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.
Perinatal depression is a collective term for mood disorders that affect people during pregnancy or the first 12 months after their baby is born.
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
- mood swings
- feeling sad, anxious, or exhausted
- having crying spells
- loss of appetite
- having trouble sleeping
Symptoms of perinatal depression can last longer than two weeks and be more severe.
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
Some people who have perinatal depression experience
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”
- 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
Postpartum psychosis is a severe mental illness that can occur after a person has a baby. It is a rare condition, affecting
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.
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
Cognitive behavioral therapy (CBT)
A person can receive CBT individually with a therapist or as part of a group.
Interpersonal therapy (IPT)
- improving their communication within relationships
- developing social support networks
- developing realistic expectations that allow them to deal with crises or other issues
There is a very low risk of congenital disabilities or health issues for fetuses that have had exposure to antidepressants.
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
Speaking with family or friends about perinatal depression can be helpful. The
- 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
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
- 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,
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.