Having a baby is a life-changing event. And no matter how excited you are to finally get to know that tiny newborn that you fantasized about throughout your pregnancy, you’re also coping with roller-coaster hormones and scant sleep.

So it’s no surprise that plenty of moms feel overwhelmed and less than ecstatic about this new phase of life shortly after giving birth — experiencing a bout of "the baby blues." For some moms, however, those feelings linger and become worse rather than better, developing into what’s known as postpartum depression (PPD).

Thankfully, postpartum depression is treatable. So if it strikes you, don’t suffer with it for longer than you have to. Read on for the information every new mom needs to know about PPD.

What is postpartum depression?

Postpartum depression is a serious medical condition and type of depression that affects some new moms after giving birth to their babies.

Though everyone experiences postpartum depression differently, it's generally characterized by lingering and profound feelings of sadness and/or indifference, a strong "overwhelmed" feeling, a sometimes paralyzing fear of being unable to cope with the stresses of parenthood and, frequently, a lack or loss of interest in the baby and life in general.

When does postpartum depression start?

Postpartum depression can start anytime within the first year of giving birth. Most commonly, it begins between a week to a month after delivery, but it can also also be the continuation of an episode that started before or during pregnancy.

How long does postpartum depression last?

Postpartum symptoms tend to last for several weeks, months or even up to a year or longer.

Postpartum depression symptoms

Though you may know something isn’t quite right, you may not think it’s actually PPD. Sometimes, when people hear “depression,” they think of someone having thoughts of harming herself — so if you don’t have those feelings, you may think you don’t have postpartum depression.

Continue Reading Below

Read This Next

Postpartum Recovery Timeline
Your Postpartum Checkups
What Happens in the ‘4th Trimester’ (and Is It a Real Thing)?
Postpartum Recovery Timeline
Your Postpartum Checkups
What Happens in the ‘4th Trimester’ (and Is It a Real Thing)?

But every case of depression, including PPD, doesn’t necessarily include thoughts of self-harm or suicide. Symptoms of postpartum depression can include:

  • Crying
  • Irritability
  • Disrupted sleep — either not being able to sleep or wanting to sleep the day away
  • Eating problems, such as no appetite or an excessive one
  • Persistent feelings of sadness, hopelessness or helplessness
  • Severe anxiety
  • Problems doing tasks at home or work
  • Loss of interest in activities you used to enjoy
  • Social isolation — feeling withdrawn or unconnected
  • Feelings of worthlessness and of being a bad mother
  • Inability to care for yourself or your baby
  • Worrying excessively about your baby’s health
  • Having scary or obsessive thoughts about your baby
  • Having negative feelings toward or little interest in your baby
  • Fear of being alone with your baby

Even if you see these symptoms in yourself, one symptom of depression is self-doubt — so you may question whether your feelings are related to stress, the baby blues, postpartum depression or simply tiredness due to new motherhood.

What’s more, you may feel guilty or embarrassed about not feeling happy after having your baby, as well as worried that it’s somehow your fault and you’ll be judged by others.

First off, know that postpartum depression is never your fault. It can happen to any mother, and it’s not because of something you did or didn’t do. Most people understand this and are compassionate rather than judgmental.

Afraid to reach out for help because you fear your baby will be taken away? That’s not a goal of your health care practitioner or other professionals. They’re focused on getting you the help you need so you’re able to take good care of yourself and your baby.

How common is postpartum depression?

PPD is actually more common than you might think, occurring in about one in eight new moms. Still, it's sometimes difficult to know if you have it — and it can be equally hard to reach out for the help that’s essential for both you and your baby.

What's the difference between postpartum depression and the baby blues?

Though "postpartum depression" and "the baby blues" are sometimes used interchangeably, they’re two distinct conditions:

  • The baby blues are very common, experienced by as many as an estimated 80 percent of new moms. After giving birth, women with the baby blues feel weepy, irritable, exhausted and anxious, and also have trouble sleeping. The baby blues usually begin within a few days postpartum and fade within two weeks.
  • Postpartum depression symptoms are often similar to those of the baby blues — which is why many women have trouble determining which one they’re experiencing. But while the baby blues last for only a short time and symptoms tend to be mild, postpartum depression symptoms can begin anytime within the first year after birth — from right after birth to when you get your first period postpartum or wean your baby off breastfeeding. Postpartum depression symptoms tend to be both more pronounced and more enduring, lasting weeks, months or even a year or longer.

What causes postpartum depression?

The causes of postpartum depression are unknown. It’s believed that hormonal changes that happen after childbirth may trigger symptoms. A prior history of depression, including postpartum depression, is a major risk factor. And stopping an effective depression medication puts women at risk for relapse.

Many other big life disruptions may play a role too, including feeling overwhelmed with a brand new baby, a lack of sleep, an unrealistic view of motherhood, stress from changes in your routines at home and work, feeling unhappy with changes in your body and struggling with a new sense of identity.

How is postpartum depression diagnosed?

Experts from the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and other organizations recommend screening for depression in all pregnant and postpartum women.

Your health care provider will ask questions about what you’re experiencing and feeling and make the diagnosis based on your symptoms. He or she may suggest testing to rule out other issues that may be causing your symptoms. For instance, you may be given a thyroid test, since irregularities in thyroid hormone levels can lead to changes in your mood.

Postpartum depression medications

Once your doctor has made a postpartum depression diagnosis, he or she may suggest antidepressants to reduce your symptoms and treat the condition, sometimes in combination with psychotherapy (more on that below).

These medications help to balance the chemicals in your brain that control your mood. The two most common options include:

  • Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, paroxetine, fluoxetine, citalopram and escitalopram, are usually the first choice of medications. However if another medication worked for you in the past, your doctor will consider prescribing it first.
  • Tricyclic antidepressants (TCA), such as nortriptyline, may be prescribed next if SSRIs don’t work.

Another medication — designed specifically to treat postpartum depression — is called brexanolone (Zulresso). It's given through an infusion over the course of 60 hours and requires you to be supervised in a medical center during your stay. This new treatment is very expensive, and many experts want to see further proof that it's more effective than other methods before they'll recommend it as a first line of treatment.

Once you start taking antidepressants, it can take a few weeks before you start to feel better. As with all medications, antidepressants may cause side effects — though usually, these are temporary and go away after a short time.

If you’re breastfeeding, one of your concerns is likely how these medications might affect your baby. The majority of psychiatric medications can be used while breastfeeding, as very little passes through the milk to a baby. Talk to your doctor so that you can find the medication that's most effective for you.

Know, too, that going on medication doesn’t mean you’ll have to be on it for the rest of your life: PPD usually goes away within six months to a year with treatment. That doesn’t mean you can just stop your medication after a year: Some people require longer term treatment to stay well. Never stop taking your medication without talking with your healthcare provider first.

Other postpartum depression treatments

Your doctor may also recommend one or more of the following postpartum depression treatments:

  • Psychotherapy (also known as talk therapy). Cognitive behavioral therapy and interpersonal psychotherapy are often effective in pregnant and postpartum women. You’ll meet one-on-one with a psychiatrist, psychologist, therapist or other mental health provider who can help you to solve problems and cope with your feelings.
  • Light therapy. Bright light therapy has been shown to reduce the symptoms of depression, though experts say some results are conflicting and more research needs to be done. During light therapy, you’ll sit with your eyes open in front of a light box that mimics daylight, which can cause a positive biochemical change that can help ease symptoms.
  • Acupuncture. Some research suggests that acupuncture can help reduce symptoms of depression.
  • Support groups. There are plenty of postpartum depression support groups (online and possibly in an area near you). Talking with others who are experiencing the same thing may help you feel less alone, and you may pick up tips that can help you better handle your symptoms and feelings. But although PPD support groups can be helpful, they shouldn’t replace medication or talk therapy.

Why postpartum treatment is so important

If you think you have postpartum depression, it's critical that you talk about it with your practitioner and your partner and/or other loved ones.

Left untreated, PPD can last for several months or sometimes even longer, and affect your relationship with your baby and others.

Experts believe that untreated postpartum depression may increase the chance of a baby having language delays, increased crying and behavior problems. And the possible long-term complications of untreated PPD are the same as in major depression — which includes being at risk of harming yourself or your baby.

For all these reasons, it’s extremely important to seek help rather than try to wait it out or deal with it on your own. If you’re having serious symptoms for more than a few weeks, chances are they won’t go away without professional attention, so don’t wait to see if they do.

The good news is that once postpartum depression is diagnosed, there are many safe and effective treatment options.

Is it possible to prevent postpartum depression?

Remember, postpartum depression is never a mom’s fault. There’s nothing you can do to cause PPD, and there’s no definite way to prevent it.

You can reduce your risk by treating depression before you try to conceive and by getting treatment for depression during pregnancy, if it occurs. You can also reduce your risk by staying on an effective medication during pregnancy after a thorough discussion with your health care provider. Keep in mind that doses sometimes need to be increased during pregnancy to keep your depression in remission.

There are several other steps you can take before and after your baby’s arrival that may potentially help reduce the severity of postpartum depression symptoms:

Prepare yourself

That TV baby with the flawless face at birth? He’s not really a newborn — who are actually blotchy, bumpy and wrinkly — but an older baby. Those movie moms who look calm and beautiful as they push their babies out with nary a labor pain? They don’t exist. Even those impossibly slender celebrity moms usually have trainers, chefs and nannies…not to mention Photoshop.

Having unrealistic expectations about delivery and motherhood can add pressure to an already demanding new situation. So help yourself get in a realistic mom-to-be mindset: Enroll in childbirth or parenting classes, read as much as you can about labor and delivery, and talk to other pregnant women and new mothers about their experiences.

Knowing what to expect — and understanding that things never go exactly as expected — helps you to avoid a letdown.

Get a support system in place

Before your baby’s birth, get your support system in place so you can reach out when you need help. Friends and family want to pitch in, so let them. Don’t be shy about asking your partner, family member or friend to hold the baby while you take a shower or letting your mother do a load of laundry. Even five minutes of venting to a pal about how sore your nipples are can make things more bearable.

Make time for sleep

Enough rest is essential to keeping perspective. And once your little one makes his debut, it'll be some time before you get eight straight hours of shut-eye again. So hit the snooze button and nap when you can. And once your little one arrives, have your partner take on overnight baby duty if possible once or twice a week so you can sleep through the night.

Eat well

Studies show that not getting enough of certain nutrients — including vitamin D — can up a woman’s PPD risk. So sticking to a well-balanced diet can actually put you in a better mood.

Exercise

Physical activity not only helps elevate your mood, it can also make you feel a whole lot better about a whole lot of things. And research shows that women who don’t exercise during and after pregnancy are more likely to experience symptoms of depression.

That doesn’t mean you need to run a marathon (though if you enjoy running, by all means keep it up while you’re expecting!). You can also walk, do Pilates, swim or try any other pregnancy-friendly workout.

Or drop into a prenatal yoga class or stream one online. Research has found that exercise-based prenatal yoga combined with meditation, deep relaxation and breathing exercises significantly reduces depression risk.

Once your baby arrives, dance him gently around the living room for 20 minutes or go for a brisk walk together to get those feel-good endorphins flowing.

Prioritize your relationships

Don’t forget to make time with friends: Social isolation can do a number on your mind, so it’s important to make sure you have some adult interaction on a regular basis. Join a local mom’s group, schedule a weekly lunch meeting with a friend or sign up for a class, such as drawing, barre or piano — whatever you’re interested in!

Doing things you enjoy — and spending time with other adults — is very important for maintaining a sense of self outside of “Mommy.”

See a professional before birth

If you’ve already experienced depression or PPD during pregnancy or are at increased risk of developing postpartum depression for another reason, seek help from an expert before your baby’s arrival.

If you're on an effective medication, don't stop taking it without supervision from your doctor. If you become depressed during pregnancy, seek help; your practitioner may recommend psychotherapy and/or medication.

Some physicians prescribe low doses of antidepressants or therapy in the last trimester of pregnancy or right after delivery to help prevent PPD. Either way, getting a handle on the issue as early as possible will make things easier after you give birth.

Postpartum depression risk factors

Some factors seem to put women at higher risk for developing postpartum depression. But even if you do have some risk factors, it doesn’t mean you’ll definitely get postpartum depression. Also keep in mind that some women without these risk factors develop the condition, too.

Postpartum depression risk factors include the following:

  • A personal or family history of depression, depression during pregnancy, postpartum depression, severe PMS, bipolar disorder or other psychiatric illness
  • A history of alcohol or drug abuse
  • Stressful events within a year of childbirth, such as illness, job loss or death of a loved one
  • Medical complications during pregnancy or delivery
  • Financial or relationship problems
  • Little or no social support
  • Caring for a chronically ill baby
  • Having a preterm baby
  • Having a baby who's been hospitalized
  • Giving birth to multiples, such as twins or triplets

Postpartum obsessive-compulsive disorder (OCD)

Nearly 30 percent of women who suffer from postpartum depression may also exhibit signs of postpartum obsessive-compulsive disorder, though OCD can occur by itself. Symptoms include obsessive-compulsive behaviors, such as waking up every 15 minutes to make sure baby is still breathing, furious housecleaning or obsessive thoughts about harming the baby.

Women suffering from postpartum obsessive-compulsive disorder are appalled by their gruesome thoughts, but in all likelihood won't act on them. Still, they can be so afraid of losing control that they may end up neglecting their babies.

Like postpartum depression, treatment for postpartum obsessive-compulsive disorder includes a combination of antidepressants and therapy. If you think you’re having obsessive thoughts and/or behaviors, be sure to get help by telling your practitioner about your symptoms.

Postpartum psychosis

Much rarer and much more serious than postpartum depression is postpartum psychosis, which typically appears within the first two weeks after giving birth. (About 1 in 1000 women who give birth experience postpartum psychosis; postpartum depression occurs in one in 10 women.) Symptoms include loss of reality, hallucinations and/or delusions.

If you’re experiencing suicidal, violent or aggressive feelings; hearing voices or seeing things; or have other signs of psychosis, call your doctor, or have your partner or family member do so, and go to the emergency room immediately.

Don’t underplay what you’re feeling, and don’t be put off by reassurances that such feelings are normal during the postpartum period — they’re not. To be sure you don’t act on any dangerous feelings while you’re waiting for help, try to get a neighbor, relative or friend to stay with you or put your baby in a safe place, like a crib.

Postpartum depression resources

The following resources offer more information and support if you or someone you know may be suffering from PPD: