Postpartum depression (PPD) is a serious but treatable form of depression that can develop during pregnancy or in the months after giving birth. Unlike the short-lived “baby blues,” PPD brings symptoms that are more intense, last longer than two weeks and can make it hard to care for yourself or your baby. Therapy, medication and support can help you feel like yourself again.
If you are struggling after having a baby, it is not your fault and it does not mean you are a bad parent. PPD is common, and asking for help is one of the best things you can do for yourself and your family.
What Is Postpartum Depression?
According to the National Institute of Mental Health (NIMH), perinatal depression is a mood disorder that can affect people during pregnancy and after childbirth. When it begins after delivery, it is called postpartum depression. MedlinePlus notes that it most often starts within the first three months after birth but can occur up to a year later.
It is also common. The Centers for Disease Control and Prevention (CDC) reports that about 1 in 8 women with a recent live birth experience symptoms of PPD.
Baby Blues vs. PPD
Many new parents have the baby blues. The Mayo Clinic explains that baby blues usually begin within the first two to three days after delivery and may last up to two weeks. They can include mood swings, crying spells, anxiety, irritability and trouble sleeping.
NIMH notes the key difference: if symptoms are severe or last longer than two weeks, it may be PPD, and it is time to talk with a health care provider.
Symptoms of Postpartum Depression
PPD can look different from person to person. Mayo Clinic, NIMH and CDC describe symptoms such as:
- Depressed mood, severe mood swings or feeling sad, anxious or “empty”
- Crying more often than usual
- Difficulty bonding with your baby or feeling distant from your baby
- Withdrawing from family and friends
- Losing interest in activities you used to enjoy
- Trouble sleeping, or sleeping too much, and overwhelming tiredness
- Changes in appetite
- Irritability or anger
- Feeling worthless, guilty or like you are not a good parent
- Trouble thinking clearly, concentrating or making decisions
- Thoughts of harming yourself or your baby
MedlinePlus notes that people with PPD who have thoughts of harming their baby rarely act on them, but these thoughts are a sign to get help right away.
Postpartum Psychosis Is an Emergency
Postpartum psychosis is rare but serious. Mayo Clinic says it usually develops within the first week after delivery. NIMH lists symptoms such as delusions, hallucinations, mania, paranoia and confusion. If you or someone you love shows these signs, call 911 right away.
Risk Factors and Causes
NIMH stresses that PPD is not caused by anything a parent did or didn’t do. It likely results from a mix of factors, including hormone changes during and after pregnancy, life stress and personal or family history.
Mayo Clinic and MedlinePlus list risk factors that include:
- A personal history of depression, bipolar disorder or earlier PPD
- A family history of depression or other mood disorders
- Recent stressful events
- A baby with health problems
- Having twins or other multiples
- Difficulty breastfeeding
- Problems in your relationship or weak social support
- Financial stress
- An unplanned or unwanted pregnancy
- Substance use
Partners Can Be Affected, Too
Mayo Clinic notes that fathers and partners can also experience depression after a baby arrives, with symptoms like sadness, fatigue, anxiety and changes in eating or sleeping. If your partner is struggling, our guide on how to help someone with depression may help.
How PPD Is Diagnosed
There is no single test for PPD. According to MedlinePlus, diagnosis is based on the symptoms you describe to your provider. Your provider may ask you to fill out a depression screening questionnaire and may order blood or urine tests to rule out a physical cause, such as a thyroid problem.
Be honest about how you are feeling, even if it feels scary. Providers ask these questions because PPD is common and treatable.
Treatment for Postpartum Depression
CDC notes that depression is treatable and most people get better with treatment. Common options include:
Talk Therapy
NIMH and MedlinePlus note that cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) can help. CBT helps you notice and change unhelpful thought patterns, while IPT focuses on improving communication and relationships.
Medication
Antidepressants are often used to treat PPD, and NIMH notes they can take 4 to 8 weeks to work. If you are breastfeeding, your provider can help you weigh options, since MedlinePlus notes that breastfeeding affects which medicines are chosen. Learn more in our guide to types of antidepressants.
NIMH notes that the FDA has also approved two medicines specifically for PPD: brexanolone, given by IV, and zuranolone, a pill. In its 2023 announcement approving zuranolone, the FDA explained that it is the first oral medication for PPD in adults. It carries a boxed warning that it can affect the ability to drive, so people should not drive or do other potentially hazardous activities for at least 12 hours after taking it. Only your provider can decide if one of these is right for you.
Support and Structured Care
Practical help with meals, sleep and baby care from family and friends can ease symptoms, according to MedlinePlus. If symptoms are making it hard to function, a more structured program such as an intensive outpatient program or a partial hospitalization program can provide more support while you live at home. Many new parents also have significant anxiety; our guide to generalized anxiety disorder explains the signs.
Frequently Asked Questions
How long does PPD last?
It varies from person to person. With treatment such as therapy and medication, MedlinePlus notes symptoms can often be reduced or eliminated.
Can PPD start during pregnancy?
Yes. Mayo Clinic notes symptoms can begin during pregnancy, and the FDA describes PPD as a major depressive episode that can begin in the later stages of pregnancy.
Can I take antidepressants while breastfeeding?
Many people do, but the choice depends on your situation. CDC recommends talking with your provider about the safety of medicines during pregnancy and breastfeeding.
What should I do if I have thoughts of harming myself or my baby?
Get help right away. Call or text the 988 Suicide & Crisis Lifeline, which is free, confidential and available 24/7. If you or your baby are in immediate danger, call 911.
Get Help for Postpartum Depression in Lancaster, PA
You deserve support during this season of life. At The Ranch Pennsylvania Outpatient Services, our mental health treatment programs offer CBT, individual, group and family therapy, and psychiatric evaluation and medication management. Explore our depression resources or read about depression treatment in Pennsylvania. You can verify your insurance online, and our admissions team is available 24/7. Calls are free and confidential.
