GoodRx Guide
What Is Postpartum Depression?
Comprehensive information for you or a loved one — including treatment options and discounts on popular medications.
Definition
Having a baby is a major life change. If you’ve just given birth, it’s totally normal to feel nervous, tired, or even sad for a few days — sometimes called the “baby blues.” These feelings usually go away within the week.
But for up to 20% of women, these symptoms don’t go away. When this happens, it may be a sign of postpartum depression (PPD). PPD is a mental health condition that causes ongoing sadness, hopelessness, and feelings of emptiness.
PPD can affect:
Your thoughts and actions
Your relationships
Your ability to function in day-to-day life
Your ability to care for yourself, and your baby
It’s important to know that PPD is a real health condition. Having PPD doesn’t mean that you aren’t a good parent, or that you don’t love your baby.
And, fortunately, PPD is treatable with medications and therapy. Getting support from your healthcare providers, friends, and family can help you recover from PPD — and move forward in your journey as a parent.
Causes
Postpartum depression is a common condition. It’s the number one health problem in childbirth, affecting 10% to 20% of all women. It can even affect men and adoptive parents.
We don’t know exactly why people get PPD. It’s possible that it’s somehow related to the emotional, social, and hormonal changes that happen when a new baby arrives.
We do know that some groups of people are more likely to get PPD. You may have a higher risk for postpartum depression if you:
Have a history of depression or bipolar disorder
Have a family member with depression or bipolar disorder
Don’t have a good support network
Have relationship or money problems
Are under age 20
Have a history of alcohol or drug use problems
Have a baby with special needs
Experience problems with pregnancy or breastfeeding
Have an unplanned or unwanted pregnancy
Having depression during pregnancy is the number one risk factor for PPD.
Symptoms
Postpartum depression usually starts in the first month after the baby arrives. It can also begin up to a year after birth. Symptoms last for at least 2 weeks — and often longer.
Common symptoms of postpartum depression are:
Feeling sad, hopeless, or anxious
Irritability
Guilt
Having a hard time feeling connected to your baby
Having a hard time feeling connected to your friends and family
Crying a lot
Feeling tired
Sleeping less or more than usual
Eating less or more than usual
Feeling nervous about your ability to care for your baby
Having trouble thinking clearly
Having thoughts about hurting yourself or your baby
Related Health Conditions
Diagnosis
If you have symptoms of postpartum depression, reach out to your healthcare provider. They can talk with you about your symptoms and make a diagnosis of PPD.
Your provider might also have you fill out a questionnaire called the Edinburgh Postnatal Depression Scale. This questionnaire can help you track your symptoms. You can also take it online and share the results with your doctor.
In some cases, your provider might also order lab tests. These tests can help rule out any physical causes for your symptoms, like hypothyroidism or low iron.
Medications
Postpartum depression is usually treated with therapy (counseling) and/or medication. There’s evidence that therapy and medications are equally effective.
Medications used for PPD include:
Antidepressants: These are the most common medications for PPD. They are daily medications that help your symptoms go away. Antidepressants take several weeks to start working, but many can be used while breastfeeding.
Brexanolone (Zulresso): This is the only medication specifically FDA approved for PPD. It is given as an infusion (IV) over three days and begins working in 48 hours. It is not safe to use while breastfeeding.
Esketamine (Spravato): This medication can be used when other depression treatments haven't helped. It is a nasal spray that works quickly. It is not safe to use while breastfeeding
Treatments
Therapy is the best nonmedication treatment for postpartum depression. Therapy can help you understand your thoughts, feelings, and behaviors. It can also teach you new skills and coping strategies. There’s evidence that therapy works just as well as medications in treating PPD.
Electroconvulsive therapy (ECT) is also used to treat postpartum depression. ECT is a medical procedure where your brain is stimulated with electricity. It can be used when therapy and medications haven’t worked.
Living
If you have postpartum depression, remember: It’s not your fault. PPD is a mental health condition that has nothing to do with your ability to be a good parent.
Just like any other health condition, you deserve extra care and support while you are recovering. You may find it’s helpful to:
Talk with friends and family about your experience
Join a postpartum support group
Get help taking care of the baby
Sleep or rest as much as possible
Exercise (if you are able to)
Let go of nonurgent responsibilities
Be kind to yourself
It’s also important to have a safety plan, in case you have thoughts of hurting yourself or your baby:
Choose a partner, friend, or family member to be your emergency contact
Have the contact information for your healthcare provider close at hand
Know the National Suicide Prevention Lifeline phone number: 1-800-273-8255
Text “HOME” to 741741 to connect with a live Crisis Text Line counselor
Call 911 or go to the nearest emergency room in a life-threatening situation
Common concerns
There are different words used for the time period before, during, and after childbirth:
Perinatal: This is the whole time period before, during, and after childbirth. It starts when you get pregnant and ends a year after giving birth.
Prenatal: This is the time period before birth. It starts when you get pregnant and ends when you give birth.
Postpartum: This is the time period after birth. It starts when you give birth and ends a year later.
It’s not clear. Many people with PPD get better in 3 to 6 months. But there’s evidence that some people can continue having symptoms for months or years — especially in people who have more severe symptoms. Early diagnosis and treatment may help you recover more quickly.
Yes. It is possible to get depression while pregnant. This is sometimes called perinatal or prenatal depression. People who have depression while pregnant have a high risk for postpartum depression.
Postpartum psychosis (PPP) is a rare condition that usually occurs in the first month after childbirth. People with PPP have an altered experience of reality, to the point where it interferes with their ability to function.
Symptoms include:
Paranoia
Dramatic mood changes
Hallucinations
Delusions
Suicidal and/or homicidal thoughts
PPP is a medical emergency. If you or a loved one are experiencing any of these symptoms, you should see a doctor immediately.
Yes. This is why it is important to talk to your doctor if you’re having symptoms.
Untreated postpartum depression can put your child at risk for:
Language and learning problems
Problems bonding
Behavior problems
Shorter height
Obesity
Problems dealing with stressful life situations
References
American College of Obstetricians and Gynecologists. (2018). Screening for perinatal depression.
Centers for Disease Control and Prevention. (2020). Depression among women.
Crisis Text Line. (n.d.). Crisis text line.
Earls, M. F., et al. (2019). Incorporating recognition and management of perinatal depression into pediatric practice. Pediatrics.
Fitelson, E., et al. (2011). Treatment of postpartum depression: Clinical, psychological, and pharmacological options. International Journal of Women’s Health.
Heger, E. (2018). When postpartum depression doesn’t go away. The Atlantic.
Markova, V., et al. (2015). Treatment for women with iron deficiency anaemia after childbirth. Cochrane.
Mott, S. L., et al. (2011). Depression and anxiety among postpartum and adoptive mothers. Archives of Women’s Mental Health.
National Health Service. (n.d.). What does perinatal mean?
National Suicide Prevention Lifeline. (n.d.). National suicide prevention lifeline.
Office on Women’s Health. (2019). Postpartum depression.
Postpartum Health Alliance. (n.d.). Screening test.
Postpartum Support International. (n.d.). PSI online support meetings.
Putnick, D. L., et al. (2020). Trajectories of maternal postpartum depressive symptoms. Pediatrics.
Sharma, V., et al. (2012). Postpartum depression: Diagnostic and treatment issues. Journal of Obstetrics and Gynaecology Canada.
Werner, E., et al. (2015). Preventing postpartum depression: Review and recommendations. Archives of Women’s Mental Health.
