Postpartum Depression After Birth: Signs, Causes and Help

Postpartum depression (PPD) is a common problem in women who have given birth. The CDC says about 1 in 8 women with a recent birth report symptoms of postpartum depression. PPD needs medical care, but it is often hard to spot, so it is often missed. It is a mix of physical, emotional and behavior signs. The good news is that PPD is treatable, and most people get better with treatment.

Causes of PPD and risk factors

The exact cause of PPD is not known, and many things likely play a part. Hormone changes may trigger it. The Office on Women's Health says the female hormones estrogen and progesterone are at their highest during pregnancy. In the first 24 hours after birth, they quickly drop back to normal levels. Researchers think this sudden change may lead to depression. Thyroid hormones may also drop after birth, and low thyroid levels can cause signs of depression.

Other things can raise the risk of PPD:

• Depression during pregnancy: many women show signs of low mood and loss of interest in life while they are pregnant.
• Self esteem: women with low self esteem may be at higher risk.
• Childcare stress: many women feel unready or have strong fears, so they find it hard to care for the baby.
• Anxiety during pregnancy: some women feel very worried while pregnant. Anxiety is not the same as depression. An anxious person worries a lot about the future, while a depressed person feels bad about today.
• Life stress: life is not equal for everyone. Some families have money problems or do not have a good place to live.
• Social support: having little or no support from others is a known risk factor.
• Relationship problems: if a new mother is going through conflict with her partner, she may have a higher risk of PPD.
• History of depression: the American College of Obstetricians and Gynecologists (ACOG) says women who have had depression at any time, before, during or after pregnancy, have a higher risk. A family history of depression also raises the risk.
• A hard birth: a difficult or traumatic birth, or problems with a past pregnancy, can raise the risk.
• Baby's temperament: not all babies are the same. Some newborns are harder to care for. If a baby cries a lot or for no clear reason, it can wear down a mother's emotional health. Read more about why babies cry.
• Unplanned or unwanted pregnancy
• Being very tired: ACOG says tiredness may be a big part of it.

What are the signs

Depression is not the same as the "baby blues," but neither one should be ignored. Many women have short mood changes after birth, like crying for no reason, getting upset easily and having mood swings. The National Institute of Mental Health (NIMH) says the baby blues are mild, short feelings of worry, sadness and tiredness in the first 2 weeks after birth. If the feelings are severe or last longer than 2 weeks, it may be postpartum depression. PPD is much more serious. The mother may feel deep sadness that makes it hard to care for her baby and do daily tasks. Signs can include:

• Feeling sad, anxious or "empty" most of the day, nearly every day
• Losing interest in things you used to enjoy
• Feeling guilty, worthless or hopeless
• Trouble sleeping, even when the baby is asleep
• Eating much more or much less than usual
• Trouble bonding with your baby
• Doubting that you can care for your baby
• Thoughts of harming yourself or your baby

NIMH says women with PPD usually will not feel better without treatment. If you have any of these signs, talk to your doctor.

How to cope with PPD

The first step is to talk to your doctor. Some women who breastfeed worry about taking medicine. The CDC says to tell your doctor if you are breastfeeding, so you can decide together if medicine is right for you. Your doctor can also refer you to a mental health professional. Support from family is also very important. When family members pay attention and help care for the baby, it can ease a new mother's fears. It is just as important that the mother understands what is happening and asks for help. Here are a few tips to help with PPD: 

• Ask for help and support from others
• Exercise, after you talk with your doctor
• Remember that not all days are the same, and hard days will pass
• Spend more time with family and friends
• Sleep or rest when your baby sleeps. Some moms like to play gentle sleep music to soothe a fussy newborn, like our Go To Sleep Lullaby, or other relaxing music for babies.
• Try mindfulness and breathing exercises
• Don't wait to get help from a professional

Where to get help now

You do not have to wait until your next checkup. Call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262). It is free, private and open 24/7, in English and Spanish, with interpreters in more than 60 languages. If you have thoughts of harming yourself or your baby, call or text 988 or call 911 right away.

Questions Parents Ask About Postpartum Depression

How common is postpartum depression?

The CDC says about 1 in 8 women with a recent birth report symptoms of postpartum depression.

What is the difference between baby blues and PPD?

The baby blues are mild and usually go away within about 2 weeks. PPD is stronger, lasts longer than 2 weeks and makes daily life hard. It needs treatment.

When does postpartum depression start?

ACOG says it most often starts about 1 to 3 weeks after birth, but it can happen up to 1 year after having a baby.

Can I take medicine for PPD while breastfeeding?

Talk to your doctor. Tell them you are breastfeeding, and together you can decide if medicine is right for you.

Who can I call for help?

Call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA, any time. In a crisis, call or text 988 or call 911.

This post is for general information only. It is not medical advice. If you have questions about your health, please talk to your doctor.