The birth of a baby can start a variety of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.

 

Most new moms experience postpartum "baby blues" after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues usually begin within the first 2 to 3 days after delivery and may last for up to two weeks.

 

But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Sometimes it is called peripartum depression because it can start during pregnancy and continue after childbirth. Rarely, an extreme mood disorder called postpartum psychosis also may develop after childbirth.

 

Postpartum depression is not a character flaw or a weakness. Sometimes it is simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and help you bond with your baby.

 

Symptoms

Symptoms of depression after childbirth vary, and they can range from mild to severe.

 

Baby blues symptoms

Symptoms of baby blues — which last only a few days to a week or two after your baby is born — may include:

 

Mood swings

Anxiety

Sadness

Irritability

Feeling overwhelmed

Crying

Reduced concentration

Appetite problems

Trouble sleeping

Postpartum depression symptoms

Postpartum depression may be mistaken for baby blues at first — but the symptoms are more intense and last longer. These may eventually interfere with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth. But they may begin earlier — during pregnancy — or later — up to a year after birth.

 

Postpartum depression symptoms may include:

 

Depressed mood or severe mood swings

Crying too much

Difficulty bonding with your baby

Withdrawing from family and friends

Loss of appetite or eating much more than usual

Inability to sleep, called insomnia, or sleeping too much

Overwhelming tiredness or loss of energy

Less interest and pleasure in activities you used to enjoy

Intense irritability and anger

Fear that you are not a good mother

Hopelessness

Feelings of worthlessness, shame, guilt or inadequacy

Reduced ability to think clearly, concentrate or make decisions

Restlessness

Severe anxiety and panic attacks

Thoughts of harming yourself or your baby

Recurring thoughts of death or suicide

Untreated, postpartum depression may last for many months or longer.

 

Postpartum psychosis

With postpartum psychosis — a rare condition that usually develops within the first week after delivery — the symptoms are severe. Symptoms may include:

 

Feeling confused and lost

Having obsessive thoughts about your baby

Hallucinating and having delusions

Having sleep problems

Having too much energy and feeling upset

Feeling paranoid

Making attempts to harm yourself or your baby

Postpartum psychosis may lead to life-threatening thoughts or behaviors and requires immediate treatment.

 

Postpartum depression in the other parent

Studies show that new fathers can experience postpartum depression, too. They may feel sad, tired, overwhelmed, anxious, or have changes in their usual eating and sleeping patterns. These are the same symptoms that mothers with postpartum depression experience.

 

Fathers who are young, have a history of depression, experience relationship problems or are struggling financially are most at risk of postpartum depression. Postpartum depression in fathers — sometimes called paternal postpartum depression — can have the same negative effect on partner relationships and child development as postpartum depression in mothers can.

 

If you are a partner of a new mother and are having symptoms of depression or anxiety during your partners pregnancy or after your childs birth, talk to your health care provider. Similar treatments and supports provided to mothers with postpartum depression can help treat postpartum depression in the other parent.

 

When to see a doctor

If you are feeling depressed after your babys birth, you may be reluctant or embarrassed to admit it. But if you experience any symptoms of postpartum baby blues or postpartum depression, call your primary health care provider or your obstetrician or gynecologist and schedule an appointment. If you have symptoms that suggest you may have postpartum psychosis, get help immediately.

 

It is important to call your provider as soon as possible if the symptoms of depression have any of these features:

 

Do not fade after two weeks.

Are getting worse.

Make it hard for you to care for your baby.

Make it hard to complete everyday tasks.

Include thoughts of harming yourself or your baby.

If you have suicidal thoughts

If at any point you have thoughts of harming yourself or your baby, immediately seek help from your partner or loved ones in taking care of your baby. Call 911 or your local emergency assistance number to get help.

 

Causes

There is no single cause of postpartum depression, but genetics, physical changes and emotional issues may play a role.

 

Genetics. Studies show that having a family history of postpartum depression — especially if it was major — increases the risk of experiencing postpartum depression.

Physical changes. After childbirth, a dramatic drop in the hormones estrogen and progesterone in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed.

Emotional issues. When you are sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you have lost control over your life. Any of these issues can contribute to postpartum depression.

Risk factors

Any new mom can experience postpartum depression and it can develop after the birth of any child, not just the first. However, your risk increases if:

 

You have a history of depression, either during pregnancy or at other times.

You have bipolar disorder.

You had postpartum depression after a previous pregnancy.

You have family members who have had depression or other mood disorders.

You have experienced stressful events during the past year, such as pregnancy complications, illness or job loss.

Your baby has health problems or other special needs.

You have twins, triplets or other multiple births.

You have difficulty breastfeeding.

You are having problems in your relationship with your spouse or partner.

You have a weak support system.

You have financial problems.

The pregnancy was unplanned or unwanted.

Complications

Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems.

 

For mothers. Untreated postpartum depression can last for months or longer, sometimes becoming an ongoing depressive disorder. Mothers may stop breastfeeding, have problems bonding with and caring for their infants, and be at increased risk of suicide. Even when treated, postpartum depression increases a woman risk of future episodes of major depression.

For the other parent. Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the babys other parent may also increase. And these other parents may already have an increased risk of depression, whether or not their partner is affected.

For children. Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, crying too much, and delays in language development.

Prevention

If you have a history of depression — especially postpartum depression — tell your health care provider if you are planning on becoming pregnant or as soon as you find out you are pregnant.

 

During pregnancy, your provider can monitor you closely for symptoms of depression. You may complete a depression-screening questionnaire during your pregnancy and after delivery. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants may be recommended — even during pregnancy.

After your baby is born, your provider may recommend an early postpartum checkup to screen for symptoms of postpartum depression. The earlier it is found, the earlier treatment can begin. If you have a history of postpartum depression, your provider may recommend antidepressant treatment or talk therapy immediately after delivery. Most antidepressants are safe to take while breastfeeding.