What You Should Know About Postpartum Depression

Having a baby can cause many intense emotions. It’s normal for new moms to have “baby blues,” which can include mood swings, crying spells, anxiety, and trouble sleeping. Baby blues typically start within the first few days after delivery and can last up to two weeks. But if symptoms continue longer, you might have postpartum depression.

What is Postpartum Depression?

Postpartum depression isn’t a character flaw or a weakness. It’s a severe, long-lasting form of depression that can begin the first few weeks after giving birth, but it can also develop during pregnancy or up to a year after birth. If not treated, postpartum depression can last for many months or longer.

There's no single cause of postpartum depression, but physical changes and emotional issues can play a role.

• Physical changes. After giving birth, your body experiences a dramatic drop in hormones (estrogen and progesterone), which can contribute to postpartum depression. Other hormones produced by your thyroid gland may also drop, which can leave you feeling tired and depressed.
• Emotional issues. When you're sleep deprived and overwhelmed, even minor problems may seem impossible to manage. You might be worried about your ability to care for a newborn, have lower self-esteem, struggle with your sense of identity, or feel like you’ve lost control. Any of these issues can contribute to postpartum depression.

If left untreated, postpartum depression can lead to issues bonding with your baby or cause problems in your family. Your child could also have emotional and behavioral problems, such as difficulties with sleeping and eating, excessive crying, and speech delays. Even after you’ve been treated for postpartum depression, you have a higher risk of future episodes of major depression.

Postpartum depression doesn’t only affect mothers—it can have a ripple effect, causing emotional strain for everyone close to your baby. New dads already have an increased risk of depression whether their partner is affected, and that chance grows if the mother has postpartum depression. Additionally, mental health issues in men are often stigmatized, so they’re less likely to seek help.

Symptoms

The symptoms of postpartum depression can differ from person to person. Signs you may have postpartum depression may include:

• Depressed mood or severe mood swings
• Anxiety and panic attacks
• Crying excessively
• Having difficulty bonding with your baby
• Withdrawing from family and friends
• Loss of appetite or eating more than usual
• Inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability and anger
• Fear that you're not a good mother
• Feelings of hopelessness, worthlessness, shame, or guilt
• Difficulty thinking clearly, concentrating, or making decisions
• Restlessness
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide—call 911 or get help immediately if this happens to you

A rarer but more severe condition called postpartum psychosis can also happen, typically developing within the first week of delivery. If you have symptoms that suggest you may have postpartum psychosis, get help immediately and call 911. Signs and symptoms can include:

• Confusion and disorientation
• Hallucinations and delusions
• Paranoia
• Excessive energy and agitation
• Obsessive thoughts about your baby
• Attempts to harm yourself or your baby

Risk Factors

Any new mom can get postpartum depression, no matter the circumstances or how many children you’ve had. However, you have an increased risk of postpartum depression if:

• You have a personal or family history of depression or other mood disorders
• You have bipolar disorder
• You’ve had postpartum depression after a previous pregnancy
• You've experienced recent stressful events, such as pregnancy complications or job loss
• Your baby has health problems or other special needs
• You have multiple births, such as twins or triplets
• You have trouble breast-feeding
• You have relationship problems with your significant other
• You have a weak support system
• You have financial problems
• Your pregnancy was unplanned or unwanted

Prevention

If you have a history of depression—especially postpartum depression—tell your doctor if you're planning to get pregnant or as soon as you find out you're pregnant.

During pregnancy, your doctor can monitor you for signs and symptoms of depression. They might have you complete a depression-screening questionnaire during your pregnancy and after delivery. Sometimes mild depression can be managed with support groups, counseling, or other therapies. In other cases, your doctor may recommend antidepressants during or after pregnancy.

After your baby is born, your doctor may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier it's detected, the earlier you can begin treatment. If you’ve had postpartum depression before, your doctor may recommend antidepressant treatment or psychotherapy immediately after you deliver your baby.

We Can Help

If you feel depressed after your baby's birth, don’t hesitate to get help. Call your doctor as soon as possible if your symptoms:

• Don't fade after two weeks
• Are becoming worse
• Make it hard for you to care for your baby or complete everyday tasks
• Include thoughts of harming yourself or your baby

If at any point you have thoughts of harming yourself or your baby, immediately seek help from your partner or loved ones in taking care of your baby and call 911. If you’re having suicidal thoughts, you can:

• Seek help from your primary care provider or other health care professional.
• Call a mental health professional.
• Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use their webchat on suicidepreventionlifeline.org/chat.

For more information about preventing or treating postpartum depression and other conditions, contact our Women’s Health Navigator at 240-215-1447.