What is postpartum depression?

Postpartum depression¹ is a mood disorder that can affect women after childbirth. “Postpartum” refers to the period following childbirth.

Giving birth to a baby can cause a wide variety of intense emotions, from excitement and joy to anxiety and fear. In some cases, however, childbirth can also cause depression.

Many new mothers experience what’s called the “baby blues”: mood swings, anxiety, tearfulness, and trouble sleeping that arise after giving birth. The baby blues often begin within two or three days following delivery and can last for as long as two weeks before going away on their own.

Postpartum depression, however, is more severe and long-lasting. It can begin any time within the first year after childbirth. The disorder causes intense, sometimes overwhelming sadness, anxiety, and exhaustion. Postpartum depression can impact all areas of postpartum life, which can make it difficult for new mothers to take care of themselves and their babies.

Rarely, some new mothers develop a serious mood disorder called postpartum psychosis². This can cause them to break from reality and experience rapid mood swings, paranoia, and delusions.

Postpartum depression is not a weakness and does not develop because of something a mother did or didn’t do. It is the result of the hormonal and physical changes that occur after giving birth, often compounded by the stress of dealing with a newborn. Effective treatment can help mothers with postpartum treatment manage their symptoms and bond with their babies more closely.

How long does postpartum depression last?

The baby blues, which are more common and less severe than postpartum depression, usually resolve on their own within a few days or weeks following childbirth. Postpartum depression can last much longer.

Postpartum depression used to be generally defined as depression or anxiety that begins within the first 4–6 weeks³ after giving birth. However, recent research suggests that this timeframe may be too restrictive. Depression and anxiety can begin in mothers during pregnancy (called antepartum depression) and arise at any time within the year following delivery.

The time it takes for a new mother to recover from the symptoms of postpartum depression depends on a number of factors, including:

• How soon treatment is sought
• Having a history of depression and anxiety
• Home environment
• Emotional and childcare support
• Commitment to self-care and treatment

Each mother’s timeline with postpartum depression is different and can be influenced by a variety of circumstances and factors. Seeking treatment is the best way to manage symptoms as soon as they arise.

How common is postpartum depression?

Postpartum depression is fairly common: it affects roughly 10–15%⁴ of new mothers. However, this rate increases in women who are dealing with poverty and can be as much as two times higher in teen mothers. The baby blues are even more common, affecting up to 80%⁵ of mothers.

Postpartum psychosis is much rarer. It occurs in roughly 1–2 out of every 1,000 births (approximately 0.1–0.2%⁶).

What causes postpartum depression?

Postpartum depression does not have one single cause⁷. As with many mental health disorders, it’s likely caused by a combination of physical, environmental, and emotional factors.

It is likely that the hormonal and physical changes that occur in a mother after birth—compounded with the stress of caring for a new baby—play a role in the development of postpartum depression. Women who already have mental health disorders, such as depression or anxiety, are also at higher risk⁸ of developing postpartum depression.

After childbirth, the levels of the hormones estrogen and progesterone in the body quickly drop. This causes chemical changes in the brain to occur that can trigger mood swings.

Additionally, many mothers are unable to get the rest they need to recover fully after birth. Sleep deprivation, as well as the other stresses of caring for a newborn, can lead to physical fatigue and exhaustion, both of which can play a role in the symptoms of postpartum depression.

Postpartum depression is never caused by something a mother didn’t do or did wrong. While some mothers can feel guilty for being depressed after having a baby (especially because they’re often expected to be elated), their feelings and reactions are not their fault.

Risk factors for postpartum depression

Postpartum depression can affect any new mother. However, the following factors⁹ can increase the risk of developing postpartum depression:

• Personal or family history of depression or other mood disorders, either during pregnancy or at other times
• Bipolar disorder
• Having had postpartum depression after a previous birth
• Experiencing stressful events during pregnancy or shortly after giving birth, including job loss or financial stress, the death of a loved one, or illness
• Medical complications during childbirth, such as premature delivery or giving birth to a baby with health problems or other special needs
• Having twins, triplets, or other multiple births
• Difficulty breastfeeding
• Lack of a strong support system
• Problems in your relationship with your spouse or partner
• Drug or alcohol abuse
• Having had an unplanned or unwanted pregnancy

Postpartum depression symptoms

The signs and symptoms¹⁰ of depression after childbirth may vary, ranging from mild to severe. The “baby blues,” which are more common than postpartum depression, often present with milder, less long-lasting symptoms. Postpartum psychosis is the most severe of postpartum mental disorders.

Baby blues symptoms

The signs and symptoms of the baby blues generally last from several days to a week or two after giving birth. These may include:

• Mood swings
• Sadness
• Anxiety and irritability
• Feeling overwhelmed
• Tearfulness
• Difficulty concentrating
• Changes in appetite
• Trouble sleeping

Postpartum depression symptoms

Postpartum depression is commonly mistaken for the baby blues at first. It may become apparent that you might have postpartum depression instead if your signs and symptoms are severe and long-lasting and begin to interfere with daily life and caring for your baby.

The symptoms of postpartum depression usually develop within a few months to a year of childbirth. In some cases, they appear during pregnancy (called antepartum depression) and can last well after giving birth.

Common signs and symptoms¹¹ of postpartum depression include:

• Depressed mood or extreme mood swings
• Feelings of hopelessness, emptiness, or being overwhelmed
• Tearfulness or crying more than usual, sometimes for no apparent reason
• Moodiness, irritability, or restlessness
• Severe fatigue or loss of energy
• Excessive worrying or anxiety (in some cases, severe anxiety and panic attacks)
• Intense irritability, anger, or rage
• Changes in appetite, including loss of appetite or eating more than usual
• Changes in sleep habits, including insomnia (difficulty sleeping, in some cases while your baby is sleeping) or sleeping too much
• Trouble concentrating, remembering details, or making decisions
• Physical aches and pains, including frequent stomach problems, headaches, and muscle pain
• Reduced interest or pleasure in things that used to be enjoyable
• Avoiding or withdrawing from family and friends
• Feelings of shame, guilt, worthlessness, or inadequacy
• Difficulty bonding or forming an emotional attachment with your baby
• Persistent doubt of your ability to care for your baby; feeling like you’re not a “good mother”
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide (if this occurs, call the National Suicide Prevention Lifeline at 1-800-273-8255)

You shouldn’t feel ashamed to experience these symptoms after giving birth. Having a baby is a big event and can cause significant emotional and physical changes to occur. If you experience any of these signs and symptoms, talk to your healthcare provider to get the proper diagnosis and treatment.

Postpartum psychosis

Postpartum psychosis is a rare condition that usually develops within the first week after giving birth.

The signs and symptoms¹² of postpartum psychosis are severe. They can include:

• Disorientation and confusion
• Sleep disturbances
• Excessive energy and agitation
• Paranoia
• Obsessive thoughts about your baby
• Hallucinations and delusions
• Attempts to harm yourself or your baby

Postpartum psychosis can lead to life-threatening thoughts and behaviors. It is a serious condition that requires immediate medical treatment. If you or a loved one shows the signs of postpartum psychosis, reach out to a healthcare provider immediately or dial 911.

Complications from postpartum depression

Postpartum depression can cause a number of complications¹³ that affect both mother and baby.

When left untreated, postpartum depression can last for months or even years. Aside from affecting the mother’s mental health, postpartum depression can interfere with her ability to bond with and care for her baby. This may cause the baby to experience problems with sleeping, eating, and behavior as they grow.

Postpartum depression can affect all members of a family:

• In mothers: untreated postpartum depression can last for months or even longer. In some cases, it can become a chronic (ongoing or long-lasting) depressive disorder. Even when treated, postpartum depression increases a woman’s risk of experiencing future episodes of major depression.
• In fathers: Postpartum depression can cause emotional strain for everyone close to a newborn. Depression in the mother may also increase the risk of depression in the baby’s father. Furthermore, new fathers are at increased risk of depression, even if their partners aren’t affected.
• In children: Children whose mothers have untreated postpartum depression are more likely to develop emotional and behavioral problems, such as difficulty eating and sleeping, excessive crying, and delays in language development.

Seeking treatment for postpartum depression is the best way to prevent additional stress and complications from arising.

Postpartum depression in new fathers

When people hear about postpartum depression, they usually think about mothers who have just given birth. However, new fathers¹⁴ can experience postpartum depression as well as new mothers.

The symptoms of this condition (sometimes called paternal postpartum depression) are the same as those experienced by mothers with postpartum depression. Fathers may feel sad, fatigued, overwhelmed, or anxious or have disruptions in their usual eating and sleeping habits.

Young fathers, as well as fathers who have a history of depression, experience relationship problems, or are struggling financially, are at the highest risk of developing postpartum depression. Paternal postpartum depression can have the same negative effects on family and partner relationships and child development as postpartum depression in mothers.

If you are a new father and experience the symptoms of postpartum depression during your partner’s pregnancy or within the first year after your child is born, talk to your healthcare professional. Some of the same treatments used for mothers with postpartum depression can help treat the condition in fathers.