Impacting approximately 1 in 8 women in the U.S. and 17.7% of women globally, postpartum depression is a common yet often misunderstood condition that can affect women during pregnancy or after giving birth. [1][2] While some emotional ups and downs—commonly known as the "baby blues"—are expected in the days following delivery, postpartum depression is more intense and long-lasting and can potentially interfere with a person’s ability to care for themselves and their baby.
Despite its prevalence, postpartum depression often goes undiagnosed and untreated, sometimes because it’s mistaken for normal new-parent exhaustion, and other times due to stigma around mental health and motherhood. [3]
Below, we’ll explore the condition in more detail and discuss common symptoms and treatment options to provide you with the knowledge and resources to get the help you need if you experience the condition.
- Postpartum depression affects nearly 1 in 8 women in the U.S. and is often mistaken for the “baby blues,” delaying diagnosis and treatment.
- It’s caused by a mix of hormonal shifts, genetics, psychological stress, and personal history, with symptoms ranging from sadness and fatigue to difficulty bonding with the baby.
- Effective treatments include therapy, medication, and support systems, and early intervention greatly improves outcomes for both parent and child.
Understanding postpartum depression
Postpartum depression, also known as perinatal depression, is a mood disorder that can affect individuals after childbirth, regardless of whether it's their first or fifth baby. It’s caused by a combination of hormonal shifts, genetic vulnerability, life stress, and psychosocial factors. [3] According to the Mayo Clinic, the drop in estrogen and progesterone levels after childbirth may contribute to depressive symptoms.
Having a high-risk pregnancy, traumatic childbirth (like an emergency c-section), and a preterm or low-birth-weight infant can put mothers at increased risk. Other factors like sleep deprivation, poor eating habits, lack of exercise, changes in identity, and the physical recovery from childbirth can also play a role. [3]
Women who have a history of depression and anxiety, premenstrual syndrome, a negative attitude towards the baby, a reluctance of the baby's sex, and a history of sexual abuse are at increased risk of developing the condition. [3] In more severe cases, postpartum depression can develop into postpartum psychosis, a rare but serious condition that requires immediate medical attention. [3]
How common is postpartum depression?
Postpartum depression is among the most common complications of childbirth. As mentioned, 17.7% of women worldwide experience it, though rates may be higher in low-income and minority populations due to disparities in healthcare access and support. [2]
The CDC reports that rates of postpartum depressive symptoms have increased in recent years, particularly during the COVID-19 pandemic. This suggests that environmental stressors can significantly impact maternal mental health. [3]
How long does it last?
The duration of postpartum depression can vary widely. Some women recover within a few weeks, while others may experience symptoms for months or even a year. According to a 2021 study, postpartum depression symptoms often peak within the first 4–6 weeks postpartum but can persist without treatment. [4]
Without intervention, postpartum depression can evolve into chronic depression, making early detection and treatment critical.
Symptoms of postpartum depression
Postpartum depression symptoms are similar to other depressive disorders but also include emotions and behaviors that specifically relate to the postpartum experience. These symptoms can include:
- Persistent sadness, hopelessness, or emptiness
- Crying more often than usual
- Difficulty bonding with the baby
- Withdrawing from loved ones
- Feeling like a bad parent
- Trouble sleeping or sleeping too much
- Feeling tired all the time
- Changes in appetite or eating habits
- Intense irritability or anger
- Thoughts of harming oneself or the baby
It’s important to recognize that these feelings are not a personal failing. Postpartum depression is a medical condition that can be treated with proper care.[3]
Spotting signs of postpartum depression
It can be hard to distinguish between postpartum depression and the "baby blues," which affects up to 80% of new mothers and typically resolves within two weeks. [3] If symptoms last longer than two weeks or become severe, it's a strong sign that medical support is needed. Gloria Anderson, CMHC and Clinical Director at Acqua Recovery, had this to add:
Postpartum depression is different. It's more intense, lasts longer, and can deeply impact your daily functioning. If you're experiencing symptoms that persist beyond two weeks, it's time to reach out for help. [9]
Medical advisor
CMHC
Postpartum depression has been referred to as one of the "worst-kept secrets” because it is often concealed by parents who fear judgment or who don’t recognize the severity of their symptoms. Loved ones can help by staying alert to changes in mood, behavior, or functioning and encouraging new parents to seek help when needed.
Postpartum depression and substance abuse
There’s a growing recognition of the link between postpartum depression and substance use disorders. A 2022 review found that perinatal mental health disorders—including postpartum depression—are associated with an increased risk of self-medication, which can worsen both mental health and family dynamics. Some individuals may turn to alcohol or drugs as a way to “self-medicate” or cope with overwhelming emotions or sleep disturbances. [5]
Stress and trauma are huge factors, too. Women who have experienced multiple stressful life events during pregnancy or who have histories of childhood trauma are at a significantly higher risk. This makes sense when we understand that addiction and using behaviors are coping skills for underlying trauma. [9]
Medical advisor
CMHC
Early identification and treatment of postpartum depression is crucial and can reduce the risk of new mothers developing substance use problems later on.
Diagnosing postpartum depression
Diagnosis typically begins with screening tools, like the Edinburgh Postnatal Depression Scale (EPDS), which is administered during a postpartum checkup. Healthcare providers may also assess for anxiety, OCD, and PTSD, which commonly co-occur with postpartum depression. This is why monitoring mothers beyond the standard 6-week postpartum visit is essential, especially since symptoms may arise later. [3]
Treatment options
The good news is that postpartum depression is treatable, and most women feel better with a combination of therapy, medication, and social support.
Therapy
Talk therapy has been proven to be an effective treatment for postpartum depression and is considered the first-line treatment for mild to moderate peripartum depression. Specifically, cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) have strong evidence supporting their use in postpartum populations.[6][7]
Medical advisor
CMHC
Therapy can help parents process their emotions, build coping skills, and reconnect with their sense of identity and purpose
Medication
Women with moderate to severe postpartum depression typically require a combination of medication and talk therapy. [3] The American College of Obstetrics and Gynecologists (ACOG) recommends antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), as the first line of treatment. Some are considered safe for breastfeeding parents. [3]
Other commonly prescribed antidepressants include serotonin-norepinephrine reuptake inhibitors and tricyclic antidepressants. [3] Recently, the FDA approved zuranalone, the first oral treatment designed explicitly for postpartum depression, which offers rapid relief in as little as three days. [3][8]
Alternative treatment
Complementary approaches—like support groups, mindfulness practices, exercise, and light therapy—can help manage symptoms, especially when used alongside traditional treatments. Transcranial magnetic stimulation has also been shown to be effective in patients who don’t respond to medications or therapy. [3]
Medical advisor
CMHC
Some people may also explore nutritional interventions or hormone therapy, although more research is needed.
Living with postpartum depression
Living with postpartum depression can be incredibly isolating, but it’s important to remember that you’re not alone, and help is available. Recovery often takes time, but with the right support, most people improve significantly. Building a care team that includes healthcare providers, mental health specialists, family, and friends can make all the difference.
The sooner postpartum depression is identified and treated, the better the outcomes for both parent and child. If you or someone you love is struggling after giving birth, reaching out for help is a powerful and brave first step.
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