Postpartum Depression

Written by Debra Fulghum Bruce, PhD
Medically Reviewed by Shruthi N, MD on June 08, 2025
9 min read

Postpartum depression (PPD) is a complex mix of physical, emotional, and behavioral changes that happen after you give birth. It's a form of major depression that begins within a year after childbirth – most often within the first three months. The diagnosis is based not only on when it happens but how serious your depression is.

Postpartum depression is linked to hormonal, social, and psychological changes that happen when you have a baby and care for a newborn. PPD can be treated with medication and counseling.

It's common to have a mild case of the "baby blues" after giving birth, but this usually goes away within a few weeks. About 1 out of every 10 people will develop a more serious and longer-lasting depression after delivering a baby. 

Your doctor may refer to postpartum depression by the umbrella term "perinatal depression." This includes depression that happens during pregnancy or after childbirth. 

Can men get postpartum depression?

No parent is immune, whatever their gender. Research has shown that about 1 in 10 new fathers get depression during the year their child is born. Their symptoms may include sadness, anxiety, or tiredness. They may feel overwhelmed or notice changes in sleep and eating habits.

Can non-birthing parents have postpartum depression?

Adoptive parents, surrogates, and parents of surrogate-born babies can all develop PPD. In the case of adoptive parents and parents of children born via surrogacy, emotional and mental stresses are the likely causes. Both hormonal and emotional factors may be in play for surrogates.

Symptoms of postpartum depression aren't always easy to detect. It's common to have these symptoms after childbirth:

  • Trouble sleeping
  • Appetite changes 
  • Serious fatigue 
  • Lower sex drive 
  • Frequent mood changes 

With PPD, these come along with other symptoms of major depression, which aren’t typical after childbirth. They may include: 

  • Being uninterested in your baby or feeling like you’re not bonding with them
  • Crying all the time, often for no reason
  • Depressed mood 
  • Intense anger and crankiness
  • Loss of pleasure 
  • Feelings of worthlessness, hopelessness, and helplessness 
  • Thoughts of death or suicide 
  • Thoughts of hurting someone else
  • Trouble concentrating or making decisions

Untreated postpartum depression can be dangerous for new parents and their children. Seek professional help when:

  • Symptoms persist beyond two weeks.
  • You can’t function normally.
  • You can't cope with everyday situations.
  • You have thoughts of harming yourself or your baby.
  • You're feeling extremely anxious, scared, and panicked most of the day.

Postpartum depression and anxiety

Many new parents have signs of depression along with anxiety symptoms like fearfulness, a fast heartbeat, or sleep problems. You might constantly worry about your baby, feel tense, and be unable to relax.

You can also have postpartum anxiety without being depressed. The causes and treatments for postpartum anxiety are similar to those for PPD. 

Some people even develop postpartum panic disorder, which causes repeated panic attacks. During a panic attack, you might feel you're losing control, going crazy, or even dying.

Postpartum depression and OCD

Symptoms of obsessive compulsive disorder (OCD) that are new rarely happen in the postpartum period (in about 1%-3% of cases). The obsessions are usually related to concerns about the baby's health or irrational fears of harming the baby. You might also have panic disorder. You can have these conditions and depression at the same time.

There’s no one cause of postpartum depression, but physical, social, and psychological changes may contribute.

Hormonal changes

Levels of estrogen and progesterone, the female reproductive hormones, increase tenfold during pregnancy. Then, they drop sharply after delivery. By three days after you give birth, the levels of these hormones drop back to what they were before pregnancy.

Other hormones produced by your thyroid gland also may drop sharply when you give birth, making you feel tired, sluggish and depressed.

Research has shown that these rapid chemical changes can strongly affect your moods. 

Lack of sleep

When you're sleep-deprived and overwhelmed due to the demands of caring for a baby, you may have trouble handling even minor problems. 

Anxiety

You may worry about your ability to care for and/or financially support a newborn, or about changes to your work and social life. You may also be concerned about the effect a new baby will have on your relationship or your other children. 

Self-image

You may feel less attractive, struggle with your sense of identity, or feel that you've lost control over your life. Any of these issues can contribute to postpartum depression.

If you have PPD, it’s not because you did anything wrong. Experts think it happens for many reasons, and those can be different for different people.

Some things that can raise the chances of postpartum depression include:

Your health and heredity

Risk factors for PPD include:

  • A history of anxiety, bipolar disorder, or depression (including previous postpartum depression)
  • Age at the time of pregnancy (The younger you are, the higher the chances.)
  • A family history of mood disorders
  • A history of premenstrual dysphoric disorder (PMDD)
  • Drinking alcohol, smoking, or using illegal substances

Your baby's situation

You're more likely to have PPD when you have:

  • A child with special needs or health problems
  • Twins or triplets

Life circumstances

These situations can raise your risk of PPD:

  • Ambivalence about the pregnancy
  • Children (the more you have, the more likely you are to be depressed in a later pregnancy)
  • Going through an extremely stressfulevent, like a job loss or health crisis
  • Limited social support
  • Living alone
  • Marital or relationship conflict

After giving birth, you can have a few different mood disorders that may include depressive symptoms. Here's how to tell the difference between them:

The 'baby blues' 

Thistemporary conditionaffects as many as 70% of those who've just had a baby. You may have sudden mood swings, such as feeling very happy and then feeling very sad. You may cry for no reason and can feel impatient, cranky, restless, anxious, and lonely. The baby blues may last only a few hours or as long as two weeks after delivery. Usually, you don’t need treatment for baby blues. Often, joining a support group of new parents or talking with other parents helps.

Postpartum depression (PPD)

This can start during pregnancy or afterward. It can happen after the birth of any child, not just your first one. You have feelings similar to the baby blues – sadness, despair, anxiety, crankiness – but you feel them much more strongly. PPD often keeps you from doing the things you need to do every day.

When your ability to function is affected, you need to see a health care provider, such as your obstetrician/gynecologist (OB/GYN) or primary care doctor. This doctor can screen you for depression symptoms and come up with a treatment plan. If you don’t get treatment for PPD, symptoms can get worse. While PPD is a serious condition, it can be treated with medication and counseling.

Postpartum psychosis

This serious mental illness affects about 1 in 1,000 people who've recently given birth. This illness can happen quickly, often within the first three months after childbirth. You may lose touch with reality and have auditory hallucinations (hearing things that aren't real, like a person talking) and delusions (strongly believing things that are irrational). Visual hallucinations (seeing things that aren't there) are less common. Other symptoms include:

  • Insomnia (not being able to sleep)
  • Feeling agitated and angry
  • Pacing and restlessness
  • Strange feelings and behaviors.

 If you have postpartum psychosis, youneed treatment right away and you almost always need medication. Some people with this condition need to be hospitalized because they're at risk of hurting themselves or someone else.

PPD is treated differently depending on the type of symptoms you have and how serious they are. Your treatment may include drugs, psychotherapy, or a combination of both.

Postpartum depression medication

 Your doctor or a mental health provider can prescribe an antidepressant such as:

  • Bupropion (Wellbutrin)
  • A selective serotonin reuptake inhibitor (SSRI)
  • A serotonin and norepinephrine reupdate inhibitor (SNRI)
  • A tricyclic antidepressant (TCA)

You might take an anti-anxiety medication if you also have anxiety symptoms. Those with postpartum psychosis may get anti-psychotic drugs.

If you're nursing, your doctor will work with you to find the safest option for you and your baby. 

The FDA has also approved the drug brexanolone (Zulresso) specifically to treat postpartum depression. This fast-acting intravenous (IV) medication works by stopping levels of hormones linked to PPD from dropping so quickly after childbirth. But due to the risk of side effects, you need to stay in a hospital while you get it. 

Therapy for postpartum depression

Talk therapies such as cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) can help you learn to cope with your emotions in healthy ways. Some people also benefit from relationship or family therapy. Your doctor can refer you to a mental health specialist for these treatments.

While they can't take the place of treatment, support groups for people with postpartum depression may help you feel better, too. It's also important to have social support from family members and friends.

How long postpartum depression last varies from person to person.

Some people recover within a few weeks. But untreated PPD could last for months or even years. In one study involving more than 4,500 women, 5% of them said they still had major symptoms three years after giving birth.

 

Postpartum depression that goes untreated can make you less able to bond with your baby and affect the whole family:

You. Postpartum depression that’s not treated can turn into a chronic depressive disorder. Even with treatment, postpartum depression can make you more likely to have episodes of depression in the future. 

PPD might keep you from taking good care of yourself or your baby. You might even think about harming yourself or your child. 

The other parent. PPD can interfere with your relationship with your partner. And when you have depression, your partner may be more likely to have it, too. 

Children. PPD can disrupt the process of bonding with your baby and keep you from providing the best care for your other children. Children of those with postpartum depression are more likely to have problems with sleeping and eating, crying more than usual, behavior issues, and delays in language development.

If you have a history of depression, or if a close relative has had postpartum depression, tell your doctor as soon as you find out you’re pregnant, or when you’re planning to become pregnant.

During pregnancy. Your doctor can monitor you for symptoms. You can manage mild depression symptoms with support groups, counseling, or other therapies. Your doctor may prescribe medications even while you’re pregnant.

Do your best to protect your mental and physical health while you're expecting. Make sure you have a support system in place. Other new or soon-to-be parents can be especially helpful. 

After your baby is born. Your doctor may recommend an early postpartum checkup to look for symptoms of depression. The earlier you’re diagnosed, the earlier you can begin treatment. If you have a history of postpartum depression, your doctor may recommend treatment as soon as you have the baby.

Managing after childbirth

Here are some tips that can help you cope with bringing home a newborn:

  • Ask for help. Let others know specifically how they can help you.
  • Be realistic about your expectations for yourself and baby.
  • Exercise within the limits of any restrictions your doctor may place on your activity; take a walk, and get out of the house for a break.
  • Expect some good days and some bad days.
  • Follow a sensible diet; avoid alcohol and caffeine.
  • Foster the relationship with your partner. Make time for each other.
  • Keep in touch with family and friends, and don’t isolate yourself.
  • Limit visitors when you first go home.
  • Screen phone calls.
  • Sleep or rest when your baby sleeps.

Postpartum depression (PPD) is a serious type of depression you get after giving birth. It lasts longer and is more serious than the normal "baby blues." Symptoms may include lasting sadness, trouble sleeping, feeling hopeless, or having trouble bonding with your baby. PPD can be treated with therapy and/or medication. Getting help early on is important to protect both your health and your baby’s.

When does postpartum depression start?

You can get postpartum depression any time after giving birth, but it often begins one to three weeks after the baby is born. You can also become depressed during pregnancy. Perinatal depression is a term that describes depression that you get during pregnancy or up to a year after giving birth. 

How common is postpartum depression?

Postpartum depression affects up to 12.5% of those who've just given birth. It's the most common complication that happens to people who've recently had babies. 

Can you have postpartum depression after a miscarriage​?

You can have PPD after a miscarriage or stillbirth. Hormonal changes can contribute to it, along with grief and distress over the loss of your pregnancy.

Can you get postpartum depression while pregnant?

Depression during pregnancy or shortly afterward is called perinatal depression. About 1 in 10 people have depression while they're pregnant. The term "postpartum depression" refers to depression that starts after childbirth.