Postpartum depression | Office on Women's Health (2023)

Postpartum depression | Office on Women's Health (1)

Your body and mind go through many changes during and after pregnancy. If you feel empty, emotionless, or sad all or most of the time for longer than 2 weeks during or after pregnancy, reach out for help. If you feel like you don't love or care for your baby, you might have postpartum depression. Treatment for depression, such as therapy or medicine, works and will help you and your baby be as healthy as possible in the future.

What is postpartum depression?

“Postpartum” means the time after childbirth. Most women get the “baby blues,” or feel sad or empty, within a few days of giving birth. For many women, the baby blues go away in 3 to 5 days. If your baby blues don’t go away or you feel sad, hopeless, or empty for longer than 2 weeks, you may have postpartum depression. Feeling hopeless or empty after childbirth is not a regular or expected part of being a mother.

Postpartum depression is a serious mental illness that involves the brain and affects your behavior and physical health. If you have depression, then sad, flat, or empty feelings don’t go away and can interfere with your day-to-day life. You might feel unconnected to your baby, as if you are not the baby’s mother, or you might not love or care for the baby. These feelings can be mild to severe.

Mothers can also experience anxiety disorders during or after pregnancy.

How common is postpartum depression?

Depression is a common problem afterpregnancy. One in 9 new mothers has postpartum depression.1

How do I know if I have postpartum depression?

Some normal changes after pregnancy can cause symptoms similar to those of depression. Many mothers feel overwhelmed when a new baby comes home. But if you have any of the following symptoms of depression for more than 2 weeks, call your doctor, nurse, or midwife:

  • Feeling restless or moody
  • Feeling sad, hopeless, or overwhelmed
  • Crying a lot
  • Having thoughts of hurting the baby
  • Having thoughts of hurting yourself
  • Not having any interest in the baby, not feeling connected to the baby, or feeling as if your baby is someone else’s baby
  • Having no energy or motivation
  • Eating too little or too much
  • Sleeping too little or too much
  • Having trouble focusing or making decisions
  • Having memory problems
  • Feeling worthless, guilty, or like a bad mother
  • Losing interest or pleasure in activities you used to enjoy
  • Withdrawing from friends and family
  • Having headaches, aches and pains, or stomach problems that don’t go away

Some women don’t tell anyone about their symptoms. New mothers may feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They may also worry they will be seen as bad mothers. Any woman can become depressed during pregnancy or after having a baby. It doesn’t mean you are a bad mom. You and your baby don’t have to suffer. There is help. Your doctor can help you figure out whether your symptoms are caused by depression or something else.

(Video) "Baby Blues" -- or Postpartum Depression?

What causes postpartum depression?

Hormonal changes may trigger symptoms of postpartum depression. When you are pregnant, levels of the female hormones estrogen and progesterone are the highest they’ll ever be. In the first 24 hours after childbirth, hormone levels quickly drop back to normal, pre-pregnancy levels. Researchers think this sudden change in hormone levels may lead to depression.2 This is similar to hormone changes before a woman’s period but involves much more extreme swings in hormone levels.

Levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps regulate how your body uses and stores energy from food. Low levels of thyroid hormones can cause symptoms of depression. A simple blood test can tell whether this condition is causing your symptoms. If so, your doctor can prescribe thyroid medicine.

Other feelings may contribute to postpartum depression. Many new mothers say they feel:

  • Tired after labor and delivery
  • Tired from a lack of sleep or broken sleep
  • Overwhelmed with a new baby
  • Doubts about their ability to be a good mother
  • Stress from changes in work and home routines
  • An unrealistic need to be a perfect mom
  • Grief about loss of who they were before having the baby
  • Less attractive
  • A lack of free time

These feelings are common among new mothers. But postpartum depression is a serious health condition and can be treated. Postpartum depression is not a regular or expected part of being a new mother.

Are some women more at risk of postpartum depression?

Yes. You may be more at risk of postpartum depression if you:3

  • Have a personal history of depression or bipolar disorder
  • Have a family history of depression or bipolar disorder
  • Do not have support from family and friends
  • Were depressed during pregnancy
  • Had problems with a previous pregnancy or birth
  • Have relationship or money problems
  • Are younger than 20
  • Have alcoholism, use illegal drugs, or have some other problem with drugs
  • Have a baby with special needs
  • Have difficulty breastfeeding
  • Had an unplanned or unwanted pregnancy

The U.S. Preventive Services Task Force recommends that doctors look for and ask about symptoms of depression during and after pregnancy, regardless of a woman’s risk of depression.4

(Video) Women's Health: Post-partum Depression

What is the difference between “baby blues” and postpartum depression?

Many women have the baby blues in the days after childbirth. If you have the baby blues, you may:

  • Have mood swings
  • Feel sad, anxious, or overwhelmed
  • Have crying spells
  • Lose yourappetite
  • Have trouble sleeping

The baby blues usually go away in 3 to 5 days after they start. The symptoms of postpartum depression last longer and are more severe. Postpartum depression usually begins within the first month after childbirth, but it can begin during pregnancy or for up to a year after birth.5

Postpartum depression needs to be treated by a doctor or nurse.

What is postpartum psychosis?

Postpartum psychosis is rare. It happens in up to 4 new mothers out of every 1,000 births. It usually begins in the first 2 weeks after childbirth. It is a medical emergency. Women who have bipolar disorder or another mental health condition called schizoaffective disorder have a higher risk of postpartum psychosis. Symptoms may include:

  • Seeing or hearing things that aren’t there
  • Feeling confused most of the time
  • Having rapid mood swings within several minutes (for example, crying hysterically, then laughing a lot, followed by extreme sadness)
  • Trying to hurt yourself or your baby
  • Paranoia (thinking that others are focused on harming you)
  • Restlessness or agitation
  • Behaving recklessly or in a way that is not normal for you

What should I do if I have symptoms of postpartum depression?

Call your doctor, nurse, midwife, or pediatrician if:

  • Your baby blues don’t go away after 2 weeks
  • Symptoms of depression get more and more intense
  • Symptoms of depression begin within 1 year of delivery and last more than 2 weeks
  • It is difficult to work or get things done at home
  • You cannot care for yourself or your baby (e.g., eating, sleeping, bathing)
  • You have thoughts about hurting yourself or your baby

Ask your partner or a loved one to call for you if necessary. Your doctor, nurse, or midwife can ask you questions to test for depression. They can also refer you to a mental health professional for help and treatment.

(Video) How Common is Postpartum Depression? — AMITA Health

What can I do at home to feel better while seeing a doctor for postpartum depression?

Here are some ways to begin feeling better or getting more rest, in addition to talking to a health care professional:

  • Rest as much as you can. Sleep when the baby is sleeping.
  • Don’t try to do too much or to do everything by yourself. Ask your partner, family, and friends for help.
  • Make time to go out, visit friends, or spend time alone with your partner.
  • Talk about your feelings with your partner, supportive family members, and friends.
  • Talk with other mothers so that you can learn from their experiences.
  • Join a support group. Ask your doctor or nurse about groups in your area.
  • Don’t make any major life changes right after giving birth. More major life changes in addition to a new baby can cause unneeded stress. Sometimes big changes can’t be avoided. When that happens, try to arrange support and help in your new situation ahead of time.

It can also help to have a partner, a friend, or another caregiver who can help take care of the baby while you are depressed.If you are feeling depressed during pregnancy or after having a baby, don’t suffer alone. Tell a loved one and call your doctor right away.

How is postpartum depression treated?

The common types of treatment for postpartum depression are:

  • Therapy. During therapy, you talk to a therapist, psychologist, or social worker to learn strategies to change how depression makes you think, feel, and act.
  • Medicine. There are different types of medicines for postpartum depression. All of them must be prescribed by your doctor or nurse. The most common type is antidepressants. Antidepressants can help relieve symptoms of depression and some can be taken while you're breastfeeding. Antidepressants may take several weeks to start working.

    The Food and Drug Administration (FDA) has also approved a medicine called brexanolone to treat postpartum depression in adult women.6 Brexanolone is given by a doctor or nurse through an IV for 2½ days (60 hours). Because of the risk of side effects, this medicine can only be given in a clinic or office while you are under the care of a doctor or nurse. Brexanolone may not be safe to take while pregnant or breastfeeding.

    (Video) Health Tip Minute: Postpartum depression signs and symptoms

    Another type of medicine called esketamine can treat depression and is given as a nasal (nose) spray in a doctor's office or clinic. Esketamine can hurt an unborn baby. You should not take esketamine if you are pregnant or breastfeeding.

  • Electroconvulsive therapy (ECT). This can be used in extreme cases to treat postpartum depression.

These treatments can be used alone or together. Talk with your doctor or nurse about the benefits and risks of taking medicine to treat depression when you are pregnant or breastfeeding.

Having depression can affect your baby. Getting treatment is important for you and your baby. Taking medicines for depression or going to therapy does not make you a bad mother or a failure. Getting help is a sign of strength.

What can happen if postpartum depression is not treated?

Untreated postpartum depression can affect your ability to parent. You may:

  • Not have enough energy
  • Have trouble focusing on the baby's needs and your own needs
  • Feel moody
  • Not be able to care for your baby
  • Have a higher risk of attempting suicide

Feeling like a bad mother can make depression worse. It is important to reach out for help if you feel depressed.

Researchers believe postpartum depression in a mother can affect her child throughout childhood, causing:7

  • Delays in language development and problems learning
  • Problems with mother-child bonding
  • Behavior problems
  • More crying or agitation
  • Shorter height8 and higher risk of obesity in pre-schoolers9
  • Problems dealing with stress and adjusting to school and other social situations10

Did we answer your question about postpartum depression?

For more information about postpartum depression, call the OWH Helpline at 1-800-994-9662 or check out these resources from the following organizations:

Sources

  1. Ko, J.Y., Rockhill, K.M., Tong, V.T., Morrow, B., Farr, S.L. (2017). Trends in Postpartum Depressive Symptoms — 27 States, 2004, 2008, and 2012. MMWR Morb Mortal Wkly Rep; 66: 153–158.
  2. Schiller, C.E., Meltzer-Brody, S., Rubinow, D.R. (2014). The Role of Reproductive Hormones in Postpartum Depression. CNS Spectrums; 20(1): 48–59.
  3. Sit, D.K., Wisner, K.L. (2009). The Identification of Postpartum Depression. Clinical Obstetrics and Gynecology; 52(3): 456–468.
  4. U.S. Preventive Services Task Force. (2016). Depression in Adults: Screening.
  5. Alhusen, J.L., Alvarez, C. (2016). Perinatal depression. The Nurse Practitioner; 41(5): 50–55.
  6. U.S. Food and Drug Administration. (2019). FDA approves first treatment for post-partum depression.
  7. Stein, A., Perason, R.M., Goodman, S.H., Rapa, E., Rahman, A., McCallum, M., et al. (2014). Effects of perinatal mental disorders on the fetus and child. Lancet; 384(9956): 1800–1819.
  8. Surkan, P.J., Ettinger, A.K., Hock, R.S., Ahmed, S., Strobino, D.M., Minkovitz, C.S. (2014). Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort. BMC Pediatrics; 14: 185.
  9. Benton, P.M., Skouteris, H., Hayden, M. (2015). Does maternal psychopathology increase the risk of pre-schooler obesity? A systematic review. Appetite; 87(1): 259–282.
  10. Korhonen, M., Luoma, I., Salmelin, R., Tamminen, T. (2014). Maternal depressive symptoms: Associations with adolescents' internalizing and externalizing problems and social competence. Nordic Journal of Psychiatry; 68(5): 323–332.
(Video) Pregnancy-Breastfeeding-Childbirth - Postpartum Depression

FAQs

How does depression affect woman? ›

Depression in women may happen earlier, last longer, be more likely to come back, be more likely to be tied to stressful life events, and be more sensitive to seasonal changes. Women are more likely to have guilty feelings and attempt suicide, although they actually take their own lives less often than men.

What are some postpartum issues? ›

Common postpartum complications

Infection or sepsis. Excessive bleeding after giving birth (hemorrhage) A disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body (cardiomyopathy)

Is post partum depression a public health issue? ›

The widespread prevalence of maternal depression in the United States and worldwide, with estimates ranging from 3% to 60%, constitutes a public health crisis, particularly one affecting low-income women and their children.

What are two possible outcomes of postpartum depression for the baby? ›

Risks include preterm birth, low birth weight and cognitive and developmental delays. Postpartum depression is linked to hormonal and chemical changes in the mother's body after giving birth and can be exacerbated by a number of factors, including economic stressors and lack access to treatment and services.

What are the 5 characteristics of depression? ›

Below, we detail five warning signs of depression.
  • Unexplained Pain. Depression does not only affect a person's mental health. ...
  • Inability to Concentrate. Almost everyone experiences some brain fog and forgetfulness. ...
  • Too Much or Too Little Sleep. ...
  • Changes in Appetite. ...
  • Moodiness and Irritability.
10 Dec 2018

Which gender has the most depression? ›

Women are nearly twice as likely as men to be diagnosed with depression. Depression can occur at any age. Some mood changes and depressed feelings occur with normal hormonal changes. But hormonal changes alone don't cause depression.

What changes occur during postpartum? ›

You may experience certain changes after delivery, including lochia (discharge), breast engorgement, discomfort in the perineal area, and constipation. Tips are provided for dealing with these, and other changes.

How long do you suffer from postpartum? ›

Most mothers experience symptoms within the first few weeks of giving birth (often within 6 weeks). But some people do not develop PPD symptoms until after 6 months. Women with PPD can experience symptoms for months or longer. In fact, studies have found that PDD can even last up to 3 years after birth.

How long are you considered postpartum? ›

For this reason, the American College of Obstetricians and Gynecologists considers postpartum care to extend up to 12 weeks after birth [2]. Some investigators have considered individuals to be postpartum for as long as 12 months after birth.

Who is at higher risk of postpartum psychosis? ›

Who is most likely to get postpartum psychosis? You do have a higher risk if you have bipolar disorder type I or schizoaffective disorder, a previous postpartum psychosis yourself, or a history of postpartum psychosis in a close relative (see the table below).

Which emotional expressions of baby blues are most common? ›

Incessant crying and tearfulness are the most common emotional expressions of postpartum blues [2,3]. within three months after childbirth. six months after childbirth.

What causes anxiety? ›

Difficult experiences in childhood, adolescence or adulthood are a common trigger for anxiety problems. Going through stress and trauma when you're very young is likely to have a particularly big impact. Experiences which can trigger anxiety problems include things like: physical or emotional abuse.

How does PPD affect the brain? ›

Recent research has shown that postpartum anxiety is related to neurobiological disruptions, such increased activation in the amygdala and insula, and decreased activity in prefrontal regions including the lateral prefrontal cortex [see (45) for a review].

How does PPD affect child development? ›

Research has listed an association between postpartum depression and delayed cognitive and language development, disorganized or insecure attachment, higher rates of behavioral problems, and lower grades.

Does PPD affect child? ›

Children with mothers suffering from long-term postpartum depression (8 months or longer) are more likely to have behavioral problems and academic challenges, and are more likely to suffer from mental health illnesses. There are many treatment combinations available to mothers suffering from postpartum depression.

What are the 4 main causes of depression? ›

Here are four of the main ones.
  • Genetics. One of the most influential factors in the onset of major depression is outside your control: your genetic code. ...
  • Substance Abuse. ...
  • Early Childhood Experiences. ...
  • Major Life Events (Both Immediate and Prolonged)
1 Sept 2019

What are the signs of a person being depressed? ›

Symptoms
  • Feelings of sadness, tearfulness, emptiness or hopelessness.
  • Angry outbursts, irritability or frustration, even over small matters.
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports.
  • Sleep disturbances, including insomnia or sleeping too much.
14 Oct 2022

What are the 3 main symptoms of depressive disorders? ›

Signs and Symptoms

Persistent sad, anxious, or “empty” mood. Feelings of hopelessness, or pessimism. Feelings of irritability, frustration, or restlessness.

Why females are more stressed than males? ›

Women suffer more stress than men because their response to stress is different. Women have a completely different hormonal system, which as a result causes them to react more emotionally and become more exhausted on an emotional level.

What are the symptoms of depression in teenage girl? ›

Symptoms
  • Feelings of sadness, which can include crying spells for no apparent reason.
  • Frustration or feelings of anger, even over small matters.
  • Feeling hopeless or empty.
  • Irritable or annoyed mood.
  • Loss of interest or pleasure in usual activities.
  • Loss of interest in, or conflict with, family and friends.
  • Low self-esteem.
12 Aug 2022

Why do females have more anxiety than males? ›

But why are women more likely to experience anxiety than men? It could be because of differences in brain chemistry and hormone fluctuations. Reproductive events across a woman's life are associated with hormonal changes, which have been linked to anxiety.

How do girls deal with mood swings? ›

How to treat significant changes in mood
  1. Get regular exercise. Moving and exercising are great for your physical and mental health. ...
  2. Avoid caffeine, alcohol, and sugar. ...
  3. Try calcium supplements. ...
  4. Change your diet. ...
  5. Practice stress management. ...
  6. Get better sleep.

Videos

1. Postnatal Depression- Women’s Health After Motherhood
(The MAMMI Study)
2. Why we all need to talk about postpartum depression | Auburn Harrison | TEDxUniversityofNevada
(TEDx Talks)
3. Postpartum Depression - What It Is, Causes, Symptoms, Treatments and More
(Rehealthify)
4. Parenting through Postpartum Depression | Camille Mehta | TEDxStanleyPark
(TEDx Talks)
5. Post Partum Depression - Mother Mental Health Toolkit
(IWK Health)
6. Women Series: Postpartum Depression And Health Care for Women
(WebTV)
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