How to Cope With Postpartum Depression

Welcoming a new baby into your life can be an exciting and special time — but it can be stressful. In fact, most women will experience a bit of the “baby blues” in the first week after childbirth. And at least 1 out of every 10 women will also have a mental health condition called “postpartum depression” (PPD). 

PPD is a type of mood disorder where you feel hopeless, sad, and empty for at least 2 weeks — and often longer. It can make you feel disconnected from your friends, family, and even your baby. And PPD can also make it hard to sleep, eat, and even to take care of yourself. 

Fortunately, PPD is treatable. Therapy and medications can both help. Creating a support network, taking parenting classes, and exercising (if you have the time) can also help. Read on for more about PPD, and things that can help you recover.

What exactly is postpartum depression?

Postpartum depression (PPD) is a type of depression that begins in the months or weeks after a new baby is born. It typically begins within the first 4 weeks after delivery, but it can show up any time within the first year. Symptoms can last for several weeks, months, or longer if it’s not properly treated. Some people can also have a postpartum anxiety disorder, or other mental illness, at the same time. 

People with PPD have some or all of the symptoms of major depression, including feeling sad, hopeless, or empty for 2 weeks or longer. 

You may have PPD if you agree with any of these statements:

• You feel sad most of the time.

• You spend a lot of time crying. 

• You feel less excited to do things you once enjoyed.

• You’ve had a significant increase or decrease in appetite or weight (not related to pregnancy).

• You can’t sleep even when you have the opportunity to do so, or you sleep too much.

• You’re moving around more slowly than usual, or you often feel restless.

• You feel tired most of the time.

• It’s hard to connect with your baby or with friends and family.

• You can’t concentrate or make decisions.

• You feel worthless, guilty, or bad about yourself.

• You’re having thoughts about harming yourself or your baby.

PPD is different from the baby blues, which affects around 3 out of 4 new mothers. During the baby blues, you may have some mild sadness, irritability, and anxiety. But here’s the difference: The baby blues usually go away within 2 weeks of delivery. PPD symptoms linger for a longer time and are also more likely to interfere with your day-to-day activities.  

How to overcome postpartum depression

Having PPD can be hard for both you and your baby. And without treatment, it may take longer for your symptoms to go away. Getting help is one of the best things you can do for yourself and your loved ones — including your new baby.   

When it comes to PPD, treatment isn’t a one-size-fits-all approach. The type of treatment that’s best for you depends on your current symptoms, culture, personal preferences, and past experiences. 

Here’s how to get better if you’re struggling with PPD:

• Talk to a healthcare professional. If you’re having symptoms of PPD, the best first step is to talk to your healthcare provider. They can help figure out if you have PPD. If you do, they can work with you to put together a treatment plan. 

• Try individual or group therapy. If your symptoms are mild or moderate, individual or group therapy is a good place to start. 

• Talk to your provider about medications. If your symptoms are more severe — or if you’ve had depression in the past — you may need medication in addition to therapy.

• Lean on your support network. To be able to look after yourself and get better, you’ll need the help of your friends, neighbors, or loved ones. See below for tips on how to build a support network if this feels overwhelming.  

Let’s take a closer look at these and other ways to treat and cope with postpartum depression.   

Psychotherapy for PPD

Psychotherapy is a mental health treatment where you talk to a therapist individually or in a group setting. It’s a great first-choice treatment for PPD — especially if your symptoms are relatively mild. For many people, therapy works just as well as medication.  

There are many different types of therapy that can treat PPD, including: 

• Interpersonal therapy: This therapy focuses on your relationships, which can improve your depression. 

• Cognitive behavioral therapy (CBT): This therapy helps you understand how your thoughts, feelings, and behaviors affect you. It also teaches you how to defuse negative thoughts and how to cope with stress, anger, and other challenging emotions. 

• Other types of therapy: Many other types of therapy can be helpful for people with PPD. These include psychodynamic psychotherapy, peer counseling, non-directive counseling, and behavioral activation therapy. 

• Group therapy: This is also an effective treatment for PPD. It allows you to connect with other parents, share advice, and learn new ways to cope with this transition. Family or couples therapy can be helpful for people with PPD, too. 

Medications for PPD

If you have mild or moderate PPD, therapy is usually the best place to start. But for many people, medication can also be helpful — either on its own or along with talk therapy. 

So far, there’s only one medication — Zulresso — that’s specifically approved for PPD. But healthcare providers also use many antidepressants “off-label“ for PPD, too. 

Here’s a quick look at the top medications used to treat PPD:

• SSRIs: SSRIs (selective serotonin reuptake inhibitors) are antidepressants that are approved for many different mental health conditions, including anxiety, depression, and more. They mostly work by affecting serotonin, a chemical that may be important for mood. Common examples include sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac). 

• SNRIs: SNRIs (serotonin-norepinephrine reuptake inhibitors) are another type of antidepressant. They mostly work by affecting serotonin and norepinephrine levels. SNRIs that are used to treat PPD include venlafaxine (Effexor) and duloxetine (Cymbalta).   

• Zulresso: This is the only medication that’s FDA approved for PPD. It’s different from other medications for PPD because it’s not a pill. It’s an IV (intravenous) infusion that’s given over 2.5 days. Unlike SSRIs and SNRIs, which take 1 to 2 months to fully take effect, Zulresso works in 3 days or less. 

Social support

When you have postpartum depression, social support can go a long way. Social support means having people in your life who care about you and are there for you — for both the good times and the bad. 

Your social support network might include:

• Friends and family

• Partner or co-parent

• Primary care doctor

• OB/GYN

• Therapist or psychiatrist

• Mental health nurse

• Your baby’s pediatrician

• Postpartum doula

• Lactation consultant 

• Night nurse or night nanny

• People you meet in a peer support group or group therapy

It can be helpful to write down the names and contact information of the people in your support network. That way they’ll be easily accessible. If you need help getting started, Choices in Childbirth has a terrific template you can print and use (there’s one for partners too). 

And if your support network needs a boost, think about reaching out for help from one of these free, confidential resources:

• Postpartum Support International (PSI) Helpline: You can call this free, confidential helpline at 1-800-944-4773. They return calls and texts within 24 hours. They offer basic information, support, and connection to local resources. PSI also has a peer mentor program, online support meetings, and live weekly expert Q&A sessions. Help is also available for partners, families, military families, queer and trans parents, adoptive parents, and more. 

• National Maternal Mental Health Hotline: This free, confidential helpline is for pregnant and new moms. They offer support, information, and referrals to other providers and support groups. It’s available 24/7 in 60 different languages at 1-833-943-5746. 

• National Parent Helpline: This is open to parents of children of all ages, including newborns. Advocates are available Monday through Friday from 10AM to 7PM (PT) to listen, offer support, and help you get connected to local resources. Call 1-855-427-2736.

Parenting education

It can be overwhelming to bring home a new baby, especially if this is your first time being a parent. Parenting classes are a great option. They can teach you about caring for your baby. Learning how to take care of your baby may actually help to prevent and treat postpartum depression. There’s evidence to support this, too. 

In a study of about 50 women with PPD, half of the moms had lessons on how to help their babies sleep better and cry less — rather than just talking to a provider about their symptoms. And it turned out that the moms who had the parenting lessons felt better than the moms who talked to a provider, especially about 6 weeks after giving birth. More research is underway now to learn more about this. 

If you’re interested in finding a class, talk to your healthcare provider. Many clinics and hospitals offer parenting classes for free or for a small fee. There are also great online options for learning at home and connecting with other new parents. 

Exercise

Exercise may be helpful for both preventing and treating PPD — especially when combined with social support, medications, or therapy. A good target is to get 150 minutes or more of “moderate-intensity” physical exercise per week. This amount of exercise is good for your overall health, too — including your heart and lungs. 

But keep in mind: There’s really not enough evidence to say yet whether exercise is a good stand-alone treatment for PPD. If it’s something you enjoy including in your life — go for it! Otherwise, if you have PPD, there’s better evidence to support medications, therapy, and/or more social support as the best places to start. 

If you can fit in time to exercise with a newborn, here are some examples of moderate-intensity exercise: 

• Take a brisk walk.

• Go for a dance.

• Ride a bike on a mostly flat surface.

• Play pickleball or tennis doubles.

• Mow the lawn.

• Deep clean your house.

• Try water aerobics.

A moderate-intensity exercise is one that gets your heart rate up and makes you sweat a bit. It should be easy for you to talk but hard for you to sing a song. You can spread the 150 minutes out over the week or do it all over a couple of days. 

Who needs help for postpartum depression?

For some, postpartum depression may get better on its own. This is especially true if you have mild symptoms and a good support network. 

But if your symptoms are more severe, you need to get professional help. 

You should seek help as soon as possible if you:

• Have thoughts of hurting yourself or your baby

• Have symptoms that seem to be getting worse rather than better

• Are having a hard time taking care of yourself or your baby

• Don’t have a lot of support from the other people in your life

• Are drinking alcohol or using drugs to cope

Remember: Having the baby blues is totally normal in the first 2 weeks after delivery. But if your symptoms persist beyond that point, you may be dealing with PPD or another postpartum mood or anxiety disorder. 

What causes postpartum depression?

Experts don’t know for sure what causes PPD. It seems to be connected to many different factors — including physical health, mental health, and life experiences. 

It’s clear from the research on this topic that the items on this list all play a role in why some people get PPD:  

• Hormone changes: During pregnancy, the body makes high levels of certain hormones, including progesterone and estrogen. In the first couple days after giving birth, these hormone levels drop a lot. This sudden change in hormones may be connected to depression. Some people might also be more sensitive to these changes, which may increase their risk of PPD. 

• Sleep deprivation: Sleep deprivation is common for the first few weeks after delivery and may potentially contribute to PPD.

• Problems during pregnancy: The risk of PPD is also higher if you had a difficult pregnancy or delivery. This might include complications during labor and delivery, like umbilical cord prolapse, hemorrhaging, or an emergency cesarean section (C-section). 

• Problems with your baby’s health: Stress related to your baby’s health may put you at higher risk for PPD. Common stressors include giving birth prematurely, having an infant born with low birth weight, or requiring time in the neonatal intensive care unit (NICU). 

• Mental health conditions: You have a higher risk of PPD if you’ve had depression before — especially if you had it during your pregnancy. People who have bipolar disorder or a substance use disorder may also be more likely to have PPD. 

• Other categories: Some groups of people may also be more likely to have PPD. This includes people who are under the age of 20, have an unplanned pregnancy, or experience money or relationship problems.

Why trust our experts?

Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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