Postpartum depression (PPD) usually occurs within 4–6 weeks of giving birth. It is different than baby blues, which is a common condition that usually occurs very shortly after birth.

PPD is common, affecting as many as 20% of people who give birth.

Certain people have an increased risk of developing PPD. According to a 2020 systematic review, the most significant risk factors are lack of social support, high stress, prenatal depression, current or past abuse, and relationship issues.

Read on to learn about when PPD starts, the early warning signs, how to get help, and more.

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PPD most commonly occurs within 6 weeks of giving birth. However, according to the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), PPD may also begin when a person is pregnant. The manual states that PPD is any new episode of depression that begins during pregnancy or within 4 weeks of delivery.

Therapists and medical professionals may use broader categories to define PPD. This is because all people with depression need help, especially during the stressful postpartum period.

Additionally, the fact that PPD often appears shortly after delivery means that a person might not notice their symptoms right away. Some people mistakenly attribute their symptoms to sleep deprivation, hormonal changes, and stress.

As a result, they might not seek help for weeks or months. It is important for a person to know that they do not need to deal with their symptoms in silence. Regardless of when a person’s depression symptoms start, they should always feel able to seek help.

Some early warning signs include:

  • feeling very sad all or most of the time
  • being unable to experience joy or pleasure
  • having symptoms similar to those of an earlier depression episode
  • having difficulty bonding with the baby
  • experiencing feelings of sadness or despair that last longer than a few days
  • having thoughts of self-harm

People with certain risk factors are more likely to have PPD, so they should be particularly aware of the warning signs. These risk factors include:

  • lack of support from a partner, friends, or family
  • relationship problems
  • serious pregnancy complications
  • a traumatic birth
  • sleep deprivation
  • nutritional deficiencies
  • a history of mental health conditions
  • current or prior abuse
  • stress, such as work or financial stress

Learn more about the symptoms of PPD and the risk factors.

Baby blues cause feelings of sadness, vulnerability, and intense emotions shortly after giving birth, usually during the first 2 weeks postpartum. The baby blues are very common — in fact, a 2018 study reports that they affect up to 85% of people after giving birth.

They may happen because childbirth is a major life change that causes both physical and emotional stress, as well as sudden physiological changes.

Although PPD and baby blues have similar symptoms, there are some important distinctions between the conditions. These include:

  • Timing: Baby blues typically begin shortly after birth. PPD may sometimes begin during pregnancy, but it can take 4–6 weeks to develop.
  • Treatment: Baby blues go away on their own. Although emotional support can help, no treatment is necessary. PPD may last for months or even years without treatment.
  • Duration: The baby blues are a fleeting phenomenon, whereas PPD lasts much longer.
  • Severity: The emotions of PPD tend to be more intense, and they are more likely to interfere with the person’s ability to bond with the baby.
  • Prevalence: Most people experience baby blues after delivery, but certain risk factors increase the likelihood of PPD.

If a person has symptoms of PPD, it is important to seek help. Loved ones of a person with PPD can encourage them to get professional help and provide a supportive environment. This may involve helping with child care and household chores.

A good time to ask for help is at a postpartum visit. The person’s doctor or midwife may have a recommendation for a mental health professional who can help. They may also prescribe medication, which is an important component of treatment.

People with PPD also need support from family and friends. Partners, friends, and family should treat PPD like any other health concern, and they must be mindful of the challenges of single-handedly caring for a baby all day, every day, without a break.

They should also know that helping a person get support is essential. Suicide remains a leading cause of maternal mortality in the postpartum period.

Postpartum Support International and Postpartum Progress both offer education and help with accessing additional resources.

Below are the answers to some common questions about PPD.

Can it start right away?

Yes, it can. PPD may start even before the baby is born.

The DSM-5-TR does not distinguish PPD from other types of depression. Instead, it defines PPD as any new episode of depression that appears during pregnancy or in the weeks following birth.

What are the warning signs?

The most important warning signs include:

  • very negative emotions all or most of the time
  • difficulty feeling joy or pleasure
  • trouble bonding with the baby
  • feelings of despair or self-loathing
  • thoughts of self-harm

Some people may have other symptoms, such as aches and pains, trouble sleeping, and changes in appetite.

How long does postpartum depression last?

Without treatment, PPD can last well beyond the immediate postpartum period. It may last months or even years.

As with other forms of depression, PPD can be difficult to treat, and seeking professional help is essential.

A person may need to try several treatments before finding one that provides relief. It is also important for a person to have social support and help with the baby.

PPD is a serious medical concern. Social, environmental, and biological factors all contribute to a person’s chances of developing it.

A person cannot think or will their way out of PPD, and it is not a sign of weakness.

Shame and blame can make the symptoms worse. Instead, a person with PPD needs early treatment and significant support. With the right treatment, the symptoms can improve, and a person can enjoy early parenthood.