Having a new baby is often a joyous occasion. But sometimes it's not. For some people, the period after giving birth can bring with it some mental health challenges.
Postpartum depression (PPD) is depression that occurs after childbirth, pregnancy loss, or termination. PPD is more than the "baby blues" or feelings of sadness and fatigue that many women experience after the end of a pregnancy. PPD is a serious disease that can occur up to a year after delivery.
For the good of the parent and their new baby, it is crucial to identify and treat PPD as quickly as possible.
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Many recently pregnant battle the "baby blues," or feelings of sadness and fatigue after giving birth. Nearly 80% of new parents report feeling depressed, anxious, disappointed, irritable, or even angry in the first days and weeks with a new baby, according to the March of Dimes.
These feelings are normal and usually fade within a week or so without treatment. Baby blues don't interfere with a parent's ability to care for their baby.
Postpartum depression (PPD) is depression that develops after a pregnancy. PPD causes intense feelings of sadness or worthlessness. It can happen up to a year after pregnancy and interferes with a parent's ability to care for and bond with their baby. In rare cases, new parents have harmed themselves or their babies.
People may have PPD symptoms:
If you have thoughts of suicide or of harming your baby, call 911 or seek professional help immediately.
The exact rates of postpartum depression are unknown. Estimates from the National Library of Medicine suggest that between 6.5% and 20% of people who give birth will have depression symptoms. Pregnant people who miscarry, terminate pregnancies or have stillbirths may also experience PPD symptoms and add to this total.
Additionally, even more recently pregnant people have another perinatal mood or anxiety disorder like postpartum anxiety. These illnesses are not normal, but they are very common.
Although PPD often is characterized by sadness, anxiety, and chronic fatigue, it has a variety of symptoms. PPD symptoms may be short-term or long-term, mild or severe, and acute or chronic.
For that reason, the medical community has divided postpartum mood disorders into different categories.
Postpartum blues, or the "baby blues," occur within a few weeks of delivery and usually last a few days. They go away completely within two weeks. They are considered normal and not serious for postpartum people.
The baby blues has milder symptoms like:
Postpartum anxiety disorder is a common mood disorder that occurs in around 10% of postpartum people, according to Postpartum Support International. It often goes undiagnosed because many people believe new parents are just naturally anxious.
Signs of postpartum anxiety include:
Symptoms may last a few weeks to much longer.
Postpartum OCD includes intrusive and persistent thoughts, sometimes involving hurting or even killing the baby. These thoughts are rarely acted upon because parents with postpartum OCD are aware of and horrified by the thoughts.
Postpartum OCD also may include compulsive behaviors, such as repeatedly cleaning or changing the baby. There aren't many studies on postpartum OCD, but they suggest it happens in between 1.7% and 7% of postpartum people, according to Postpartum Support International.
Postpartum panic disorder causes severe anxiety and repeated panic attacks. A panic can feel like dying, going crazy, or losing control. It can occur in up to 10% of postpartum people, according to PostpartumDepression.org.
Symptoms of postpartum panic disorder include:
People with a history of anxiety and panic attacks, as well as those with thyroid dysfunction, are at a greater risk of developing postpartum panic disorder.
Postpartum PTSD affects 9% of postpartum women. Like PTSD, symptoms of postpartum PTSD are from some real or perceived threat to the parent or trauma usually occurring during childbirth or shortly after.
Trauma-inducing situations may include:
Past traumas, including sexual assault or violence, may put women at higher risk of developing postpartum PTSD.
Symptoms of postpartum PTSD include:
Postpartum people may have strong feelings of guilt, self-blame, and shame about their trauma.
Though rare, postpartum psychosis is the most serious postpartum mood disorder. It affects about 1 to 2 out of every 1,000 births, according to a review in BMC Psychiatry. Postpartum psychosis usually begins in the first few weeks after delivery.
Symptoms may include:
People with postpartum psychosis are unaware of their actions, and 10% of those with the condition take their own life or their child's life. Because of this risk, immediate treatment – even hospitalization – is vital.
People with past histories of psychotic illnesses are at greater risk and should be monitored closely postpartum.
Research in BMC Pregnancy Childbirth found that postpartum depression may affect between 8 and 13% of fathers — called paternal PPD.
Risk factors for paternal PPD include:
The symptoms of paternal PPD are the same as PPD in the birthing parent. However, it may not be as obvious — even to the person. Additionally, paternal PPD may start later, often after their partner already has it.
Postpartum depression is the most common complication of childbirth. Any person who has had a baby, miscarriage, stillbirth, or termination can get postpartum depression. It affects first-time parents as well as those with large families.
Although the exact cause of PPD remains unclear, several factors are likely involved. Changing family roles, new baby stress, marital strife, and a family history of mental illness can all contribute to postpartum depression.
Physiological changes play a role, too. After childbirth, the levels of the hormones estrogen and progesterone in the brain quickly drop. This dramatic shift leads to chemical changes in the brain that may trigger mood swings.
Also, many new parents find it difficult to get the rest they need after giving birth. Sleep deprivation can lead to body pain and exhaustion, which also may contribute to the symptoms of postpartum depression.
Postpartum depression can affect anyone who has recently been pregnant. There are some factors that increase risk, though.
People at risk of developing postpartum depression include:
According to a study published in Health Affairs, PPD affects:
High-risk patients can get treatment before childbirth to head off or reduce postpartum depression.
If you are at high risk and are expecting or have delivered a child recently, ask your provider to assess your risk for PPD.
Left untreated, PPD can seriously harm a person's health. They may not eat well or lack the energy to care for their child. They may even start to think about hurting themselves or their baby. Experts have also noted behavioral problems and developmental delays in infants whose parents have PPD.
Common symptoms of postpartum depression include:
A recently pregnant person experiencing these symptoms should get a complete medical evaluation, including thyroid screening.
If you think you're having a depressive episode or have any symptoms of postpartum depression, seek help from your doctor. Treatment can improve symptoms of postpartum depression and make sure you and your baby are safe and cared for. It can also help you feel like yourself again so you can enjoy parenthood.
Don't let shame stop you from getting treatment for a postpartum mood disorder. PPD is not your fault. If you're in a depressive episode, you cannot "pull yourself together" any more than if you had any other physical illness.
Some new parents are too embarrassed to seek treatment. But remember, you are not alone.
If a health care provider suspects postpartum depression, they will conduct a physical exam and review your medical history. The doctor may order a thyroid screening to check your hormone levels. They may also refer you to a behavioral health specialist.
Doctors plan treatment for postpartum depression based on factors like age, health, medical history, severity and duration of symptoms, tolerance for medications, breastfeeding status, and personal preferences.
Treatments include lifestyle changes, counseling, and medicine.
By UPMC Editorial Staff. Last reviewed on 2024-09-05.
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