Postpartum Depression: Signs, Symptoms, & Treatment

By Nancy Youssef, MD
Medically reviewed
September 1, 2021

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, a mother 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 indicate postpartum depression are:

  • 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.

One in 10 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.

Baby blues vs. postpartum depression

The baby blues are feelings of sadness, anxiety, and moodiness that typically occur in the first few days after your baby is born.

These feelings arise as a result of hormone changes, exhaustion, and the emotional toll of child rearing.

The baby blues are incredibly common—upwards of 80% of moms experience them—and typically go away on their own within two weeks after giving birth. 

Postpartum depression may be mistaken for baby blues at first.

But PPD is different, and must be taken seriously. The symptoms may feel similar, but they are typically more severe and last much longer.

If your feelings of sadness last longer than two weeks, you should talk to your healthcare professional to determine whether you have postpartum depression.

Postpartum depression affects one in seven new mothers, and unlike the baby blues, does not go away easily on its own. If you’re experiencing PPD, you should seek help to get you back to feeling like yourself.

Neither the baby blues nor postpartum depression are character flaws. They are real conditions that can target any new mother, no matter their background or circumstances. The good news: They are both treatable. 

Causes of Postpartum Depression

Though a personal history of depression increases the risk of developing postpartum depression, the condition cannot be attributed to a single cause.

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 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.

Doctors believe 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.

There is nothing that can prevent developing this disorder: PPD is a mental health condition, not a character flaw.

Can men get postpartum depression?

Some men find themselves struggling with depression symptoms after the birth of their child.

This is typically referred to as paternal postpartum depression or paternal postnatal depression.

Some research shows that as many as 25% of fathers may struggle with feelings of depression in the year following the birth of their child—but this number could be even higher, as men are less likely to report their symptoms.

First-time fathers tend to experience feelings of depression in the first few weeks postpartum.

Though it’s not widely studied, researchers believe that fathers may develop paternal postpartum depression due to changes in hormone levels (including testosterone), lack of sleep, and increased stress.

Men are also more likely to develop paternal postpartum depression if their partner is experiencing depression, or if they suffered from depression or a mood disorder prior to the birth of their child. 

Paternal postpartum depression often goes untreated because public awareness of it is so low.

Unlike new mothers, fathers don’t typically have postnatal check-ins, so their suffering can go unnoticed if they don’t report it, leading them to suffer in silence.  

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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 healthcare 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 you are suffering from PPD and require treatment, their options to provide relief may include the following.

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 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 breast milk.

One of the most common medications prescribed for PPD is sertraline, an antidepressant that is marketed as Zoloft.

Sertraline is a selective serotonin reuptake inhibitor, or SSRI, a type of antidepressant that works by stopping the reabsorption of serotonin, making more of this chemical available in the body. Increased levels of serotonin are believed to help boost your mood. 

Sertraline is considered a first-line treatment for PPD because infants who are breastfeeding from a mother who is taking this SSRI do not show quantifiable levels of the drug in their bloodstream. 

How to deal with postpartum depression

After you’ve spoken with your doctor and followed their treatment plans, there are some other things you can do on your own to deal with postpartum depression.

  • Maintain a healthy diet: Eating good-for-you foods doesn’t just give your body the nutrients it needs, but can also make you feel mentally and physically better. Stay hydrated, limit junk food, and eat a balanced diet of protein, fruits and vegetables, dairy, and grains. 
  • Exercise: Just as working out has been shown to help people with major depressive disorder, exercise has been shown to help decrease symptoms of postpartum depression. It may feel hard, especially in the first few weeks after delivery, but make time to move your body however feels best for you.
  • Make time for rest: Though getting good sleep and mothering a newborn can often seem mutually exclusive, you need to make time for rest and relaxation. That means getting enough sleep and resting your body. If you need to cut back on chores or other responsibilities, allow yourself to do so, for the sake of your mental health.
  • Communicate with loved ones: Do not let yourself slip into solitude—this can cause depressive symptoms to feel heightened. Try to be open with your loved ones, and speak to other women who have experienced postpartum depression. Consider joining a support group. It can be difficult, but remember you are not alone, and this is not your fault.
  • Do things you used to enjoy: Whether it’s shopping, reading, board games, yoga, or another activity—whatever brought you happiness before delivering your baby, do it. Remembering what joy feels like can help you feel like yourself again. 

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 can affect the infant’s health and well-being.

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 depression or other mood disorders or 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 can be 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.

Severe postpartum depression

If left untreated, postpartum depression can become more severe—even reaching a point where a mother considers hurting herself or her baby.

Once these thoughts begin, emergency medical attention is necessary. 

Severe postpartum depression can be characterized by a variety of symptoms, including:

  • Confusion or disorientation
  • Violence or erratic behavior 
  • Hallucinations, or experiencing other senses that aren’t really there
  • Thoughts of hurting the baby
  • Suicidal thoughts or suicide attempts 
  • Feelings of persecution or delusion

Postpartum psychosis

Postpartum psychosis is the most severe type of postpartum depression—an incredibly rare mood disorder that typically develops in the first week after giving birth.

Only about 0.1% of mothers suffer from postpartum psychosis. 

Mothers experiencing postpartum psychosis may have symptoms including:

  • Paranoia 
  • Confusion and disorientation
  • Violent and suicidal thoughts 
  • Delusions of grandeur
  • Excessive energy
  • Sleep disturbances
  • 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.

This is especially true if the mother is having obsessive thoughts about injuring themself or their baby, which may lead to action. I

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

The condition is treatable with professional help, typically with hospitalization and antipsychotic medication.

Postpartum anxiety

While it’s normal to be a little bit anxious when you bring home a child, mothers suffering from postpartum anxiety can be debilitated by these feelings, experiencing stress or worry to the point that it impacts their functioning.

Studies show that postpartum anxiety is actually more common than postpartum depression—affecting approximately one in six new mothers—despite getting far less attention. Symptoms may include:

  • Hyperventilation 
  • Panic attacks
  • Poor concentration
  • Insomnia
  • Rumination and overthinking

Postpartum anxiety may go away on its own, but it may also get worse. See a doctor if you are experiencing symptoms. Doctors can help by prescribing anti-anxiety medication and/or therapy.

Postpartum anxiety can also go hand-in-hand with postpartum depression for some mothers, making both conditions harder to deal with alone, making it even more crucial to seek help.  

Postpartum OCD

While it’s normal to want to give your baby the best possible care and attention, there are cases where new moms experience this feeling to the extreme, developing a condition called postpartum obsessive-compulsive disorder, or postpartum OCD.

Postpartum OCD is uncommon, impacting only 1-2% of childbearing women. It can also affect some fathers.  

New parents suffering from postpartum OCD typically struggle with obsessive thoughts related to their baby, starting at or around the time of delivery, and compulsive actions meant to control or stop the obsessive thoughts.

These can include repetitive cleaning of the baby and/or their belongings, obsessive checking on the baby, ritualistic behavior (like counting or touching) intended to keep the baby safe from harm, and more.

These obsessive thoughts and compulsive behaviors tend to get in the way of normal life. 

Postpartum OCD can be dangerous if left untreated, and can lead to symptoms of depression. Treatment typically includes therapy and/or antidepressant medication.

How to Prevent Postpartum Depression

If you have a history of depression—especially postpartum depression—the best way to prevent it is to let your doctor or medical professional know about your history as early as you can so they can help you prepare for its potential onset.

As soon as you decide you want to get pregnant, alert your doctor to the fact that you have a history of depression.

They can set up check-ins throughout your pregnancy and after delivery to monitor for signs and symptoms of depression, and may have you complete depression-screening questionnaires throughout the process.

This way, treatment—therapy, antidepressants, or both—can be started as soon as possible if needed.

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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.

Postpartum Depression Statistics

When it comes to mental health, sometimes it can really help to know you’re not alone. Looking at statistics is one way to make this realization.

To recap, some of the most pertinent statistics related to postpartum depression are as follows:

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 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 here.

Frequently Asked Questions

Why do women get postpartum depression?
There’s no clear cause for postpartum depression. However, there are a variety of both physical and emotional factors that may make it more likely for a woman to develop it—including chemical, social, and psychological changes that take place throughout and after pregnancy. These can include changes in hormones like estrogen and progesterone, sleep deprivation and inadequate diet, struggling with self-identity and loss of control, and more. Women who have suffered from mood disorders in the past—or who have a family history of mood disorders—are also more likely to get postpartum depression.
When can postpartum depression start?
Expert opinions vary. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) states that postpartum depression can begin within four weeks after delivery. The American College of Obstetricians and Gynecologists (ACOG) defines postpartum depression as symptoms that occur within 12 months after childbirth.
Can postpartum depression last years?
Studies have shown that postpartum depression can in fact last years, but this is uncommon. Women who experience long-term postpartum depression tend to be younger, have less education, have had a previous mood disorder diagnosis, and have experienced gestational diabetes. Getting the proper care and treatment when symptoms arrive can help prevent long-term postpartum depression.
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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