Postpartum Depression: Signs, Symptoms, & Treatment

By Nancy Youssef, MD
Medically reviewed
March 24, 2020

Giving birth is an emotional experience. New parents often feel a combination of excitement, awe, and joy. They may also experience feelings of sadness, anxiety, or overwhelming fatigue. When women feel moodier than usual in the first two weeks after they’ve given birth, it’s called postpartum blues or “baby blues.”

Postpartum blues are extremely common (nearly four out of five new mothers experience symptoms). The condition is not severe, does not last more than two weeks, and usually goes away on its own without treatment.

However, some new parents have feelings of depression that are more intense and last longer than two weeks. New mothers and fathers suffering from postpartum depression (PPD) may have crying spells, lose their appetite, or find less interest in activities they once enjoyed. They may oversleep or experience insomnia, withdrawal from family and friends, or have trouble bonding with their baby.

More rarely, they may hallucinate or have thoughts of hurting themselves or other family members. Postpartum depression is a medical condition that is both common and treatable.

What Is Postpartum Depression?

Postpartum depression is a form of depression that largely affects women after they’ve given birth or within the first year of their baby’s life. The disorder is very common, affecting one in seven new mothers.

Though the signs of postpartum depression can vary, women experiencing the disorder may feel too sad, tired, or anxious to complete daily tasks, care for herself, or nurture her child. The five key symptoms that really indicate postpartum depression are the following:

  • Depressed mood
  • Indifference or decreased interest in activities that once brought pleasure
  • Weight gain or loss
  • Decreased concentration or indecisiveness
  • Feelings of guilt or suicide

Male postpartum depression, sometimes called paternal postpartum depression, is a less prevalent, but still common condition. Postpartum depression statistics suggest that globally, one in ten new fathers struggle with the condition.

While many women turn their sadness and anger inward, postpartum depression in men often presents as increased irritability, rage, anger, impulsiveness, and/or heavy use of alcohol and drugs, among other symptoms.

Causes of Postpartum Depression

Although a personal history of depression increases the risk of developing postpartum depression, the condition cannot be attributed to a single cause. Rather, it is likely a mixture of genetic, physical, and emotional factors that include natural hormonal changes, sleep deprivation and the stress of caring for a newborn.

In the weeks after childbirth, a woman undergoes a steep drop in her estrogen and progesterone hormone levels, which in turn can trigger chemical changes in her brain that are often associated with postpartum depression. Men may also experience a decline in their testosterone after the birth of an infant as well.

Doctors believe that these hormonal changes, when coupled with exhaustion, stress, and in some cases, the physical pain of recovering from childbirth, contribute to an individual’s postpartum depression. It is vital to remember that PPD is a mental health condition and there is really nothing that can prevent developing the disorder.

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Symptoms of Postpartum Depression

Although postpartum depression symptoms are broad and can vary from person to person, generally speaking, PPD causes new parents to:

  • Cry more often than usual
  • Feel sad, hopeless, overwhelmed or angry
  • Feel moody or restless
  • Oversleep or find that they are unable to sleep
  • Feel overwhelming fatigue and a loss of energy
  • Find less pleasure or reduced interest in activities they once enjoyed
  • Fear that they are not good parents
  • Loss of appetite or excessive eating
  • Withdraw from loved ones
  • Have trouble bonding with their baby
  • Experience extreme anxiety or worry
  • Feel worthless and inadequate
  • Experience physical aches and pains, stomach aches, headaches, and/or muscle pain

In rare, severe cases, new parents might have recurrent thoughts about death, suicide, or of hurting themselves, their new baby, or other family members. If you or anyone you know is experiencing these symptoms, call your doctor, 911 for emergency services, or go to the nearest emergency room immediately. You can also call the National Suicide Prevention Lifeline toll-free, 24-hours a day at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889).

How Is Postpartum Depression Diagnosed?

If you suspect you might be suffering from postpartum depression, you should make an appointment with your health care provider. During the appointment, the provider will go over your symptoms and look for signs of PPD. They may also use postpartum depression screening tools like the Edinburgh Postnatal Depression Scale to determine whether you’re suffering from PPD or from something else. Reaching out is important and there is no shame in seeking help. Often as a new mom, many women may be reluctant to seek help but it’s important to discuss how you are feeling no matter if it’s the first week after delivery or a year after delivery.

Postpartum Depression Treatment Options

If your doctor believes that a patient requires postpartum depression treatment, they will suggest a plan to help the person find relief, including:

  • Therapy: Talking one-on-one with a mental health professional who specializes in cognitive behavioral therapy or interpersonal therapy can be beneficial. This practice can help patients recognize negative thoughts and behaviors, and better understand and handle interpersonal challenges.
  • Medication: You may be prescribed postpartum depression medication, including antidepressants and/or anti-anxiety medications. Although many medications are safe for new mothers, women who are breastfeeding should talk to their medical providers about any treatments. There are medications that breastfeeding moms can take that do not transfer to the baby via the breastmilk. It’s important to be treated for PPD head on to also provide a stronger link between you and your baby emotionally.

How long does postpartum depression last?

Without treatment, postpartum depression can last for months, and in some cases, years. If you suspect that you or someone you know is suffering from postpartum depression, it is important to be screened and treated as soon as possible. PPD can adversely influence a new parent’s ability to bond with their baby, which in turn can affect the infant’s health and wellbeing.

Risk Factors

Although postpartum depression’s causes are still unclear, there are factors that put certain individuals at a higher risk for developing the condition. Those include:

  • A general history of depression or bipolar disorder or a history of depression during or after pregnancy
  • A family history of mood disorders like depression or other mental illnesses
  • Medical complications during childbirth
  • Significant stress during pregnancy or after giving birth due to job loss, domestic violence, personal illness, or the death of a loved one
  • Little to no emotional support from a spouse or partner, family, or friends
  • Mixed feelings or reservations about the pregnancy, whether the pregnancy was planned or unplanned
  • Alcohol, street drugs, and/or prescription drug abuse

While there is no guaranteed way to completely prevent postpartum depression, habitually practicing self-care can help you stay aware of any mood changes that might require you to seek treatment. If you would like to consider non-medication therapies, join group or individual psychotherapy like cognitive behavioral therapy as well as interpersonal therapy. Some studies indicate that light therapy has been effective in treating postpartum depression. In addition, a postpartum depression action plan is available here.

While postpartum blues and postpartum depression are common, 1-2 out of every thousand women will experience a much rarer, more extreme form of postpartum psychiatric illness called postpartum psychosis. New mothers with postpartum psychosis may hallucinate, feel disoriented, or display erratic behavior.

They may have paranoid, bizarre or violent and suicidal thoughts, delusions of grandeur, and dramatic mood swings. The onset of postpartum psychosis is rapid, often within the first 2-3 days after giving birth, and the consequences of the condition can be devastating.

If you suspect that you or someone you know is experiencing postpartum psychosis, it is important to seek treatment as quickly as possible.

When to Seek Help

If you have had a child within the last year and have experienced any of the symptoms listed above for more than two weeks, it’s time to talk to your doctor about whether you should be screened for postpartum depression.

To learn more about postpartum depression and the adverse effects it can have on a new parent’s health and wellbeing, check on the U.S. Department of Health and Human Services’ website on mental health and the National Institute of Mental Health’s postpartum depression facts page.

How K Health Can Help

Anxiety and depression are among the most under-reported and under-treated diseases in America. Nearly 20% of adults in the US suffer from mental health illness and fewer than half receive treatment. Our mission is to increase access to treatment for those suffering in silence.

You can start controlling your anxiety and depression and get access to the treatment you need with K Health. Starting at $12/month get prescriptions for mental health medications plus unlimited doctor visits through the K Health app. Start your free assessment to see if you’re eligible.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Nancy Youssef, MD

Dr. Youssef is a board certified family medicine physician who completed her residency at at Advocate Christ Medical Center and later obtained her teaching in family medicine fellowship at Tufts/Cambridge Health Alliance Family Medicine. She graduated from the University of Illinois. Aside from her work at K Health, Dr. Youssef is currently working in urgent care and primary care specializing in Women's Health.

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