Postpartum depression (also called PPD) is a type of depression some women have after having a baby.
We’re taking a comprehensive look at all that it entails. What causes postpartum depression? What are signs and symptoms of postpartum depression? Are there certain risk factors or ways to prevent PPD? We explore all of these questions, and then discuss what to do if you or your partner experiences postpartum depression.
What Is Postpartum Depression?
Postpartum depression involves feelings of deep sadness and helplessness that happen in some women after giving birth. According to the Journal of Obstetrics and Gynecology, “the prevalence of PPD appears to peak at 2–6 months following delivery, and as many as 14.5% of postpartum women may experience a new depressive episode within 3 months after delivery.”
However, the reality is that symptoms of PMAD can begin any time during or after pregnancy, including after a loss or while weaning.
Before we get further into the discussion, it is important to note that postpartum depression is just one of the mental health issues that can arise during or after pregnancy. PPD is considered one of the perinatal mood and anxiety disorders (PMAD) which also include conditions like postpartum anxiety, postpartum rage, obsessive compulsive disorder (OCD), and postpartum psychosis. While existing data reports that 20% of women experience some type of perinatal mood and anxiety disorder (PMAD), the Needed Maternal Mental Health report data suggests that number is significantly understated. It found that “63% of women reported they’ve struggled with mental health in the perinatal stage.”
Causes of postpartum depression
There is no single or definitive cause of postpartum depression. However, certain psychological, social, and biological stressors that are common in pregnancy and postpartum may contribute:
- Hormones: The dramatic drop in estrogen and progesterone after birth may play a role in feelings associated with PPD. In addition, thyroid hormones may also become imbalanced and impact physical and emotional health.
- Lack of sleep. Sleep deprivation can exacerbate just about any challenge, including mental health
- Increased responsibility: The increased responsibility that comes with caring for a new life can cause intense feelings of concern for their wellbeing, or like a significant weight on your shoulders.
- Loss of self: Some women feel like they have lost themselves in the process of welcoming a baby. They may feel different physically or emotionally, or like their life will never be the same.
Please know that developing postpartum depression, or any perinatal mood and anxiety disorder is not your “fault” or a result of anything you did or did not do.
Are some people more at risk of postpartum depression?
Certain factors can increase the risk of postpartum depression, but it is quite possible to experience postpartum depression without any risk factors. Risk factors may include the following:
- Depression before or during pregnancy
- A family history of depression
- Experience with abuse or adversity as a child
- A difficult pregnancy or traumatic birth
- Lack of support from family, friends, or your partner
- Experience with domestic violence
- Relationship struggles
- Stress in your life (e.g., financial challenges, etc.)
- Under the age of 20
- Facing breastfeeding challenges
- A baby who was premature, has special health care needs, or spent time in the NICU
- An unplanned pregnancy
What is the difference between baby blues and postpartum depression?
The baby blues are common in the initial few weeks after childbirth. The baby blues affect between 60 and 80% of new mothers and may include the following symptoms:
- Mood swings
- Feeling sad or anxious, especially by things that wouldn’t normally bother you
- Feeling trapped or overwhelmed
- Having crying spells
- Loss of appetite
- Trouble sleeping
The baby blues usually go away within a few weeks. By contrast, postpartum depression symptoms last longer and are more severe.
Postpartum depression symptoms
Because symptoms can be similar, postpartum depression can be mistaken for baby blues at first. However, when symptoms become more intense, don’t resolve, or interfere with your ability to care for your baby and handle other daily tasks, it is likely to be postpartum depression.
The following symptoms typically start within the first few weeks after giving birth, but they can appear at any time during the perinatal journey:
- Depressed mood or severe mood swings
- Crying too much
- Difficulty bonding with your baby
- Withdrawing from family and friends
- Loss of appetite or eating much more than usual
- Inability to sleep, called insomnia, or sleeping too much
- Overwhelming tiredness or loss of energy
- Less interest and pleasure in activities you used to enjoy
- Intense irritability and anger
- Fear that you're not a good mother
- Hopelessness
- Feelings of worthlessness, shame, guilt or inadequacy
- Reduced ability to think clearly, concentrate or make decisions
- Restlessness
- Severe anxiety and panic attacks
- Thoughts of harming yourself or your baby
- Recurring thoughts of death or suicide
Postpartum psychosis symptoms
Postpartum mental health challenges extend far beyond postpartum depression. Another condition that falls into the category of perinatal mood and anxiety disorders (PMAD) along with postpartum depression is postpartum psychosis. It is a rare but serious condition that usually develops within the first week after delivery. Symptoms may include the following:
- Feeling confused and lost
- Having obsessive thoughts about your baby
- Hallucinating and having delusions
- Having sleep problems
- Feeling paranoid
- Making attempts to harm yourself or your baby
Postpartum psychosis can be life-threatening and requires immediate treatment.
About PPD in the other parent
It isn’t just women who can experience postpartum depression. New fathers or partners can also experience postpartum depression. While less common than in women who have birthed a baby, the symptoms are similar. Partners may feel sad, defeated, helpless, or overwhelmed. They may also have changes in their usual eating and sleeping patterns that are unrelated to caring for a newborn.
Fathers or partners who are young, have a history of depression, experience relationship problems or are struggling financially are most at risk of postpartum depression.
Risk factors are similar to those for women and include a history of depression, rela, and hormonal changes
If you're a partner of a new mother and are having symptoms of depression or anxiety during your partner's pregnancy or after your child's birth, talk to your health care provider. Similar treatments and supports provided to mothers with postpartum depression can help treat postpartum depression in the other parent.
Postpartum Depression Prevention
You can’t necessarily prevent postpartum depression, but there are steps you can take to support your mental health during pregnancy and postpartum.
If you have a history of depression, tell your OB, midwife, or other healthcare practitioner as soon as you find out you’re pregnant, or if you’re planning to become pregnant. Together, you can keep an eye out for symptoms and seek out support through counseling or other therapies.
And you don’t need to have a history of depression to be proactive in seeking support. Finding a trusted mental healthcare provider during your fertility journey or when you become pregnant can help establish a good foundation for mental health support once baby has arrived.
Managing Your Mental Health After Childbirth
A new baby can change the dynamic and impact your mental health, whether or not you experience postpartum depression. Here are some tips to consider for supporting your mental health, both before and after baby has arrived:
Before baby has arrived:
- Discuss a visitor policy with your partner: decide when and how often you want to allow people to visit, and decide who will have hard conversations if needed
- Find a therapist or mental health practitioner: it feels less daunting to find one before you have your baby
- Brainstorm ways to relieve stress or clear your head: some of your typical tools, like a long session at the gym, might not be accessible, so think about how you might adjust when baby arrives. Maybe that means getting a comfortable baby carrier for walks, or finding some new shows to watch or books to read.
- Make a plan for nighttime wakings: disrupted sleep can impact mental health, but discussing a plan for who will get up can help. For example, if you are breastfeeding, you will likely be the one to feed baby at night, but your partner can be the one to change the diaper and get baby back to sleep to minimize the time you need to be awake.
Once baby has arrived:
- Ask for help: be specific in what you want or need.
- Continue your prenatal supplements: your nutrient needs remain high, and certain nutrients can support mental health.
- Engage in gentle movement: You may not be able to get back into your usual fitness routine yet, but getting outside for a walk can make a big difference in your day.
- Watch for triggers: there can be a lot of downtime with a newborn, and many women find themselves scrolling social media and comparing themselves to other moms
- Give yourself grace: the newborn phase and the postpartum phase are temporary. They might feel long and hard (they can be!) but they do not last forever, and you deserve to get back to feeling like yourself.
Helping a friend or loved one
People with postpartum depression may not recognize or admit that they're depressed. As a new parent, it can be easy
If you suspect that a friend or loved one may be experiencing symptoms of postpartum depression, don’t wait for improvement, let them know that you’re available to help them seek medical attention.
When to see a doctor
Reach out for support if your symptoms of depression:
- Don't decrease after 2-4 weeks;
- Get increasingly worse;
- Make it hard for you to care for your baby or complete daily tasks; and/or
- Include thoughts of harming yourself or your baby.
You can contact your healthcare provider, or call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262). It is a free and confidential mental health support line open 24/7 for moms and their families before, during, and after pregnancy.
How is postpartum depression treated?
Treatment for postpartum depression looks different for everybody, which is why it is important to work with a trusted provider to guide your journey. Some of the different tools that can be used alone or together include the following:
- Therapy: Counseling sessions include meetings (virtual or in person) with a mental health professional who is experienced in working with postpartum women.
- Support groups: Support groups include other women experiencing PPD and can provide an outlet to talk as well as a community of support to help you feel less alone.
- Self-care: It sounds trite, but it is true. Taking care of yourself can help you feel more like yourself. Work with your partner and others close to you to carve out some time to get some rest, eat nourishing food, and engage in gentle movement. Don’t be afraid to ask for help!
- Medication: In some cases, medicine may be prescribed to help manage symptoms. These may take several weeks to start working.
The Bottom Line
Having a baby is a great joy, but it can also feel like a huge challenge that impacts your mental health. Postpartum depression is a real concern for many women. It can impact your own life as well as your baby’s. Getting help is a sign of strength and important for the long term wellbeing of you and your family.
