Part 1 of 17

What is postpartum depression?

You’ve probably heard of the “baby blues.” That’s because it’s quite common for new mothers to feel a little sad, worried, or fatigued. As many as 80 percent of mothers have these feelings for a week or two following childbirth. This is completely normal and usually fades in a few weeks.

Although some of the symptoms sound the same, postpartum depression is very different from the baby blues.

Postpartum depression is a lot more powerful and lasts longer. It follows about 15 percent of births and can cause severe mood swings, exhaustion, and a sense of hopelessness. The intensity of those feelings, at a time when you least expect it, can make it difficult to care for your baby or yourself.

It can strike first-time moms or those who’ve given birth before.

Postpartum depression shouldn’t be taken lightly. It’s a serious disorder, but it can be overcome through treatment.

Part 2 of 17

What are the symptoms of postpartum depression?

Although it’s normal to feel moody or fatigued after having a baby, postpartum depression goes well beyond that. Symptoms are severe and can interfere with your ability to function.

Symptoms of postpartum depression vary from person to person and even from day to day.

If you have postpartum depression, chances are you’re familiar with several of these indicators:

  • You cry a lot, even when you don’t know why.
  • You’re exhausted, but you can’t sleep. Or you sleep too much.
  • You can’t stop eating, or you aren’t interested in food at all.
  • You have various unexplained aches, pains, or illnesses.
  • You don’t know why you’re irritable, anxious, and sometimes downright angry.
  • Your moods change suddenly and without warning. You feel out of control.
  • You’re having difficulty remembering things, you can’t concentrate, and you’re unable to make simple decisions.
  • You feel sad for no obvious reason.
  • You have no interest in things you used to enjoy.
  • You can’t bond with your baby. You feel disconnected and wonder why you’re not over-the-moon with joy, like you thought you’d be.
  • Everything feels overwhelming. Life is hopeless.
  • You feel worthless and guilty about your feelings.
  • You can’t open up to anyone because they’ll think you’re a bad mother and perhaps even take your baby, so you withdraw.
  • You want to escape from everyone and everything.
  • You have intrusive thoughts about harming yourself or your baby.

Your friends and family may notice that you’re withdrawing from them and from social activities, or that you just don’t seem like yourself.

Symptoms are most likely to start within a few weeks of delivery. Sometimes postpartum depression doesn’t surface until months later. Symptoms may let up for a day or two, and then return with a vengeance. 

Without treatment, symptoms may continue to worsen.

Part 3 of 17

Treatment for postpartum depression

If you have symptoms of postpartum depression, you should see your doctor as soon as possible so that you can get started on treatment.

There are two main treatments for postpartum depression: medication and therapy. Either can be used alone, but they may be more effective when used together. It’s also vital to make some healthy choices in your daily routine.

Whatever treatment you first choose, it may take a few tries to find out what works for you. That’s why open communication with your doctor is so important.

Medicine

Antidepressants have a direct effect on the brain. They alter the chemicals that regulate mood. They won’t work right away, though. It can take several weeks before you notice a difference.

Some people have side effects while taking antidepressants. These may include fatigue, decreased sex drive, and dizziness. If side effects seem to be making your symptoms worse, tell your doctor right away.

Although some antidepressants are safe to take if you’re breast-feeding, others may not be. Be sure to tell your doctor if you’re breast-feeding.

If your estrogen levels are low, your doctor may recommend hormone therapy.

Therapy

A psychiatrist, psychologist, or other therapist can provide counseling, even if you take antidepressants. Therapy can help you make sense of destructive thoughts and offer strategies for working through them.

Self-care

This part of treatment may be a little more difficult than it sounds. Practicing self-care means cutting yourself some slack.

You shouldn’t attempt to shoulder more responsibility than you can handle. Others may not instinctively know what you need, so it’s important that you tell them. Take some “me time,” but don’t isolate yourself. Consider joining a support group for new mothers.

Alcohol is a depressant, so you should steer clear of it. Instead, give your body every opportunity to heal. Eat a well-balanced diet and get a little exercise each day, even if it’s only a walk around the neighborhood.

Treatment can sometimes take longer, but it helps most women feel better within six months.

Part 4 of 17

Are there natural remedies for postpartum depression?

Postpartum depression is serious and not something you should attempt to treat without a doctor’s input.

Along with medical treatment, natural remedies such as exercise and getting the right amount of sleep certainly can help improve symptoms. Massage, meditation, and other mindfulness practices may make you feel better.

Herbal remedies may be appealing, but it’s important to note that the U.S. Food and Drug Administration (FDA) doesn’t regulate dietary supplements the same way they regulate drugs. The agency monitors supplements for safety, but doesn’t evaluate the effectiveness of health claims.

Another thing to keep in mind is that natural supplements can still interact with medications and cause problems. Tell your doctor or pharmacist about all the supplements you take and in what amounts, even if they seem harmless. Many things you ingest can end up in your breast milk, which is another reason to keep your doctor informed.

St. John’s wort is an herb some people use to treat depression. According to the March of Dimes, there’s simply not enough research to know if this is safe for treating postpartum depression.

There’s some evidence that low intake of omega-3 fatty acids may be associated with postpartum depression. However, there’s not enough research to know if taking supplements would improve symptoms.

Maintain a diet high in nutrients, but low in processed foods. If you’re not getting the nutrients you need in your diet, ask your doctor to recommend the right dietary supplements.

Learn more about natural remedies for postpartum depression »

Part 5 of 17

What causes postpartum depression?

The exact cause isn’t clear, but there are some factors that may contribute to postpartum depression.

One of the biggest physical changes after giving birth involves hormones. While you’re pregnant, your levels of estrogen and progesterone are higher than usual. Within hours of giving birth, hormone levels drop back to their previous state. This abrupt change may lead to depression. Low thyroid levels may also be a factor.

Some other physical factors may include:

  • sleep deprivation
  • inadequate diet
  • underlying medical conditions
  • drug and alcohol abuse

You may be more likely to develop postpartum depression if you’ve had a mood disorder in the past, or if they run in your family.

Emotional stressors may include:

  • recent divorce or death of a loved one
  • you or your child has serious health problems
  • social isolation
  • financial burdens
  • lack of support

Postpartum depression may be triggered by a combination of physical changes and emotional stressors.

Part 6 of 17

Postpartum depression facts and statistics

About 80 percent of mothers have the baby blues in the weeks following childbirth.

In contrast, a large-scale 2013 study found that 14 percent of mothers screened positive for depression. Of those:

  • 19.3 percent thought about harming themselves
  • 22.6 percent had previously undiagnosed bipolar disorder

Those who tested positive were more likely to:

  • be younger
  • have less education
  • be publicly insured
  • be African-American

Conducting home visits or phone interviews with 973 women, study authors found:

  • 26.5 percent had onset of depression before pregnancy
  • 33.4 percent started having symptoms during pregnancy
  • 40.1 percent noticed symptoms after childbirth

Suicide is said to be the reason for about 20 percent of postpartum deaths. It’s the second most common cause of death in postpartum women.

According to the nonprofit Postpartum Progress, only about 15 percent of women with postpartum depression get professional help. In addition, these figures represent only live births. They don’t include postpartum depression in women who miscarried or whose babies were stillborn. That means the actual incidence of postpartum depression might be higher than we think.

Postpartum anxiety is common, affecting more than 1 in 6 women following childbirth. Among first-time mothers, it’s 1 in 5.

Postpartum OCD is fairly rare. About 1 to 3 percent of childbearing women are affected.

Postpartum psychosis is rare, affecting 1 to 2 per 1,000 women after childbirth.

It’s estimated that up to 25 percent of fathers experience depression in the first year postpartum.

Going beyond the first-year postpartum, a 2010 study found that 39 percent of mothers and 21 percent of fathers had an episode of depression by the time their child was 12 years old.

Part 7 of 17

Where to find support for postpartum depression

First, consult with your OB-GYN so physical symptoms can be addressed. If you’re interested, your doctor can refer you to a therapist or other local resources. Your local hospital is another good place to get referrals.

You might feel more comfortable reaching out to others who’ve been through the same thing. They understand what you’re feeling and can offer nonjudgmental support. Consider joining a group for new mothers. Some of them may also be struggling with depression, anxiety, or postpartum depression.

These organizations can help guide you to the appropriate resources:

Postpartum depression is serious. If you don’t like one support system, it’s okay to try another. Keep trying until you find the help you need.

Part 8 of 17

How to deal with postpartum depression: 4 tips

After you consult with your doctor, there are a few other things you can do to deal with postpartum depression.

1. Communicate

You may be tempted to keep your feelings to yourself, especially if you’re a naturally reserved person. It might be helpful to talk things over with someone you trust. You may find out that you’re not alone and that others are willing to listen.

2. Fight isolation

Remaining in seclusion with your feelings can feed into depression. It’s not necessary to have a whirlwind social life, but do try to maintain your closest relationships. It can help you feel connected.

If you’re comfortable in a group setting, you have several options. You can join a depression support group or a group specifically for new moms. If you’ve let previously enjoyable activities go, try them again to see if it helps. Being in a group can help you focus on other things and relieve stress.

3. Cut back on chores

If you’re not up to chores and errands, let them go. Use your energy to take care of basic needs for you and your baby. If at all possible, enlist the help of family and friends.

4. Rest and relax

Both your body and your spirit need a good night’s sleep. If your baby doesn’t sleep for long periods, get someone to take a shift so you can sleep. If you have trouble drifting off, try a hot bath, a good book, or whatever helps you relax. Meditation and massage may help ease tension and help you fall asleep.

Learn more about how to deal with postpartum depression »

Part 9 of 17

Is there medication for postpartum depression?

Postpartum depression can be treated with antidepressants such as:

Selective serotonin reuptake inhibitors

Paroxetine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft) are selective serotonin reuptake inhibitors (SSRIs). They’re the most commonly used antidepressants. These drugs affect serotonin, a chemical in the brain that regulates mood. They generally have fewer side effects than other antidepressants.

Atypical antidepressants

These newer antidepressants also target several neurotransmitters in the brain. Duloxetine (Cymbalta) and venlafaxine (Effexor) are examples of atypical antidepressants.

Tricyclic antidepressants and monoamine oxidase inhibitors

These older antidepressants affect neurotransmitters in the brain. They tend to produce side effects and are not usually prescribed until all other options have been tried.

However, all antidepressants can cause side effects. Some of them include:

  • dry mouth
  • nausea
  • dizziness
  • headaches
  • insomnia, restlessness, fatigue
  • weight gain
  • perspiring
  • diarrhea, constipation
  • decreased sex drive
  • anxiety
  • tremors

Antidepressants often take several weeks to start working, so patience is required. They must be taken exactly as prescribed, without skipping doses. While taking antidepressants, you’ll need to see your doctor regularly.

You’ll start with the smallest dose, but your doctor can increase the dose a little at a time if it’s not working. It may take some trial and error to find the best medication and the right dosage for you.

If you’re taking a high dose, or you take antidepressants for a long time, you may have to taper off when you’re ready to stop. Stopping suddenly can increase side effects.

Hormone therapy may be an option if your estrogen levels are down. Side effects of hormone therapy may include:

  • weight changes
  • breast pain or tenderness
  • nausea, vomiting

Hormone therapy can also increase your risk of developing certain cancers.

Before taking any medication or hormone therapy, tell your doctor if you’re breast-feeding. Some of these medications can be passed to your baby through breast milk.

Part 10 of 17

What is severe postpartum depression?

Without treatment, postpartum depression can get progressively worse. It’s most dangerous when it leads to thoughts of harming yourself or others. Once these thoughts begin to occur, medical intervention is necessary.

The most severe form of postpartum depression is postpartum psychosis. Postpartum psychosis is a rare occurrence. When it does happen, it’s usually within the first few weeks after delivery. Psychosis is more likely if you have a history of mood disorders.

Signs of severe postpartum depression include:

  • seeing, hearing, smelling, or feeling things that aren’t really there (hallucinations)
  • having irrational beliefs, placing far too much importance on insignificant things, or feeling persecuted (delusions)
  • disorientation, confusion, talking nonsense
  • strange or erratic behavior
  • rage or violent actions
  • suicidal thoughts or attempted suicide
  • thoughts of harming your baby

These are all signs that you need emergency medical treatment. Hospitalization may be necessary.

Severe postpartum depression is potentially life-threatening, but it can be successfully treated.

Part 11 of 17

What are the risk factors for postpartum depression?

Any new mother can develop postpartum depression, regardless of age, ethnicity, or how many children you have.

These things might increase your risk:

  • You’ve had a form of depression or other mood disorder before.
  • There’s a family history of depression.
  • You have serious health problems.
  • You’ve recently been through something stressful, such as a divorce, death, or the serious illness of a loved one.
  • The pregnancy was unwanted or difficult.
  • You have twins, triplets, or other multiples.
  • Your baby was born prematurely or with health problems.
  • You’re in an abusive relationship.
  • You lack emotional support or feel isolated.
  • You don’t eat well.
  • You abuse drugs or alcohol.
  • You’re sleep deprived and exhausted. 

If you have some of these risk factors, talk to your doctor as soon as you notice symptoms. Postpartum depression can increase your risk of substance abuse or harming yourself or your baby.

Part 12 of 17

Postpartum depression prevention

Absolute prevention isn’t really possible. But since some factors may make you more prone to postpartum depression, you may be able to do a few things to reduce risk.

Be proactive. During pregnancy, tell your doctor if:

  • You’ve had a previous episode of postpartum depression.
  • You’ve ever had major depression or another mood disorder.
  • You currently have symptoms of depression.

Your doctor may be able to prescribe the appropriate therapy and make recommendations in advance.

You may also be able to reduce your chances of developing postpartum depression by considering the following:

  • Get your support system in place before your baby is born.
  • Make an action plan and write it down. Include contact information for your doctor, local support services, and a family member or friend you can confide in.
  • Have an arrangement for childcare in place so you can take a break. If symptoms appear, you’ll know exactly what to do.
  • Maintain a healthy diet and try to get some exercise every day.
  • Don’t withdraw from activities you enjoy and try to get plenty of sleep.
  • Keep the lines of communication with loved ones open.

A new baby changes family dynamics and alters sleep patterns. You don’t have to be perfect, so go easy on yourself.

Report symptoms to your doctor right away. Early treatment can help you recover faster.

Part 13 of 17

What is postpartum psychosis?

Psychosis means you’re no longer grounded in reality. Postpartum psychosis is rare. When it does happen, it’s usually within the first few weeks after you’ve given birth.

Often, postpartum psychosis is associated with bipolar illness.

The earliest symptoms are restlessness, irritability, and insomnia. These could easily be overlooked as baby blues or even sleep deprivation.

Hallucinations and delusions are also common symptoms that include seeing, hearing, smelling, and feeling things that seem real, but aren’t. For example, a voice telling you to harm your baby or feeling that your skin is crawling with bugs.

Delusions are having irrational or grandiose ideas or feeling persecuted despite evidence to the contrary. For example, you believe people are plotting against you. Delusions can also revolve around the baby.

Other symptoms include:

  • nonsensical chatter, confusion, disorientation
  • feelings of rage for no apparent reason
  • erratic or violent behavior such as throwing things, breaking things, and lashing out at people around you
  • rapidly shifting moods
  • preoccupation with death that might include suicidal thoughts or an actual suicide attempt
  • intrusive thoughts about your baby, such as you might blame your baby for the way you feel, or you might wish your baby would go away

Postpartum psychosis is a severe, life-threatening emergency. The risk of hurting yourself or your baby is very real.

If you or someone close to you exhibits these symptoms, seek immediate medical attention.

Postpartum psychosis is treatable. It usually requires hospitalization and antipsychotic medication.

Learn more about postpartum psychosis »

Part 14 of 17

How is postpartum psychosis treated?

There are a variety of medications used to treat psychosis. They may be used alone or in combination and include:

  • mood stabilizers
  • antidepressants
  • antipsychotics

These medications can help control your symptoms and keep you stabilized. If they don’t, another option is electroconvulsive therapy (ECT). ECT uses electrical currents to trigger chemical changes in the brain. It’s usually well-tolerated and can be effective in treating postpartum psychosis.

Once you’re stabilized, your doctors may recommend that you consult with a therapist who can help you work through your feelings.

Treatment should continue even after you’ve been discharged from the hospital. As you recover, your medications may need some adjusting.

If you also have bipolar or another mental health disorder, you’ll need to continue to follow your treatment plan.

Part 15 of 17

Postpartum anxiety

Postpartum depression gets more attention, but it may be that postpartum anxiety is more common. It affects more than 1 in 6 women after childbirth.

It’s normal to feel a little stressed or worried when you bring a new baby into your home. Sometimes, those feelings cause anxiety that interferes with everyday life.

Common symptoms include episodes of hyperventilation and panic attacks. Hyperventilation occurs when you breathe so quickly and deeply that you run low on carbon dioxide. This can leave you feeling as though you can’t catch your breath.

Panic attacks can mimic symptoms of a heart attack and involve:

  • pounding heartbeat
  • chest pain
  • sweating
  • shortness of breath

Other symptoms of postpartum anxiety include:

  • excessive worry, even about inconsequential matters
  • being unable to sleep because you are worrying
  • running the same problems over in your mind, even though they’ve been solved or aren’t very important
  • poor concentration due to worry
  • over-protecting your baby due to constant worry about what could go wrong
  • worrying about or imagining you have various illnesses (hypochondria)

You can have anxiety and depression together, making it difficult to figure out what’s going on without a doctor’s help.

While postpartum anxiety may go away on its own, it could also worsen. It’s a good idea to talk to your doctor. Anxiety can be treated with antianxiety medications and therapy.

Learn more about postpartum anxiety »

Part 16 of 17

Postpartum OCD

You want to raise your baby in a healthy environment and you might feel pressure to have everything perfect. Those aren’t unusual thoughts for a new mom. But it can sometimes blossom into full obsessive-compulsive disorder (OCD).

Postpartum OCD isn’t very common. About 1 to 3 percent of childbearing women develop OCD. It usually starts within a week of delivery.

Obsessions could be about anything, but they’re likely to focus on the baby’s safety. For example, you might worry about the baby dying during the night or that you’ll drop your baby.

If you have postpartum OCD, you might engage in ritualistic behaviors related to those thoughts. These are a few examples:

  • repetitive organizing, cleaning, and obsessing over germs that may come in contact with your baby
  • repeatedly checking on your baby during the night, even though you did so recently
  • mental compulsions, such as constantly praying for your baby’s safety
  • performing rituals such as counting or touching something a certain way, thinking it will prevent bad things from happening
  • spending a lot of time researching your or your baby’s health
  • inability to control these behaviors

If you have symptoms of postpartum OCD that don’t go away within a few weeks, see your doctor.

Postpartum OCD can be treated with therapy alone or with antidepressant medication.

Part 17 of 17

Postpartum depression in men

It’s not uncommon for new fathers to have the blues on occasion. As with new mothers, these feelings are normal and tend to fade away as everyone makes the transition.

Men can also develop postpartum depression, or paternal postnatal depression. New fathers don’t have follow-up exams with doctors like new mothers do, so it can go unnoticed. Men are also less likely to report symptoms of depression.

Estimates say up to 25 percent of fathers have feelings of depression in the first year postpartum. First-time fathers tend to have a higher level of anxiety in the weeks following a birth.

Fathers may be at higher risk of postpartum depression if their partner has depression.

Another risk factor is having experienced depression or another mood disorder in the past. If that’s the case, talk to your doctor before the baby is born. Mention any signs of depression, however small.

You should also try to get a support system in place. This could involve arranging for childcare, joining a depression support group, or time out with friends.

Symptoms of depression are similar in men and women, but they may come on more gradually in fathers. That can make them harder to recognize.

There haven’t been many studies into the causes of postpartum depression in men. Researchers theorize it may have something to do with changes in testosterone and other hormone levels.

It may be related to lack of sleep, stress, and the changing family dynamics. There’s also less information and fewer systems in place to help new fathers cope with these feelings.

Like new mothers, new fathers need to maintain a nutritious diet, exercise daily, and get plenty of rest. If symptoms of depression don’t clear up or are severe, you should see your doctor for a proper diagnosis.

Depression can be treated with antidepressant medications, either alone or along with therapy. In cases where both parents exhibit signs of depression, couples counseling or family counseling may be good options.