Postpartum Depression (PPD): Signs, Symptoms & Treatment

Feel­ing down after giv­ing birth? 

It may be con­fus­ing to feel sad after your baby is born, espe­cial­ly after all of the excite­ment lead­ing up to it. But it’s actu­al­ly very nor­mal. And while that sad­ness usu­al­ly goes away with­in a few days, it can some­times linger. If it does, you may have post­par­tum depres­sion, or PPD. 

PPD is well known, but it’s often not well under­stood. Here are answers to com­mon ques­tions about PPD.

How Com­mon Is PPD?

If you have PPD, you’re in good com­pa­ny. PPD is the most com­mon com­pli­ca­tion among women who have recent­ly giv­en birth. 

What Are the Signs of PPD?

There are many pos­si­ble symp­toms of PPD that can range from mild to severe. 

Com­mon tell-tale signs of PPD include:

• Changes in appetite or eat­ing habits
• Cry­ing exces­sive­ly or cry­ing for no reason
• Feel­ing anx­ious around your baby or hav­ing lit­tle inter­est in being with them
• Feel­ing on edge, sad, hope­less, guilty, or worthless
• Increased irri­tabil­i­ty or anger
• Not being inter­est­ed in things you usu­al­ly enjoy
• Severe mood swings
• Trou­ble sleep­ing or over­whelm­ing tiredness
• With­draw­ing from fam­i­ly and friends
• Wor­ry­ing that you’re not a good mother

Also read: My Baby is Sleep­ing, But I Can’t: All About Post­par­tum Insomnia

What’s the Dif­fer­ence Between Baby Blues and PPD?

In the first few days after child­birth, many moth­ers have some of the symp­toms of PPD, like feel­ing sad, cry­ing for no rea­son, hav­ing self-doubt, or get­ting testy with their loved ones.

Often, these symp­toms are the ​“baby blues” – some­thing that up to 85% of new moth­ers expe­ri­ence. Even though the symp­toms can be sim­i­lar, PPD symp­toms are often more severe. There are a few oth­er clues that can help you tell baby blues and PPD apart: 

• Baby blues start about two to three days after child­birth. PPD typ­i­cal­ly devel­ops with­in 1 to 3 weeks (or even lat­er) after giv­ing birth.
• Baby blues go away on their own, but PPD needs to be treated.
• Baby blues last a few days to a cou­ple of weeks. PPD can last for many weeks or months if left untreated. 

You don’t have to nav­i­gate PPD alone. If your symp­toms per­sist beyond a cou­ple of weeks, reach out to a Behav­ioral & Men­tal Health pro­fes­sion­al or your OBG­YN ear­ly; they can help you devel­op a safe, effec­tive treat­ment plan tai­lored to your needs.

Find Men­tal Health Providers near you >

What’s the Dif­fer­ence Between PPD and Post­par­tum Anx­i­ety (PPA)?

Cer­tain signs of PPD and PPA over­lap, but they are two sep­a­rate con­di­tions. PPD is main­ly asso­ci­at­ed with sad­ness, while PPA is most­ly asso­ci­at­ed with exces­sive wor­ry. It’s pos­si­ble to have both con­di­tions at the same time.

Com­mon signs of PPA include: 

• Phys­i­cal symp­toms: heart pal­pi­ta­tions, short­ness of breath, or dif­fi­cul­ty sit­ting still
• Emo­tion­al symp­toms: rac­ing thoughts (par­tic­u­lar­ly about worst-case sce­nar­ios) or obsess­ing over irra­tional fears
• Behav­ioral symp­toms: being over­ly cau­tious about non-dan­ger­ous sit­u­a­tions, avoid­ing cer­tain peo­ple or places, or con­stant­ly re-check­ing things

Also read: How do I Know if I Have an Anx­i­ety Disorder?

How Is PPD Treated?

When you’re in the midst of PPD, it can feel like you’re stuck. But there is a light at the end of the tun­nel. With treat­ment, almost all women recover. 

There are sev­er­al treat­ment options, includ­ing med­ica­tion, talk ther­a­py, and sup­port groups. Your provider may pre­scribe an anti­de­pres­sant or zura­nolone, which is the first drug specif­i­cal­ly approved for treat­ing PPD by the U.S. Food and Drug Administration.

If you do go on zura­nolone, there are a few things to be care­ful about. Researchers know that zura­nolone pass­es into breast milk, but they don’t know how that might affect your baby. You also need to use birth con­trol while on zura­nolone and for a week after your last dose, since it can harm a fetus. 

A Word from Our Doctor: 

“Patients are often wor­ried they can­not take any med­ica­tion while preg­nant or nurs­ing and that is not the case. It is espe­cial­ly impor­tant to have a con­ver­sa­tion with your OBG­YN pri­or to sud­den­ly stop­ping any anti­de­pres­sant or anti anx­i­ety med­ica­tion. This can cause severe and some­times life threat­en­ing symp­toms at a time when new moms are already at risk for depres­sion and anx­i­ety. Remem­ber your fam­i­ly can­not thrive if you do not care of your­self as well, and that always includes your men­tal health.”

- Cyn­thia Magsam, MD, CLC, Obstet­rics & Gyne­col­o­gy physi­cian with Duly Health and Care.

What Caus­es PPD? Can You Pre­vent It?

Yes and no. The cause of PPD isn’t always clear. It could be due to changes in hor­mones after child­birth, a his­to­ry of depres­sion, fatigue, emo­tion­al adjust­ment to hav­ing a baby, lack of a sup­port sys­tem, a fam­i­ly his­to­ry of PPD, or a com­bi­na­tion of these fac­tors. With­out a clear cause, PPD can be a bit hard to prevent. 

For­tu­nate­ly, there are steps you can take to decrease your risk. Talk to your provider about your risk lev­el and learn the signs ahead of time so you can rec­og­nize PPD and treat it right away.

Also read: Oh, Baby! Make Time for You — 6 Ideas for Self-Care Dur­ing Pregnancy

Once your baby is born, you can low­er your risk by:

• Lim­it­ing vis­i­tors at the begin­ning (with­out iso­lat­ing yourself)
• Sleep­ing or rest­ing while your baby sleeps
• Get­ting phys­i­cal activ­i­ty, even if it’s just a quick, easy walk outside
• Set­ting real­is­tic expec­ta­tions for your­self and your baby
• Accept­ing that there will be bad days

Keep­ing up with your rela­tion­ships is also impor­tant, even if you’re not see­ing peo­ple in per­son. Stay in touch with friends and fam­i­ly, and don’t be afraid to reach out to them if you need help. If you have a part­ner, make time for each oth­er to help keep your rela­tion­ship strong. 

Did I Do Some­thing Wrong?

Not at all. PPD is com­mon and it’s not due to any­thing you did wrong before, dur­ing, or after preg­nan­cy. You don’t need to feel embar­rassed or guilty. 

This includes cas­es where PPD caus­es you to be unin­ter­est­ed in being with your baby or makes it dif­fi­cult to care for them. This is noth­ing to be ashamed of and it doesn’t mean you’re a ​“bad” mom. 

Can Men Get PPD, Too?

Yes, and it may be more com­mon than you think. About 10% of fathers expe­ri­ence depres­sion before or right after their child is born, and as many as one in four dads have PPD symptoms.

A lot of the symp­toms are the same in men and women, but men are more like­ly to have anger or aggres­sion, feel cyn­i­cal or frus­trat­ed, or work all the time. Just like women, men with PPD may be treat­ed with med­ica­tion, talk ther­a­py, sup­port groups, or a com­bi­na­tion of sev­er­al methods. 

What About Adop­tive Parents?

Depres­sion after birth isn’t lim­it­ed to bio­log­i­cal par­ents. Adop­tive par­ents may have post-adop­tion depres­sion (PAD), which shares many symp­toms and treat­ment options with PPD. 

Adop­tive moth­ers might not have the hor­mon­al risk fac­tors, but they do have emo­tion­al ones. Many adop­tive par­ents put extra pres­sure on them­selves, par­tic­u­lar­ly if they adopt a child from a dif­fer­ent back­ground, which can cause excess stress. You may want to work with a coun­selor or adop­tion spe­cial­ist to set real­is­tic expec­ta­tions and ease stress. 

And that goes for every­one with symp­toms of PPD. Work­ing with a pro­fes­sion­al and get­ting treat­ment can help you get your men­tal health back on track after giv­ing birth. 

Tak­ing care of your men­tal health means tak­ing care of your fam­i­ly. Con­nect with a Behav­ioral and Men­tal Health provider who can sup­port you through post­par­tum depres­sion and help you feel like your­self again.

Find Men­tal Health Providers near you >