Updated on August 15, 2024.
Postpartum depression (PPD) is a mood disorder that affects 1 in 8 women, according to the Centers for Disease Control and Prevention (CDC). It develops up to a year after childbirth and typically involves feelings of extreme sadness and exhaustion. For people affected, it can interfere with their ability to care for themselves and their newborn.
PPD is a form of perinatal depression, a term that includes depression that occurs during pregnancy (a condition known as prenatal depression) as well as after childbirth.
Postpartum depression is more than the 'baby blues'
Feelings of sadness, emptiness, and tiredness affect many people after giving birth. Sometimes referred to as the “baby blues,” these feelings can happen within the first month after having a baby. But this experience is temporary and usually passes within 2 weeks. Symptoms that are especially severe or last longer than a few weeks could be a sign of PPD.
What are the causes of PPD?
There’s no one cause of PPD. It can be triggered by a range of issues. It can also affect anyone who has just given birth, regardless of age, race, income, and other personal or social factors. Some contributing factors may include:
Hormone changes after childbirth: Levels of the hormones estrogen and progesterone are very high during pregnancy but they decrease to previous levels very quickly about 24 hours after childbirth. This sharp reduction may contribute to PPD.
Thyroid levels: Thyroid hormones help maintain energy levels and may play a role in mood regulation. Levels of these hormones may also drop after childbirth, which may lead to symptoms of depression.
Genes: For some people, depression runs in the family. If you have family members who have had depression, you may be at higher risk for PPD.
Exhaustion and sleep deprivation: These can result from the birth itself and the typical challenges of caring for a newborn. It may take weeks (or longer, in the case of cesarean births) for a person who has given birth to regain their previous levels of strength and energy.
There are a number of additional factors that may increase your risk of developing PPD. These include:
- A personal history of depression or mental illness
- Intense stress in your life, whether from the demands of childcare, work, illness, or changes in family dynamics that result from having a newborn
- Diabetes
- Pregnancy complications, such as premature birth, pregnancy loss, or having a baby with congenital differences
- Having trouble breastfeeding or caring for your baby
- Smoking, drinking alcohol, or using illegal drugs
- A personal history of experiencing physical or sexual abuse or domestic violence
What are the symptoms of PPD?
The symptoms of PPD can be different for everybody. The condition shares many of the hallmark symptoms of depression, including feeling constantly low, a lack of interest in activities that once brought you joy, and a general lack of pleasure in life.
Other symptoms of PPD may include:
- Persistent anxiety
- Feelings of emptiness
- Irritability and feelings of anger
- Crying more than usual
- Frequent headaches or body aches
- Eating too much or too little
- Sleeping more (or less) than you usually do
- Problems concentrating (mental fog)
- Feeling a lack of attachment to your baby
- Worrying that you could hurt your baby
- Feeling guilty or fearful about your role parenting a child
- Thoughts of self-harm or suicide
PPD symptoms may begin right after delivery or up to a year later, but it usually occurs within the first 3 months after childbirth.
If you are having thoughts of self-harm, call, text, or chat 988 to the 988 Suicide & Crisis Lifeline. If someone you know who has recently given birth is actively considering suicide, stay with them, call 911, or take them to the nearest emergency room.
Get the help you need for PPD
Ideally, PPD (and prenatal depression) can be identified before you give birth. The American College of Obstetricians and Gynecologists (ACOG) recommends that everyone receiving care before and during pregnancy be screened for depression. This involves having a conversation with a healthcare provider (HCP) about how you are feeling during the time leading up to getting pregnant and once you become pregnant.
Whether or not the topic was discussed during a previous visit, if you suspect you might have PPD, make an appointment with your OBGYN, midwife, therapist, family doctor, or another HCP as soon as you can. If PPD is left untreated, it can linger for months or years. The good news is that most people who receive treatment do get better.
Speaking up about your mental health may feel difficult, but it is often the first step toward feeling like yourself again. Many HCPs will also screen for depression a few weeks after delivery as a routine practice. This can help identify depression in people who might not realize they have it or help support people who feel uncertain about getting help.
What is the treatment for PPD?
If you’ve been diagnosed with postpartum depression, your HCP might recommend a combination of treatments.
You might be advised to receive counseling, such as talk therapy, from a mental health professional. Your HCP can refer you to an appropriate specialist if needed.
Treatment for PPD may also include medications, such as certain members of a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs).
Another medication an HCP might suggest is brexanolone, the first medication approved by the U.S. Food and Drug Administration (FDA) specifically for treating moderate to severe PPD. The medicine is given by intravenous (IV) infusion directly into a vein over the course of 60 hours (or 2.5 days). You must receive this medicine at a special treatment center where you can be observed by an HCP for any side effects that may crop up. If you have questions about brexanolone and whether your insurance covers it, speak with your HCP.
In 2023, the FDA approved Zurzuvae (zuranolone), the first oral medication to treat PPD, which may be another option for many people.
Be sure to let your HCP know if you are breastfeeding, as that may influence the decision to treat your PPD with medicine.
The outlook for PPD
If you’re a new parent and worry you might have PPD, know that you’re not alone. Many people experience PPD and having the condition is not a sign of weakness. Talk to your HCP as soon as you can to get the help you need.
