What Is Postpartum Depression?
From the day you saw those two pink lines, you dreamt of the day when your baby was finally placed into your arms. You’d smile at your expanding bump, dreaming of your baby’s firsts; their first gummy smile, the first time they said “Mama!”, and their first wobbly steps.
One thing you didn’t dream of? Postpartum Depression.
Postpartum depression (PPD) isn’t a new struggle many mothers face, but it hasn’t always been talked about like it should have been. Like many other mental disorders, it was considered shameful to have postpartum depression and speaking up about your struggles was heavily frowned upon.
Now, celebrities like Adele, Chrissy Teigen, and Drew Barrymore are speaking up about their personal struggles with PPD. Understanding and raising awareness about postpartum depression is so important so no mama has to think they’re alone in this battle.
It’s important to remember that being diagnosed with postpartum depression does not reflect on your abilities as a mother. It doesn’t make you less able to take care of your child, and it’s certainly not something you should be ashamed about.
In this article:
- What is postpartum depression?
- What causes postpartum depression?
- How common is postpartum depression?
- What are the signs of postpartum depression?
- Preventing postpartum depression
- How to treat postpartum depression
- How long does postpartum depression last?
- Postpartum depression resources
What is postpartum depression?
Postpartum is exactly what it sounds like; depression that occurs after having a baby or miscarriage.
Some women experience the typical round of baby blues (If you haven’t heard of the “baby blues”, you can read about it here), with the fog lifting around 2 weeks postpartum. For other women, the fog only gets stronger; lasting longer and more intense.
Although most women develop PPD in the first six months, many women may not experience baby blues at all, only to develop postpartum depression later on in their motherhood journey.
All too often, women claim they won’t get PPD because they’ve never been diagnosed with depression or anxiety, or they assume that since they feel happy initially they’ve avoided it. It might even be the case that they believe it to be an extended bout of the “baby blues”.
Unfortunately, that simply isn’t the case. Postpartum depression can develop anywhere from a few weeks post-birth up to twelve months postpartum, and while being previously diagnosed with depression or anxiety is a risk factor, any mama can develop PPD.
Knowing what to expect with postpartum depression can help you keep an eye out for symptoms and know when to tell your doctor about them.
What causes postpartum depression?
Between lack of sleep, your rollercoaster of hormones, and having a human entirely dependent on your existence (no big deal, right?), it’s difficult to say the cause behind postpartum depression.
It can also vary depending on the person. Your cousin may have developed PPD due to thyroid-related problems from childbirth, but your best friend may have developed it due to exhaustion and feeling really overwhelmed with her new role as a mama.
Some factors that can lead to PPD are:
- Having depression or anxiety before kids
- Thyroid changes
- Having a premature baby
- Giving birth to multiples
- Sleep deprivation
- Hormone changes
- Stressful life events; illness, death of a loved one, financial problems.
How common is postpartum depression?
While it’s not as common as the baby blues (which affects 70% of mamas), postpartum depression affects 1 in 9 women.
Postpartum depression doesn’t discriminate. It can affect any mama, regardless of age, ethnicity, marital status, income, or number of kids (although this research supports that women who have multiple kids are more likely to be affected by PPD).
What are the signs of postpartum depression?
It’s easy to assume that your symptoms of postpartum depression are due to your hormones and the fact that you just had a baby. However, if those symptoms last longer than two weeks and don’t seem to get better, you may want to call your doctor, even if you’re only experiencing one or two symptoms.
- Feeling sad, hopeless, or overwhelmed
- Excessive crying
- Difficulty bonding with your baby
- Feeling moody or irritable
- Being overly anxious
- Unable to sleep, even when the baby is sleeping
- Trouble concentrating
- Not eating or eating too much
- Withdrawing from family and friends
- Physical aches and pains; like headaches, stomach problems, and muscle pain.
More severe symptoms of postpartum depression include thoughts of harming yourself or your baby and recurrent thoughts of death or suicide. If you’re experiencing these thoughts, tell someone you trust and call your provider immediately. These symptoms should not be ignored.
More rarely, some women develop postpartum psychosis. Symptoms for postpartum psychosis develop in the first few weeks after delivery and include:
- Inability to sleep (insomnia).
- Confusion and inability to think clearly.
- Hallucinations or delusions, meaning you sense or believe things that aren’t real.
- Obsessive and fearful thoughts about your baby.
- Paranoia -- you’re deeply suspicious of other people, and no one can talk you out of it.
- Inability to eat.
- Thoughts of harming yourself or your baby.
Postpartum psychosis is considered an emergency and requires immediate treatment.
Preventing postpartum depression
Like most mamas, you are probably wondering what you can do to prevent PPD. While there isn’t one guaranteed way to prevent postpartum depression, there are a few things you can do to lessen your chances to develop it.
- Spoiler alert: Movies and TV shows have a knack for setting unrealistic expectations. Those glowing mothers with perfect hair just minutes after giving birth? Not real. Those gloriously chunky babes who smile up at their mamas at two days old? Also not real. The first three months postpartum are usually filled with unwashed mom buns, shirts that smell like spit up, lots of take-out, and relatively no sleep. It’s a time when you and your baby are figuring each other out and learning your new routine and encounter a lot (and we mean a lot) of trial and error. Knowing what to expect in the first few months postpartum will help limit your expectations so you don’t feel like you are failing as a mother.
- Build your tribe: Having a tribe, regardless of how small, is so important. Even if it’s just your mama, your partner, and your sister, you’re going to need their help. Letting yourself lean on them when you’re feeling overwhelmed or asking them to hang out with the baby while you shower will help you feel somewhat normal (and they won’t mind, promise!).
- Take a nap. And then another one: One thing you’re going to miss once your babe is here? Napping. Not only is sleep necessary for your very pregnant self, but it’s also essential to staying sane.Not getting enough sleep can lead to serious medical problems; like increased chance of heart disease, high blood pressure, and diabetes. It also leaves you with brain fog, inability to concentrate, and a short temper. Are you convinced yet? Good! Now finish reading this article and go catch some zzz’s! And once babe is here, try taking shifts overnight so you can get as much uninterrupted sleep as possible (easier said than done, but a solid effort never hurt anyone).
- Eat your veggies: Did you know that not getting enough Vitamin C can make you more prone to depression? Eating a well-balanced diet can help boost your mood and energy, which may seem non-existent these days. Pregnant women should be consuming 85mg of vitamin C a day, and that jumps to 120mg if you breastfeed. Taking a prenatal vitamin will cover a portion of that, but incorporating veggies like broccoli, spinach, and orange juice will help fill any gaps in your nutrient needs.
- Know your risk: Talking to your doctor about your risk for postpartum depression, and create a game plan to prepare for the possibility of PPD. Being active in knowing your risk and the signs and symptoms to look out for will help relieve stress (which is a risk factor for PPD), and sharing the signs and symptoms with your spouse will help them know what to look for too.
- Put on your walking shoes (or any shoes that fit): We all know that exercise leads to better overall health, but did you know that it can be considered a natural cure for depression? Recent research on the effects of exercise preventing postpartum depression has had fantastic results. “We know that exercise is just as effective as anti-depressants for adults,” said Beth Lewis of the University of Minneapolis in Minnesota. “...With postpartum depression, it’s even more complicated due to the increased stress and sleep deprivation after having a baby...We’re starting to learn more about exercise and how it helps.” This research study found that women who participated in exercising had lower scores on a depression symptom checklist than women who didn’t exercise. In fact, women who didn’t qualify for postpartum depression symptoms found they experienced a mood boost after exercising. You don’t have to be in training for a marathon or do CrossFit. Prenatal yoga, walking in the park, stretching and breathing, and aerobics are all great options when it comes to preventing (and managing!) postpartum depression.
How to treat postpartum depression
After you tell your provider how you’ve been feeling, they may have some more questions about your health or may want to run tests to rule out other possibilities (like thyroid problems). Once you’ve officially been diagnosed with postpartum depression, you’ll have a few options.
Medications for PPD
Depending on your severity and preferences, your doctor may suggest antidepressants. The two most common types of antidepressants are
- Selective serotonin reuptake inhibitors (SSRIs), such as Zoloft or Paxil, are usually the first choice.
- Tricyclic Antidepressants (TCA), like Elavil or Tofranil, are prescribed if SSRIs aren’t working.
Antidepressants usually take a few weeks to help you feel better, and – like all medications – they may have some side effects. Most side effects wear off over time, but if you experience any that concern you, let your doctor know.
If you’re breastfeeding, make sure to tell your doctor. Some antidepressants are safe while breastfeeding, but others may not be. Ask your doctor about the risks associated with taking antidepressants and breastfeeding.
Talking to a therapist or psychiatrist (also known as “Talk Therapy”) may help you understand why you’re experiencing PPD and help you learn ways to manage it. Sometimes, therapy and antidepressants are both suggested to give you maximum benefits and learn how to manage your depression when you wean from the antidepressants.
There are two different types of therapy that have been proven beneficial for postpartum depression. Those are:
- Cognitive behavioral therapy (CBT) helps you recognize your negative thoughts and behaviors and figure out a game plan to change them.
- Interpersonal therapy (IPT) focuses on problematic personal relationships and how to overcome them.
Other treatment options
- Support groups
- Bright light therapy
- Up your Omega-3
Untreated postpartum depression can last for months or even years. Not only does untreated PPD affect the mother’s health, but it can also affect her relationship and bonding with her baby and can negatively affect the baby in how they eat, sleep, and develop.
How long does postpartum depression last?
Postpartum depression doesn’t run on a time frame. Undiagnosed, it can last for years. With proper diagnosis and treatment, the time frame can be from 8-12 weeks.
The most important thing to understand about PPD is that it doesn’t last forever. It may feel like forever, but once you seek help you’ll be feeling like yourself in no time. The key is to ask for help as soon as you recognize symptoms.
Postpartum depression resources
Are you or someone you know struggling with postpartum depression? The following resources can provide you with more information and support:
- Postpartum Support International: 1-800-944-4773 or text 503-894-9453
- Postpartum Health Alliance: 619-254-0023
- National Health Alliance on Mental Illness (NAMI): 800-950-6264
- Postpartum Depression: Know the Signs
Remember those daydreams you had while pregnant? Those are completely achievable. You may be under a dark cloud now, but sunshine is right around the corner (and so is your sweet smiley babe). Once you’ve begun treatment, regardless if it’s with antidepressants, therapy, or a combination of both, you’ll be feeling like yourself in no time.
Asking for help and receiving treatment is the best way to manage your symptoms and bond with that sweet squish.
Centers for Disease Control and Prevention, Depression During and After Pregnancy, May 2019.
Office On Women's Health, Postpartum depression, May 2019.
WebMD, The Basics of Postpartum Depression, March 2019.
National Institutes of Health, National Library of Medicine, Postpartum depression risk factors: A narrative review, August 2017.
American College of Obstetricians and Gynecologists, Postpartum Depression, December 2013
National Institute of Mental Health, Postpartum Depression Facts
- Emily Rader