The transformation into parenthood brings both positive and negative emotions. Whether it is your first child or you are a parent to multiples, this is a huge adjustment and transition of identity and expectations. Pregnancy and postpartum results in a wide range of physical, mental, and emotional changes for families that can last months after a baby is born.
It is reported that 1 in 5 women experience postpartum depression. As noted on Postpartum Depression, “With approximately 4 million live births occurring annually in the United States, this equates to almost 600,000 postpartum diagnoses.”
It is safe to assume that this number is likely higher due to stigmatization, underreporting, and poor screening. While the hormonal changes and adjustment period are to be expected, postpartum depression widely impacts many women and birthing individuals around the globe.
Evidence shows that postpartum depression also impacts non-birthing individuals. It is reported 1 in 10 dads experience postpartum depression and research reflects that those family building through adoption and surrogacy can also experience postpartum depression.
What Is Baby Blues?
It is estimated that 85% of childbearing individuals experience “baby blues.” Baby blues is often described as a range of emotions such as sadness and weepiness, irritability, anxiety, fatigue, and sleep difficulties.
Baby blues typically begins by day 2-3 and subsides after a few weeks. If symptoms persist or get worse, then postpartum depression may be present.
A rollercoaster of emotions, fatigue, and sleep challenges is normal during the early days, weeks, and months postpartum. Add in other siblings to care for, work, and household tasks, and it is easy to understand how feelings of sadness, irritability, or anxiety can find their way into the day. However, symptoms of postpartum depression present with a higher intensity, duration, frequency, and severity, which impact different areas of functioning.
What Is Postpartum Depression?
Postpartum depression, also referred to as peripartum or postnatal depression, is described as a medical condition that involves a major depressive episode during pregnancy or after delivery.
Perinatal depression or prenatal/antenatal is often associated with depression during pregnancy, and postpartum depression refers to depression experienced after childbirth.
It is estimated that 27% of women enter pregnancy with anxiety or depression, 33% develop symptoms during pregnancy, and 40% develop symptoms following childbirth.
Research also shows that about 29–44% of Black women experience postpartum depressive symptoms, with women of color receiving less treatment.
About 75% of women who present with maternal mental health conditions go untreated.
Signs And Symptoms Of Postpartum Depression
Symptoms of postpartum depression are varied. Here are some of the most common symptoms to watch out for in yourself and your partner.
- Feelings of extreme or persistent sadness, depressed mood, and hopelessness
- Feelings of anger or irritability
- Lack of interest in pleasure in things once enjoyed, or lack of interest in the baby
- Appetite and sleep disturbance
- Fatigue and little energy
- Crying and sadness
- Mood swings
- Difficulty concentrating
- Feelings of guilt
- Shame or hopelessness
- Thoughts of suicide or self-injury or possible thoughts of harming the baby or others.
It is important to note that thoughts do not equate to causation. The severity can vary from person to person, however, the presence of suicidal, self-injury or homicidal thoughts should always be taken seriously. A trained doctor, therapist, psychiatrist, or healthcare professional should conduct a thorough, proper screening.
Sometimes, emergency crisis services are necessary. Suicidal thoughts do not automatically mean one may act on the thoughts, but they pose a greater risk and should be monitored closely by a trained professional. When thoughts are accompanied by a plan of action, intent, and means to cause harm, these are medical emergencies. Contact 911 and find your nearest emergency room or crisis center.
Postpartum depression can present in many different ways. Postpartum depression is often portrayed as someone who is bound to the couch or bed, unable to leave the house, and ignoring their basic hygiene and self-care. While postpartum depression can present this way, it is essential to note that postpartum depression can look different from person to person.
It is important not to gloss over the new mom or parent who appears to “have it all together.” Many parents appear happy, bubbly, involved, and functioning but who secretly struggle with postpartum depression symptoms.
Risk Factors Of Postpartum Depression
While this list is not all-encompassing, the causes and risks of postpartum depression typically include a mixture of biological, psychological, and social factors.
Research reflects that those who have a history of depression or anxiety are at an increased risk of depression during or after pregnancy.
Additional risk factors and adverse events that may influence the onset of postpartum depression include:
- Those with a family history of depression or other psychiatric disorders
- Experiencing particularly stressful life events
- Lack of support
- Rapid changes in sex and stress hormones, and thyroid hormone levels during pregnancy and after delivery
- Having a child in the NICU, medical complications for the mother and/or child, birth trauma, or traumatic stress during delivery
- Gestational Diabetes
- History of trauma, abuse, or domestic violence
- Poverty
- Difficulty with adjustment to parenthood
- Poor sleep and nutrition
- Financial and work strains
- Pregnancy or child loss loss, and infertility difficulties
- Unplanned pregnancy
- Alcohol and substance use
- Difficulty breastfeeding
Support And Self-Care For Postpartum Depression
Adequate sleep, rest, and nutrition are imperative, along with basic hygiene needs. If approved by your doctor, finding time for light movement, such as a walk or just being outside, can help you get some fresh air and positively impact your mood.
Having strong support is critical during postpartum adjustment. While there is a high focus on the new baby, it is vital to not forget that mom needs to be taken care of. Recruiting family, friends, or other perinatal professionals, such as a postpartum doula, to step in and help can help reduce some of the mental load new parents experience.
Across racially/ethnically diverse populations, social support is protective against perinatal depression, and more significant social support is associated with less severe perinatal depression symptoms.
Talking with a trusted friend and finding time for socialization is also important. The early days of postpartum can prove to be isolating and a whirlwind of emotions. If meeting with a friend is too daunting, start small with a brief phone call.
Working up to joining a postpartum support group can also be highly beneficial. Many local hospitals, birthing centers, churches, and libraries offer free groups for a safe space to connect with other parents. Building your support circle with other parents can have many benefits, whether you are a new or seasoned parent.
Finding The Right Help For Postpartum Depression
If you or someone you know is experiencing postpartum depression, be sure to discuss it with your healthcare provider or encourage your loved one to seek assistance. Share your concerns and your observations with your doctor and request referrals and resources you can turn to for help.
While postpartum depression affects many new and seasoned parents, it is important to note that help is available. Postpartum depression is not your fault, and with treatment and support, symptoms can subside.
Even if postpartum depression symptoms are generally mild, reaching out for support during such a vulnerable time of transition can be very helpful. Finding a trusted and trained counselor or therapist can serve as a positive sounding board.
Other providers who specialize in maternal health, such as postpartum doulas, acupuncturists, or chiropractors, can also be helpful sources of support.
Medication management may be necessary. Sometimes, this can be temporary or more long-term. Be sure to talk with your doctor and be honest about your symptoms and concerns to create an individualized care plan.
Request referral information from your primary care provider or search for local support in your area to narrow down healthcare professionals. If you are using insurance, you can search for care providers from your member portal. Psychology Today or the therapist directory from Postpartum Depression or Postpartum Support International can help you find a therapist and psychiatrist trained in maternal mental health in your area. There are also a variety of maternal mental health platforms available, such as Seven Starling, Maven Clinic, or Pomelo Care.
Postpartum Support International also offers a variety of free virtual support services, a peer mentorship program, and a helpline in English and Spanish. The helpline is available 8 a.m.- 11 p.m. EST by calling or texting 1-800-944-4773. Press #1 for Spanish and #2 for English.
The National Maternal Mental Health Hotline can also be a place for support. Call or text 1-833-TLC-MAMA (1-833-852-6262). This free, 24/7, confidential hotline for pregnant and new moms is available in English and Spanish.
If in crisis or experiencing active thoughts of self-harm or harm to others, stop, contact 911, or have someone transport you to the closest emergency room.
Call or text 988 to be connected to The Suicide and Crisis Lifeline.
While postpartum depression can have a ripple effect on physical, mental, and emotional well-being, it is something that many people experience. You are not alone, and there is no shame in asking for help. The saying “it takes a village” is there for a reason, and we are not meant to do this parenthood thing alone.
The information provided is for educational purposes only. It should not be a replacement for medical care or advice. This info is not intended to diagnose or replace mental health or medical treatment. Consult with your doctor if you have any questions about your health or are experiencing any medical or mental health emergencies. If experiencing an emergency, contact 911 or have someone transport you to your nearest emergency room.