Many women experience mood changes, anxiety, and tearfulness in the weeks following childbirth. For some, however, these symptoms may become more persistent and severe, which could indicate postpartum, or postnatal, depression.
Postpartum depression usually begins within the first 3 months after giving birth, according to a 2014 review of clinical studies. According to the authors, it can remain a long term problem for some women, especially if they do not receive treatment.
Postpartum depression is a serious mental illness. It is different than the “baby blues,” which is a feeling of sadness, fatigue, and anxiety that affects up to 80% of women after having a baby. The baby blues usually go away within 3–5 days.
Being aware of the signs of depression can help people get appropriate treatment.
Without treatment, postpartum depression can last for months or even years. However, effective treatment is available that can help women manage their symptoms and improve their quality of life.
The Office on Women’s Health advise women who have recently had a baby to seek help for postpartum depression if they experience persistent feelings of emptiness, sadness, or flatness for more than 2 weeks.
The researchers behind a review of studies looking at risk factors that make some women more prone than others to persistent postpartum depression found that the symptoms of postpartum depression often decreased over time. However, the results also suggested that 38% of women with postpartum depression experienced chronic symptoms and ongoing depression.
About 50% of the women who were receiving medical care for depression continued to experience symptoms more than 1 year after childbirth.
Of those with postpartum depression who were not receiving clinical treatment, 30% still had symptoms of depression up to 3 years after giving birth.
It is important to understand that neither the baby blues nor postpartum depression is due to anything that the woman has done. It is a common problem that many women experience, and it does not mean that they are bad mothers.
Some factors do appear to increase the risk of postpartum depression.
They include having:
- depression before or during pregnancy
- a history of bipolar disorder or depression
- a family member with a diagnosis of depression or mental illness
- experienced a stressful life event around the time of pregnancy, such as domestic violence, a bereavement, a job loss, or illness
- a lack of support from a partner or other loved ones
- medical complications during the delivery
- a preterm birth or a child with a health condition
- mixed feelings about the pregnancy
- an alcohol or drug use disorder
Risk factors for long term depression
Researchers have also identified some risk factors for long term postpartum depression, noting that it is often a continuation of preexisting depression, rather than a new set of symptoms that starts at delivery.
Other factors that appeared to play a role include:
- a poor relationship with a partner
- a history of sexual abuse
Some studies suggested that depression was more likely to affect women who are young, on a low income, or from a minority background, but the data were less consistent for these findings.
Ill health in the child did not seem to increase the risk of long term postpartum depression.
The researchers urged doctors to be ready to spot the signs that postpartum depression is becoming chronic and to take into account the wider factors that may contribute to depression.
They also called for further studies on the causes of postpartum depression and its likely duration.
The symptoms of postpartum depression include:
- feeling sad, worried, anxious, and overwhelmed
- having fears of not being able to love or look after the baby
- crying more than usual
- feeling moody, restless, or angry
- difficulty sleeping
- eating too much or too little
- experiencing aches and pains, including headaches, without a clear reason
- social isolation and avoiding activities that used to be enjoyable
- thoughts of self-harming or harming the baby
- difficulty taking care of herself, the baby, and the family
- feelings of worthlessness or guilt
- difficulty focusing and making decisions
- If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Call 911 or the local emergency number.
- Stay with the person until professional help arrives.
- Remove any weapons, medications, or other potentially harmful objects.
- Listen to the person without judgment.
- 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 a day at 1-800-273-8255.
Anyone who has concerns about how they are feeling after giving birth should see a doctor, who will be able to offer effective treatment. The treatment options may include:
Medication: A doctor may prescribe an antidepressant, such as a selective serotonin reuptake inhibitor (SSRI). They will work with the individual to establish a suitable dosage. Once they achieve this, the woman may continue to use the medication for 6–12 months. The doctor will also discuss how the medication may affect breastfeeding.
Transcranial magnetic stimulation: This treatment uses magnetic waves to stimulate and activate nerve cells. It is noninvasive and will not interfere with breastfeeding. Doctors usually give this treatment five times a week for 4–6 weeks.
Counseling: Attending cognitive behavioral therapy (CBT) sessions may also help, especially if a woman does this in combination with other treatments.
An individual can also take some steps at home that may help bring relief.
- getting as much rest as possible
- asking others to help with tasks, if possible
- resisting the urge to try to do everything perfectly
- spending time with friends and other family members
- sharing their feelings with others
- joining a local support group
- getting some exercise, for example, walking outside with the baby in a stroller
It is also a good idea to avoid making significant life changes around this time, as they can add to the stress.
Click here to get some tips on how to cope with postpartum depression.
Postpartum depression can affect the early relationship between a mother and her child.
According to the Office on Women’s Health, a child may experience the following if their mother has untreated depression:
- problems with learning and language development
- behavioral issues
- more frequent crying
- agitation and stress
- growth problems
- a higher risk of obesity
- difficulty adjusting to social situations and school life
Seeking help for depression can help protect the well-being of both the mother and the child.
Postpartum depression affects many women after delivery. Without treatment, it can persist for months or even years. However, treatment can help relieve symptoms and improve quality of life.
Anyone who has concerns about their feelings should speak to a healthcare professional or doctor. A trusted friend or family member can often assist in getting help if the woman does not feel that she can do this alone.
Seeking treatment for postpartum depression can bring benefits for the woman, baby, and wider family in the long term.
My friend had a baby 2 months ago, and I think that she has postpartum depression. She will not talk about it, but I can see that something is wrong. I think she is afraid that the authorities will take the baby away if she says that she cannot cope. How can I help?
I would start by supporting her in seeking help. Start with her obstetrician or gynecologist. They are trained to screen mothers after delivery and are familiar with resources and medications to help.
If she is reluctant to see her doctor, reassure her that this is not an uncommon occurrence after delivery. With intervention and support, she can improve her condition and be more available emotionally and physically for her baby.
Valinda Riggins Nwadike Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.