Understanding Postpartum Depression

It's common to feel tired and moody after having a baby. But if you have very strong feelings of sadness or anger or have trouble doing your daily tasks, you may have a serious mood disorder called postpartum depression. It can be treated with counseling and medicines. Left untreated, it may stop you from bonding with your baby. It's important to see your health care provider right away and get help.

Postpartum depression is a serious mood disorder that can happen after giving birth. About 3 out of 20 new moms have it. Symptoms can include feeling very intense sadness, tiredness, and anxiety. These feelings can become so strong that it's hard to do your daily tasks. You may find it hard to take care of yourself and your baby.

Symptoms may start about 1 to 3 weeks after your baby is born. But they can also appear up to a year later. If you or the people around you think you may have postpartum depression, or if you have symptoms for more than 2 weeks, contact your health care provider right away. Treatment is available.

Postpartum depression is different from the “baby blues” (postpartum blues). The baby blues are common soon after giving birth. You may feel sad, moody, or anxious. But these feelings go away in about 2 weeks. If you still have these feelings after 2 weeks, or if you start to feel worse at any time, contact your health care provider. They will see if you have postpartum depression. It's important to get treated right away.

It's likely caused by a mix of physical and emotional factors. These include:

• Changing hormone levels. Right after you have a baby, your levels of estrogen and progesterone drop. This sudden change may set off depression. Your thyroid hormone levels may also drop at the same time.
• Depression. You may be at greater risk if you have a history of depression or if you are currently being treated for it.
• Extreme tiredness (fatigue). It can take a few weeks to recover from giving birth. And you may not get the rest or sleep you need.
• Lifestyle issues. Other things may also play a role. These can include money, health, or relationship problems. Or, you may not be getting support from friends or family.

Symptoms may vary. But they are very intense and may include:

• Feeling very tired, with no energy (fatigue).
• Crying often or for no reason.
• Feeling very sad, anxious, or overwhelmed.
• Being moody.
• Feeling that you can't take care of your baby.
• Sleeping too much, or not sleeping.
• Having trouble eating.
• Having trouble making decisions and focusing.
• Not being able to do your daily tasks.
• Not being interested in your baby.
• Not wanting to be around family or friends.
• Wanting to hurt yourself or your baby.

Early diagnosis and treatment are important. Only a health care provider can diagnose you. Contact your provider if you have symptoms of depression. Also contact them if you have trouble doing your daily activities for longer than 2 weeks.

Your provider will talk with you and ask for a health history. You may be asked to fill out a form that helps find depression. You may also have some blood tests done. These are used to find out if your symptoms may be caused by thyroid or other health problems.

If not treated, postpartum depression can be serious for you and your baby. Those who aren't treated:

• Are less likely to breastfeed their baby.
• May not bond with their baby.
• Are less likely to take good care of their baby.
• Are more likely to have problems with their partner.
• May have thoughts of harming themselves.
• May have thoughts of harming their baby.

You are more at risk if you have:

• A history of depression (including postpartum depression in a past pregnancy).
• A family member with depression.
• A history of alcohol or drug abuse.
• Had a problem in childbirth, such as a premature birth.
• A baby with health problems or special needs.
• No emotional support from your partner, family, or friends.
• Other stresses in your life, such as money or relationship problems.
• Mixed feelings about this pregnancy, such as with an unplanned pregnancy.

Treatment is available. Your health care provider can help you decide on the best treatment for you. They may advise:

• Medicine. Antidepressants are the main type of medicine for postpartum depression. These medicines affect the brain chemicals that help control moods. Let your provider know if you are breastfeeding. Most antidepressants are considered safe to use when breastfeeding.
• Talk therapy (counseling or psychotherapy). This involves talking with a mental health provider about your feelings and issues that might add to the depression. Therapy may be done in private sessions with just you and the provider. Or it may be done in group sessions with other new parents. You and your mental health provider may talk about:
  • Your new role and changing relationships with others.
  • Balancing your well-being while caring for your baby.

Medicine and talk therapy can be used alone or together.

Joining a support group may also help you cope. Check online for support groups in your area, or ask your provider for suggestions.

Along with seeing your health care provider and getting treatment, it's important to take care of yourself. Tell your family and friends how you are feeling and what kind of help or support you need. Make sure to also:

• Get enough sleep.
• Eat healthy foods.
• Rest when your baby takes a nap.
• Get some light exercise.
• Ask for and accept any help with meals, shopping, taking care of the baby, and laundry.

If you have thoughts of harming yourself or others, call or text 988 now. You will be connected to trained crisis counselors at the National Suicide Prevention Lifeline. An online chat option is also available at https://988lifeline.org. Lifeline is free and available 24/7.

Find more information at:

• Postpartum Support International at www.postpartum.net
• Office on Women's Health at www.womenshealth.gov