Symptoms
The symptoms of postpartum depression are similar to a major depressive episode. In the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5), the description of postpartum major depression is a “major depressive episode with a peripartum-onset specifier.” Postpartum depression tends to develop within several weeks of delivery. Some experts feel the criteria to qualify for postpartum-onset should extend longer, perhaps up to six months after childbirth. Symptoms of PPD may include the following:
Change in weight or appetiteCryingDepressed mood, loss of interest or pleasureDifficulty making decisionsFeelings of inadequacyFeelings of worthlessness or guiltInsomnia or hypersomniaLoss of energy or fatigueProblems with concentrationRestlessness or agitationSadness
Some people also experience suicidal thoughts.
Diagnosis
If you’re feeling overwhelmed by symptoms of postpartum depression, contact a healthcare provider or mental health professional right away. They will evaluate your symptoms and determine if you are experiencing baby blues, depression, or something else—and create a plan for treatment. During your evaluation, you will likely complete a depression screening questionnaire as well as discuss the symptoms you’ve been having, including the duration and severity. Your provider also may conduct blood tests to check for medical abnormalities that might be contributing to your symptoms. Sometimes people put off getting treatment for PPD because they feel embarrassed or ashamed for their feelings, especially because people often expect new parents to feel overjoyed rather than depressed or fatigued. Instead, what people should know is that adjusting to being a new parent is really hard—and depression after giving birth is very common. But effective treatment can make a world of difference. Be sure to talk to someone if you are feeling stressed, sad, irritable, overwhelmed, and/or depressed.
Causes
Researchers are uncertain about exactly why postpartum depression occurs—and why it affects one person and not another. However, some potential causes that are believed to contribute to this mental health condition include genetics, lack of sleep, low thyroid hormone levels, and rapidly changing hormonal levels following childbirth. There was an error. Please try again. Some of the risk factors that increase your chance of developing PPD are the following:
Diabetes (pre-existing or gestational diabetes) Difficulty breastfeeding or caring for your baby Health issues with your baby Life stressors, such as unstable relationships, illness, or financial troubles Limited support from family or friends Negative feelings about being a mom Past experience of depression or postpartum depression Pregnancy complications, such as preterm birth, stillbirth, or birth defects
Types
Other postpartum mental health conditions related to PPD include postpartum psychosis and postpartum anxiety disorders. Here is what you need to know about the other types of postpartum mental health conditions.
Postpartum Psychosis
Sometimes called puerperal psychosis, this postpartum mental health condition develops in around 1 to 2 out of 1,000 people. Postpartum psychosis usually begins earlier than postpartum depression, within the first two weeks after giving birth. Postpartum psychosis is distinguished from postpartum depression by the presence of delusions (believing things that aren’t actually true) and/or hallucinations (hearing things or seeing things that aren’t there). Other symptoms can include intrusive thoughts and an inappropriate response to or disinterest in one’s child. Postpartum psychosis symptoms may change rapidly, with periods of elevated mood being quickly followed by profound sadness or rage. Periods of lucidity are common and not necessarily an indicator of recovery. It is thought that postpartum psychosis often represents an episode of bipolar illness.
Postpartum Anxiety Disorders
Anxiety disorders are also common following childbirth. You may find that you are so anxious that you find it difficult to care for your baby or yourself, such as being unable to eat or sleep. Some people find themselves afraid that they will harm their baby. In fact, according to the Women’s Preventive Services Initiative (WPSI), which is a national coalition of women’s health professionals, anxiety is one of the most prevalent health disorders in the U.S. Impacting as many as 40% of women over the course of their lifetime, anxiety can be caused by a number of underlying issues, including the stresses of childbirth and becoming a parent Consequently, if you are experiencing signs of anxiety, talk to a healthcare professional. They can administer a quick questionnaire to assess your anxiety and make a referral for care as needed.
PPD vs. “Baby Blues”
When healthcare providers talk about “baby blues,” they are referring to a short-term, milder version of postpartum depression. However, having baby blues does not meet the clinical criteria for PPD. Baby blues are commonly experienced by many people after childbirth as they adjust mentally and physically to the realities of parenthood. During this time, women may suddenly feel like they can’t possibly handle taking care of a baby no matter how prepared they are as parents. Lack of sleep and the postpartum hormonal adjustment both contribute to the symptoms of baby blues. Fortunately, the experience of baby blues is usually short-lived (a week or two is a common duration) and resolves as people get used to being parents.
Treatment
If you suspect you may have postpartum depression, contact a healthcare provider right away. It’s extremely important to get professional help—even if you aren’t sure whether you are depressed or coping with prolonged baby blues. Treatment can make a big difference in both your quality of life and the health of your baby.
AnxietyCryingInsomniaTirednessMoodinessSadness
Care for postpartum depression depends on the symptoms, diagnosis, and severity of the condition. While self-care and social support are often sufficient to help people return to normal functioning if they have mild baby blues, true PPD usually needs formal treatment from an expert in postpartum depression to resolve. Even if you feel like you are experiencing a mild case of the baby blues, talk to your healthcare provider about your symptoms so they can monitor your progress. Having support can ensure that you get treatment as soon as possible should your symptoms worsen. If you feel like your symptoms are getting more intense and/or are interfering with your life, seek care right away. Treatment options may include medications, psychotherapy, support groups, and more. Enlisting the support of family and friends is crucial, as well, particularly for help with caring for your baby while you follow the treatment protocol prescribed by your provider
Therapy
If you opt for psychotherapy, you will likely meet with a mental health professional such as a psychiatrist, psychologist, or social worker. They will help you work through any challenges you are facing as well as develop new coping skills that can help you better manage your symptoms. Common types of psychotherapy that are used to treat postpartum depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT focuses on changing your thinking patterns and behaviors while IPT works to help people understand and change communication patterns in their relationships.
Medications
Medication treatment for postpartum depression often involves the use of antidepressants. Antidepressants can take a few weeks to be effective, and you may need to try out a few medications before finding one that helps you. Your healthcare provider will determine which type of medication and dosage are right for you. If you’re breastfeeding, ask for a medication that is safe for your baby. In 2019, the medication Zulresso (brexanolone) became the first drug to be approved by the FDA specifically to treat postpartum depression. Other antidepressants are approved to treat depression generally.
Coping
The time shortly after birth is also a recovery, readjustment, and let-down period for many people following months of pregnancy. Fortunately, there are some things that you can do to make managing this transition a bit easier. Here are some things you can do to help you adjust.
Accept help from others. Ask for help if you are struggling. Refrain from blaming yourself. Eat a healthy diet. Exercise. Get out of the house for a change of scenery. Ask someone to watch the baby while you take a break. Join a social group for new moms to maintain social connections. Prioritize time for self-care. Talk to other women who have “been there.” Try to get as much sleep as possible.
Self-care and lifestyle changes can also be important complements to other treatments. For example, make time for a baby-and-me yoga class, go for a long walk, take a bubble bath, get a massage, or book a haircut. Meanwhile, several studies have found that exercise can reduce the symptoms of postpartum depression.
A Word From Verywell
Postpartum depression, anxiety, and psychosis are serious conditions and can come on very rapidly. If you or your loved one are experiencing signs of depression, know that it’s no one’s fault, and reaching out to a healthcare provider or mental health professional can help. If someone is showing signs of delusions or hallucinations postpartum, seek medical attention immediately. Many resources, including the Postpartum Support International hotline above, are available any time of day. Don’t hesitate to talk to someone. Even if you think it’s “just” the baby blues, a little extra support can go along way.
