The experience of childbirth can bring on waves of powerful emotions, from happiness and excitement to fear and sadness. Many new parents experience changes in their emotional state, which can include feeling down, irritability, and anxiety. Once they settle into a routine with their new child, however, these emotions are likely to get better or pass.

However, some parents can develop postpartum depression. This is a serious mental health concern that develops within the first few months after the birth of a new child. The feelings of sadness, numbness, loneliness, and desperation can lead to difficulty caring for and bonding with the new child. Postpartum depression can last for months, and while it may eventually get better by itself, it is important to understand that there is help for this condition.

Below are some questions to help people who may be struggling with postpartum depression.

What is postpartum depression?

Postpartum depression is a mood disorder that affects parents after the birth of a new baby. While the condition is primarily associated with new mothers, new fathers can also struggle with postpartum depression symptoms. Symptoms of postpartum depression include:

  • Exhaustion and fatigue
  • Extreme sadness, depressed mood, and mood swings
  • Restlessness or irritability
  • Anxiety or panic attacks
  • Feeling overwhelmed
  • Inability to concentrate
  • Appetite changes
  • Difficulty sleeping outside of normal childcare or persistent insomnia
  • Oversleeping
  • Thoughts of harming oneself or the child
  • Persistent thoughts of suicide or death

Milder versions of these symptoms, often referred to as “the baby blues,” can occur within a few months after childbirth, but typically clear up quickly. Postpartum depression in particular is characterized by extreme, intense, life-limiting versions of these symptoms, including suicidal ideation. Although postpartum depression can get better on its own, getting help is the best way to overcome this mental health condition.

What causes postpartum depression?

There are many different reasons that a new parent can develop postpartum depression, including genetics, childhood trauma, or current environment. Having a baby is a major life change, and large changes in a person’s life can trigger latent mental health concerns. However, women in particular experience postpartum depression because pregnancy and childbirth involve a large flood of hormones, such as estrogen and progesterone, and after birth, those hormones rapidly decline. Hormonal changes can affect levels of neurotransmitters like dopamine and serotonin, which can also trigger or cause a mental health concern like postpartum depression.

Newborns require near-constant interaction and can cause new parents to lose sleep. This change in sleep patterns can affect brain chemistry and trigger depression. About 24 percent of new mothers can develop prenatal and/or postpartum depression, while nearly 5 percent of men develop these conditions.

What are other postpartum mental health concerns?

The baby blues and postpartum depression are common experiences for many new parents, but postpartum anxiety and postpartum psychosis are also possible due to changes in hormones, brain chemistry, sleep and eating patterns, and life structure. Postpartum psychosis typically develops within the first week after childbirth and includes disorientation, confusion, hallucinations, unusual sleep disturbances, paranoia, delusions, and attempts to harm oneself and/or the baby. Postpartum anxiety disorder can include panic disorder and obsessive-compulsive disorder, which are characterized with symptoms including recurring panic attacks, fear of dying or losing the baby, intrusive and repetitive thoughts expressed in behaviors, fear of thoughts and feeling “crazy,” and constant worries about harm and the future.

Who is at risk for postpartum depression?

Although any new parent can potentially develop postpartum depression, some individuals are more at risk of this condition than others. It is more likely if the person:

  • Is younger than 20
  • Struggling with addiction or substance abuse
  • Had mixed feelings about the pregnancy or the pregnancy was unplanned
  • Had existing struggles with depression, anxiety, bipolar disorder, or other mood disorders
  • Had a stressful pregnancy or delivery
  • Has a close family member with mood disorders
  • Has troubles in relationship or is single during pregnancy or childbirth
  • Lives in a stressful home situation, especially involving money or housing troubles
  • Has little support from family, friends, and a partner

How is it diagnosed?

In order to determine whether a new parent is experiencing postpartum depression, a therapist will ask their client to fill out a questionnaire to diagnose symptoms and their severity. The therapist may ask about family history, current environment, and existing partner and family support, in order to determine the potential risk level for postpartum depression. The therapist may also refer their client to a physician for blood tests to assess thyroid and hormonal levels. This can be an indicator that a physical imbalance has led to psychological manifestations. There may be other tests to rule out other postpartum conditions, too.

How is it treated?

Treatment for postpartum depression is similar to treating other mood disorders, although the use of medications is much more carefully considered and monitored in breastfeeding mothers.

The most common and effective treatment is therapy. Typically, this is in the form of Cognitive Behavioral Therapy, which helps the individual recognize their symptoms, develop relaxation techniques, and work through negative thoughts and behaviors. Another common form of therapy is interpersonal therapy, which helps the individual work through problematic personal relationships that may contribute to postpartum depression.

The individual experiencing postpartum depression may also receive prescription medications to treat the condition. These are most typically in the form of antidepressants, which can be selective serotonin reuptake inhibitors (SSRIs), serotonin/norepinephrine/dopamine reuptake inhibitors (SNRIs), tricyclic antidepressants, or monoamine oxidase inhibitors (MAOIs). Some common brand names are:

  • Prozac
  • Zoloft
  • Paxil
  • Celexa
  • Wellbutrin
  • Effexor
  • Cymbalta

In rare instances, stronger prescription medications used to treat bipolar disorder or anxiety disorder may be used for a very short time period to help the new parent stabilize their mood and begin therapy. Again, this may not be recommended for breastfeeding mothers, as prescription medications can affect the baby.

What are potential health concerns if it is untreated?

Untreated postpartum depression can last for several months or even years. The condition affects how the parent bonds with their child, which can affect the child’s mental health later in life. Intrusive thoughts or compulsions, especially suicidal or violent thoughts, or persistent thoughts involving death can lead to intense fear for the future and fear of oneself. In some cases, the new parent may act on these intrusive thoughts through self-harm or by harming their child.

Relationships between partners and with other family members or friends can be damaged if postpartum depression goes untreated. The new parent could begin to self-medicate with alcohol or drugs, which can damage their mental and physical health in the long-term and, for breastfeeding mothers, can damage the child’s health too.

What is the prognosis for postpartum depression?

People who experience depression in any form are more likely to develop postpartum depression when they have a child. Additionally, once a person experiences postpartum depression, they are more likely to develop the condition if they have another child. Children of parents who experienced postpartum depression are more likely to develop this mental condition themselves when they have children. However, getting help from a physician and/or a therapist will help to relieve these symptoms and improve outcomes for the whole family.

Get Help for Postpartum Depression

Some psychologists believe that postpartum depression is one of the most common mood disorder that goes untreated in the United States. However, thanks to a better understanding of how this condition affects new mothers, as well as new fathers, education before and during pregnancy is improving. New parents are often encouraged to seek help for any symptoms they believe reflect a change in their emotional baseline. This helps to prevent mood disorders not only right after childbirth, but also throughout life.