openly to loved ones about feelings and concerns
- keeping in touch with friends and family, especially if parenting alone
- asking a healthcare professional about local self-help groups
- asking others for help with practical and emotional challenges
- resting, rather than doing housework, when the baby sleeps
- if possible, avoiding major changes, such as moving house, soon after delivery
- seeking help for housing, social, and other issues that arise
Postpartum depression is a common and potentially serious mental health condition. Without treatment, the symptoms can worsen, making it harder for the person to care for the baby and themselves.
Anyone who experiences a low mood for at least 2 weeks in the first year after delivery should seek medical care. Treatment can help significantly.
A number of specialist hotlines are available for people who want to talk about their feelings and ask for advice:
The All-Options hotline: 1-888-493-0092
The National Postpartum Depression helpline: Call 1-800-PPD-MOMS (1-800-944-4774). Text 503-894-9453 in English or 971-420-0294 en Español.