What is postpartum depression?

“Postpartum” means the time after childbirth. If you feel empty, emotionless, hopeless, or sad all or most of the time for longer than 2 weeks during or after pregnancy, you might have postpartum depression. You might also feel unconnected to your baby, as if you are not the baby’s mother, or you might not love or care for the baby.

Postpartum depression is a serious mental illness that involves the brain and affects your behavior and physical health, interfering with your day-to-day life.

Feeling hopeless or empty after childbirth is not a regular or expected part of being a mother. Treatment for postpartum depression, such as counseling and/or medicine, works and will help you and your baby be as healthy as possible.

This article details Postpartum Depression, though it is important to note the some women first develop depression during pregnancy rather than postpartum, or had feelings of depression prior to being pregnant and it worsened since conception. Additionally, mothers can develop Anxiety, OCD, or Psychosis during and/or after pregnancy.

How common is postpartum depression?

Depression is a common problem after pregnancy. 1 in 7 new mothers develops postpartum depression!

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, seek help:

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.

postpartum depression treatment and therapy

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

Most women, about 80%, have the baby blues in the days after childbirth. If you have the baby blues, you may:

Have mood swings
Feel sad, empty, anxious, or overwhelmed
Have crying spells
Lose your appetite
Have trouble sleeping

For many women, the baby blues go away in 3 to 5 days. If your baby blues don’t go away after 2 weeks, you may have postpartum depression. 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.

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. 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 can help you get your thyroid levels regulated.

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, and can also contribute to postpartum depression.

Are some women more at risk of postpartum depression?

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

Have a personal history of depression, anxiety, postpartum depression or bipolar disorder
Have a family history of depression, anxiety, postpartum depression or bipolar disorder
Get Premenstrual dysphoric disorder (PMDD or PMS)
Have inadequate 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 or in the Neonatal Intensive Care Unit (NICU)
Have difficulty breastfeeding
Had an unplanned or unwanted pregnancy
Had complications in pregnancy, birth or breastfeeding
Had a major recent life event: loss, house move, job loss
Are a mother of multiples
Went through infertility treatments
Have a thyroid imbalance
Have any form of diabetes (type 1, type 2 or gestational)

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

Call your doctor, nurse, midwife, pediatrician, counselor, or schedule an appointment with Karen if you have any of the above symptoms or:

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 (Call 911 or go to your closest ED if in crisis)

What can I do at home to feel better?

Postpartum depression and anxiety treatment and support

Here are some ways to begin feeling better 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.
Get outside, go on a walk, exercise.
Remember to eat well, drink water, and nourish your body.
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 get help right away.

How is postpartum depression treated?

The common types of treatment for postpartum depression are:

Counseling. During counseling, you talk to a mental health expert to learn strategies to change how postpartum depression makes you think, feel, and act. You learn strategies to feel better. It is best to seek counseling from someone with training specific to perinatal mental health or postpartum depression, as it is a unique presentation, with different contributors and treatment than general depression.
Medicine. There are different types of medicines for postpartum depression. All of them must be prescribed by your doctor or prescribing nurse. The most common type is antidepressants. Antidepressants can help relieve symptoms of depression and some can be taken while you are pregnant or breastfeeding. Antidepressants may take several weeks to start working.
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:

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