Perinatal depression is a type of depression that affects a person during or after a pregnancy. It can cause a person to feel sad, worthless, or like they cannot care for their baby.

Read on to learn about perinatal depression, including its causes, symptoms, and treatments.

We also outline what to do if someone is in crisis and explore the risk factors for the condition.

This article also discusses how doctors diagnose perinatal depression.

A pregnant female who may have perinatal depression.Share on Pinterest
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Perinatal depression is a collective term for mood disorders that affect people during pregnancy or the first 12 months after their baby is born.

Perinatal depression that occurs during pregnancy is known as prenatal depression. If it occurs after a baby is born, it is known as postpartum depression.

The American College of Obstetricians and Gynecologists (ACOG) notes that perinatal depression is one of the most common complications during and after pregnancy.

How does it differ from the baby blues?

Baby blues is a term for mild changes in mood after a person gives birth. These changes generally go away in the two weeks following delivery.

Symptoms of baby blues can include:

Symptoms of perinatal depression can last longer than two weeks and be more severe.

The National Institute of Mental Health (NIMH) states that there is no one cause for perinatal depression. It notes that a combination of genetic and environmental factors can cause it.

Causes may include:

  • life stress
  • the physical and emotional demands of being pregnant or caring for a new baby
  • changes in hormone levels during and after pregnancy
  • family history of depression or bipolar disorder
  • having had perinatal depression during a previous pregnancy
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An infographic of a person with their baby, surrounded by common symptoms of perinatal depression. Design by Bailey Mariner; Photograph by Hailey Seelig/Getty Images

Some people who have perinatal depression experience few symptoms. Other people may have many symptoms.

Regardless of how many symptoms a person has, they should speak with a healthcare professional if they experience any signs of perinatal depression.

Symptoms of perinatal depression include:

  • feeling constantly sad, anxious, or “empty”
  • irritability
  • feelings of guilt, worthlessness, hopelessness, or helplessness
  • losing interest or pleasure in hobbies or activities
  • fatigue or abnormal loss of energy
  • feeling restless or having difficulty staying still
  • difficulty concentrating, making decisions, or remembering things
  • difficulty sleeping, even when the baby is asleep
  • waking up early or oversleeping
  • abnormal appetite, weight changes, or both
  • aches, pains, headaches, cramps, or digestive problems with no obvious cause or that do not clear with treatment
  • trouble bonding with their new baby
  • thoughts of death, suicide, or harming themselves or their baby

Learn more about when postpartum depression symptoms start.

Postpartum psychosis is a severe mental illness that can occur after a person has a baby. It is a rare condition, affecting 4 in every 1,000 people after they give birth. It usually occurs in the first 2 weeks after a person gives birth.

Postpartum psychosis can cause a person to experience the following:

If a person has symptoms of postpartum psychosis, they should seek medical help immediately. A person who has postpartum psychosis may be at risk of harming themselves or their baby.

The NIMH recommends the following steps if a person, or someone they know, is in crisis:

  1. Call 911 if it is an emergency.
  2. Call the free National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
  3. Contact the Crisis Text Line for free by texting HOME to 741741.

Certain risk factors may increase a person’s chances of developing perinatal depression, such as:

  • history of depressive, bipolar, or anxiety disorders
  • family history of depressive or perinatal disorders
  • an unwanted or teenage pregnancy
  • multiple births
  • a traumatic or difficult pregnancy or birth
  • ongoing health problems with the baby
  • lack of social support due to socioeconomic status or financial difficulties
  • history of physical or sexual abuse
  • a substance misuse disorder
  • American Indian/Alaska and Hawaii Native heritage, possibly due to inequities in healthcare

A review from 2020 notes that it is easy for a person to miss signs of perinatal depression. This is because signs such as mood swings, stress, and lack of sleep can be found in many pregnant people.

The ACOG recommends perinatal screening for all pregnant people. Studies have shown that screening can improve outcomes for depressed mothers.

A healthcare professional may use a questionnaire when screening a person for perinatal depression. The most reliable questionnaire doctors use is the Edinburgh Postnatal Depression Scale (EPDS). The EPDS contains 10 questions with a sensitivity and specificity of 70⁠–88%.

A doctor may screen a person for perinatal depression during their first prenatal visit and their last trimester. A person should also have a screening at their 6-week postpartum visit.

If a person screens positively for perinatal depression, their doctor may request a clinical evaluation. A mental health professional can then diagnose them with depression.

Treatment for perinatal depression can include medication, therapy, or both. We discuss these in further detail below.

Cognitive behavioral therapy (CBT)

CBT is a form of therapy that teaches a person to think, behave, and react differently in certain situations. It can help a person to change unhelpful patterns of thinking and behaving.

A person can receive CBT individually with a therapist or as part of a group.

Interpersonal therapy (IPT)

IPT comes from the theory that a person’s interpersonal and life events affect their mood and vice versa. This therapy aims to help a person by:

  • improving their communication within relationships
  • developing social support networks
  • developing realistic expectations that allow them to deal with crises or other issues

Learn more about IPT here.

Medication

Healthcare professionals generally use antidepressants to treat perinatal depression. However, a person who is pregnant or breastfeeding should inform their doctor before starting antidepressants.

There is a very low risk of congenital disabilities or health issues for fetuses that have had exposure to antidepressants.

Learn more about antidepressants here.

If these treatments are not effective, a doctor may recommend that a person have electroconvulsive therapy (ECT). This involves a doctor passing small electric currents through a person’s brain. The process is generally safe and low risk.

Self-care

Speaking with family or friends about perinatal depression can be helpful. The NIMH notes that family members may:

  • encourage a person to speak to a healthcare professional
  • offer emotional support
  • assist with daily tasks, such as caring for the baby

Additionally, the United Kingdom’s mental health charity Mind suggests the following self-care tips for a person who has perinatal depression:

  • be kind and forgiving to themselves
  • keep a mood diary
  • take a shower or get dressed
  • speak with people with similar experiences

Learn more about coping with postpartum depression here.

The NIMH suggests the following resources for people with perinatal depression:

Perinatal depression can have serious consequences if a person does not get treatment. During pregnancy, experts associate untreated perinatal depression with an increased risk of:

After pregnancy, experts associate untreated perinatal depression with:

  • intense sadness
  • anxiety
  • a lack of interest in life and their child, which can lead to poor maternal bonding
  • failure to initiate breastfeeding or shorter breastfeeding duration

In severe cases, symptoms may progress to a person having thoughts of self-harm or harming their child. In rare cases, this can lead to maternal suicide or infanticide.

However, the NIMH notes that, with proper treatment, most people’s symptoms improve.

Perinatal depression is a serious mental health condition that can affect a person during or just after pregnancy. It can have severe consequences for a person and their baby.

The condition lasts longer and is more severe than the baby blues. If a person has any signs of perinatal depression or postpartum psychosis, they should see a doctor immediately.

Perinatal depression can result from a mix of genetic and environmental factors.

There is a variety of treatments available to a person with perinatal depression. Perinatal depression can improve with proper treatment.

If a person is going through a crisis or knows someone who is, they should seek help immediately.