What Is Postpartum Depression?

What is postpartum depression?
Photo Illustration by Keila Gonzalez
Photo Illustration by Keila Gonzalez

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Postpartum depression is a condition that has gotten more attention over the past few years, especially with celebrities like Kylie Jenner and Julia Fox speaking up about experiencing it. Unfortunately, postpartum depression is fairly common: about one in eight women who give birth in the US have symptoms of the mental health condition, according to the Centers for Disease Control and Prevention (CDC).

Different than the "baby blues," which presents as mood swings, crying spells, anxiety, and difficulty sleeping within the first two to three days after delivery and lasts up to two weeks, postpartum depression is a more severe, long-lasting form of depression.

Postpartum depression can happen up to a year after having a baby but usually starts about one to three weeks after childbirth, making this a condition new parents should at least be aware of.

Understanding Postpartum Depression

Postpartum depression is depression that happens after having a baby, according to the CDC. Postpartum depression causes intense feelings of worry, sadness, anxiety, and fatigue that interfere with a person's ability to go about their life as usual, says Tamar Gur, MD, PhD, a women's health expert and reproductive psychiatrist at the Ohio State University Wexner Medical Center.

"Postpartum depression steals your joy at a time when you need it most," Dr. Gur says. "It feels like a cloud has come to settle in and you have trouble doing things you used to do. You feel really empty, and you find yourself struggling to do anything."

Postpartum depression "is the same as any other clinical depression unrelated to childbirth, but in this case, it occurs within the context of having a baby," says Karen Kleiman, LCSW, director of the Postpartum Stress Center and author of "The Art of Holding in Therapy: An Essential Intervention For Postpartum Depression and Anxiety."

Symptoms largely mirror those of typical depression, like feeling sad, anxious, or empty; experiencing a loss of energy; or not eating the same as usual, but can also include certain signs tied to feelings around the baby, Dr. Gur says. According to the CDC, other symptoms can include:

  • Crying more often than usual
  • Feeling angry
  • Withdrawing from loved ones
  • Feeling numb or disconnected from your baby
  • Worrying that you will hurt your baby
  • Feeling guilty about not being a good parent or doubting your ability to care for your baby

"Postpartum depression is something that can happen to anybody, but it's more likely to happen to women with a history of depression or anxiety," says Catherine Birndorf, MD, founder of The Motherhood Center in New York City and an associate professor of psychiatry at the Weill Cornell Medical College.

Causes of Postpartum Depression

Depression is complex, and postpartum depression is no exception. "There is no single factor that causes postpartum depression," Kleiman says. "It is believed to be an illness that involves complex interactions between a number of variables, biologic, genetic, hormonal, cultural, psychosocial, and psychological. Any one of these variables can make a woman vulnerable to the emergence of depression and anxiety, and that risk will be heightened with each added variable"

That being said, the American College of Obstetricians and Gynecologists (ACOG) says the following factors are likely to influence whether someone develops postpartum depression:

  • Hormonal changes. Levels of estrogen and progesterone decrease sharply in the hours after childbirth, and those changes can trigger depression in some people. "That abrupt shift from high to low can cause a hormonal storm that can cause people to feel low, sensitive, and sad," Dr. Birndorf says.
  • History of depression. Women who have had depression at any time or who are currently being treated for depression have an increased risk of postpartum depression.
  • Emotional factors. Feelings of doubt about pregnancy, having trouble adjusting to the idea of a new baby, or having a baby who is sick can raise the risk. "There is an increase in postpartum depression in moms who have babies in the NICU," Dr. Gur says.
  • Fatigue. Feeling tired after having a baby is common. But it can take weeks for new moms to get back their strength, which can lead to feelings of doubt and depression.
  • Lifestyle factors. Lack of support from others, along with stressful life events, like the death of a loved one, a family illness, or moving to a new city, can increase the risk.

Most Effective Treatments For Postpartum Depression

Treatment usually involves a combination of talk therapy and antidepressants. "Absolutely for severe depression — anytime there's suicidal ideation or it's impacting your quality of life, medication is indicated," Dr. Gur says. "We have a lot that can help."

Antidepressants can be transferred to the baby during breastfeeding, but the levels found in breast milk are generally very low, ACOG says.

Treatment may also include making certain lifestyle tweaks, like avoiding alcohol and highly processed or sugary foods, resting when you can, trying to find some time to exercise or be active, and learning to accept help when it's offered, Kleiman says.

If you suspect you may be struggling with postpartum depression, Dr. Birndorf says it's crucial to speak up. "If you know that something feels off, then something is wrong," she says. "It's important to say, 'I'm not right and I'm not OK.'"

Dr. Gur stresses that help is available for postpartum depression. "There are a lot of good treatments," she says. "Things don't have to be that hard or that bad."