Key facts
- Postpartum depression is a common complication of pregnancy and childbirth, not a sign of being a bad parent.
- It is more intense and longer lasting than the "baby blues," which usually ease within two weeks.
- It can begin during pregnancy or any time in the first year after birth.
- The core treatments are psychotherapy, medication, or both, and they work for most people.
What is postpartum depression?
Postpartum depression is a type of depression that occurs during pregnancy or in the weeks and months after giving birth. Because it can begin before delivery as well as after, clinicians often use the broader term perinatal depression. It is different from the short-lived "baby blues," which many new parents feel in the first days after delivery. Postpartum depression is more severe, lasts longer, and interferes with the ability to care for yourself and your baby.
It is also common. The Centers for Disease Control and Prevention reports that about 1 in 8 women with a recent live birth experience symptoms of postpartum depression. The National Institute of Mental Health emphasizes that perinatal depression can affect any pregnant or postpartum person, regardless of age, race, income, or background. It is a real medical condition driven by hormonal, physical, emotional, and social changes, not a personal failing or a sign of being a bad parent. The encouraging part is that postpartum depression is highly treatable, and reaching out for help is a sign of strength.
Symptoms
Postpartum depression looks different from person to person, but common signs include:
- Persistent sad, anxious, or "empty" mood
- Severe mood swings or excessive crying
- Difficulty bonding with your baby
- Withdrawing from family and friends
- Doubting your ability to care for your baby, or losing interest in the baby
- Changes in appetite or sleep beyond the usual demands of a newborn
- Overwhelming fatigue or loss of energy
- Intense irritability or anger
- Feelings of worthlessness, shame, guilt, or inadequacy as a parent
- Difficulty concentrating, remembering, or making decisions
- Physical aches and pains that do not have a clear cause
- Thoughts of harming yourself or your baby
The "baby blues" usually peak a few days after birth and ease on their own within two weeks. They involve mild mood swings, tearfulness, and worry, and most new parents experience some version of them. Postpartum depression is different: the symptoms are more intense, last longer, and get in the way of daily life. Symptoms that last longer than two weeks, that get worse, or that make it hard to function are a reason to talk to a professional. Thoughts of harming yourself or your baby need help right away (see the crisis box above).
Types
- Baby blues: mild mood swings, tearfulness, and worry that begin soon after birth and typically resolve within two weeks without treatment.
- Postpartum depression: more intense and persistent depressive symptoms that interfere with daily life and need treatment.
- Postpartum anxiety: excessive worry, racing thoughts, or panic that can occur with or without depression. See anxiety.
- Postpartum psychosis: a rare but serious emergency involving confusion, hallucinations, paranoia, or delusions that requires immediate medical care.
Partners, including fathers and non-birthing parents, can also experience depression after a baby arrives, and their symptoms deserve attention and treatment too. Postpartum depression is not the parent's fault, and it does not reflect how much they love their child. With the right care, the large majority of people recover fully.
Causes and risk factors
There is no single cause, and it is not something a parent brings on themselves. Postpartum depression usually results from a combination of factors:
- Hormonal changes: the rapid drop in estrogen and progesterone after delivery, along with thyroid changes, can affect mood.
- Physical factors: exhaustion, sleep deprivation, pain, and the demands of recovering from childbirth.
- Personal and family history: a previous episode of depression, anxiety, or postpartum depression, or a family history of mood disorders, raises risk.
- Pregnancy and birth experiences: a difficult or complicated pregnancy or delivery, pregnancy loss, or having a baby with health needs.
- Life circumstances: limited social support, financial stress, relationship strain, being a young or single parent, or a recent stressful life event.
Having one or more risk factors does not mean a person will develop postpartum depression, and people with no obvious risk factors can still develop it. That is why screening during and after pregnancy matters. The American College of Obstetricians and Gynecologists recommends that clinicians screen patients for depression and anxiety during the perinatal period.
How postpartum depression is treated
Postpartum depression is highly treatable. Most people respond well, and a combination of approaches often works best. The right plan depends on how severe the symptoms are, whether you are breastfeeding, and your own preferences, so it is worth discussing options openly with your provider.
Psychotherapy
Talk therapy, particularly cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), helps you work through difficult thoughts, build coping skills, and adjust to the changes of parenthood. For mild to moderate symptoms it is often a first-line treatment, and it can be used on its own or alongside medication.
Medication
Antidepressants can help correct the brain chemistry involved in depression, and a prescriber can discuss options that are considered appropriate during pregnancy or breastfeeding. There are also medications developed specifically for postpartum depression. The decision weighs the benefits of treatment against any risks, and untreated depression carries risks of its own for both parent and baby. Learn more about antidepressants.
Support and self-care
Rest when you can, accept help with the baby and household, connect with other parents, and stay in touch with people you trust. Peer support, such as the warmline run by Postpartum Support International, can help you feel less alone. These supports complement, but do not replace, professional treatment for moderate to severe symptoms.
When to seek help
Reach out to a doctor, midwife, or mental health professional if low mood, anxiety, or other symptoms last more than two weeks, get worse, or make it hard to care for yourself or your baby. You do not need to wait for a scheduled checkup, and you do not need to be sure it is "bad enough." Your obstetric or pediatric provider can help, refer you, or start treatment. In the US, the National Maternal Mental Health Hotline offers free, confidential support for new and expecting parents at 1-833-852-6262 (call or text), any time.
Seek help immediately if you have thoughts of harming yourself or your baby, or any signs of postpartum psychosis such as confusion, hallucinations, paranoia, or rapid mood changes, which is a medical emergency. Call or text the 988 Suicide & Crisis Lifeline, or call 911 or go to the nearest emergency room. Getting help early makes recovery easier, and effective treatment is available.
Frequently asked questions
How is postpartum depression different from the baby blues?
The baby blues are mild and usually pass within two weeks. Postpartum depression is more intense, lasts longer, and interferes with daily life, so it needs professional care.
Can fathers and partners get postpartum depression?
Yes. Partners, including fathers and non-birthing parents, can also experience depression after a baby arrives. Their symptoms deserve attention and treatment too.
Is it safe to take antidepressants while breastfeeding?
Many treatment options are considered compatible with breastfeeding. A prescriber can weigh the benefits and risks and help you choose an approach that fits your situation.
Related conditions
Therapists who specialize in postpartum depression
Connect with a licensed therapist on Psychology.com who works with postpartum depression.
- A FAMILY MATTER
- Advance Thru Psychotherapy and Family Development
- Asktheinternettherapist.com
- Barbara L Edwards
- Beth Britton
- Beth Wilson
References
- National Institute of Mental Health (NIMH). Perinatal Depression.
- Centers for Disease Control and Prevention (CDC). Depression Among Women.
- Postpartum Support International (PSI). Perinatal Mental Health: Signs, Symptoms and Treatment.
- 988 Suicide & Crisis Lifeline. Free, confidential 24/7 support.