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Labor & postpartum Call your provider

Postpartum depression

Also known as PPD, Perinatal depression, Postnatal depression. During pregnancy or within the first year after birth.

Postpartum depression is a common, treatable medical condition, not a character flaw, not weakness, and not a sign that you do not love your baby. It runs deeper than the short-lived baby blues: a longer-lasting low mood that interferes with daily life and bonding, and it can begin during pregnancy or any time in the first year after birth. About 1 in 8 new mothers experience it. If you are having thoughts of harming yourself or your baby, this is urgent: call or text 988 now. For everything short of that, reaching out is the first step, and it works.

Know the warning signs When to call a provider
How common
About 1 in 8 new mothers
Roughly 10% to 15%; the baby blues are even more common and milder.
When
Pregnancy to 12 months after
It can start before birth, which is why it is called perinatal.
Urgency
Call your provider
Thoughts of harming yourself or the baby are a 988 or 911 emergency.
Outlook
Very treatable
Therapy, medication, and support help most people recover.

Understanding it

What is postpartum depression?

Postpartum depression is depression in the perinatal period, during pregnancy or the year after birth. It affects about 1 in 8 new mothers, with the broader perinatal figure often given as 1 in 7. It is one of the most common complications of childbirth, and a medical condition, not a personal failing.

It helps to separate three experiences. The baby blues are very common, affecting up to three in four new parents, and mild: tearfulness, mood swings, and feeling overwhelmed in the first days, easing on their own within about two weeks. Postpartum depression runs deeper and lasts longer, interfering with your ability to function and to bond. And postpartum psychosis is rare but a true emergency, with confusion, hallucinations, or delusions, needing immediate care.

The causes are not fully understood, but they are physical as much as anything: the steep drop in hormones after delivery, genetics, exhaustion and sleep loss, and the enormous adjustment to a newborn. A personal or family history of depression or anxiety raises the risk. None of this is something you brought on yourself.

Above all, it is very treatable. Talk therapy, medication, and support, often together, help the great majority recover, and there are now medications developed specifically for it. Getting help is not weakness; it is one of the strongest, most caring things you can do.

Symptoms

What are the symptoms?

Postpartum depression is more than the baby blues: deeper, lasting longer than two weeks, and interfering with daily life and bonding. Know the difference, and know the emergency signs that call for immediate help.

Early signs

  • Persistent sadness, emptiness, or hopelessness, or severe mood swings
  • Loss of interest or pleasure in things you used to enjoy
  • Crying often, or feeling overwhelmed and unable to cope
  • Anxiety, or intrusive worries about the baby
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Sleeping or eating far more or less than the newborn schedule explains
  • Feelings of worthlessness, guilt, or being a bad parent
  • Trouble thinking, concentrating, or making decisions

Emergency signs — call 911

  • Thoughts of harming yourself or your baby: call or text 988 (Suicide and Crisis Lifeline) or 911 now
  • Any thoughts of suicide
  • Hallucinations (seeing or hearing things that are not there), delusions, or paranoia
  • Extreme confusion or feeling out of touch with reality
  • Not sleeping for days, with agitation or racing thoughts, which can signal postpartum psychosis

Why it matters

Risks to you and baby

Your wellbeing

Untreated, it can persist and deepen, and in severe cases carries a risk of suicide. That is why it deserves the same seriousness as any other medical condition, and why help matters.

Bonding and your baby

Depression can make it harder to bond, and, if untreated, it can affect a baby's development. This is a reason to get treatment, never a reason for shame. Treating it helps both of you.

It affects partners too

Fathers and partners can also become depressed after a baby arrives. If your partner seems to be struggling, they deserve support and screening too.

Recovery is the norm

With treatment, most people recover fully. Reaching out early tends to shorten how long you suffer and helps your whole family.

How it's found

How is it diagnosed?

Postpartum depression is diagnosed by talking with a provider, often prompted by a short screening questionnaire. Screening is recommended during pregnancy and after birth.

Screening questionnaires

Brief, validated tools like the Edinburgh Postnatal Depression Scale (EPDS) or the PHQ-9 flag symptoms and are used at prenatal and postpartum visits.

Clinical evaluation

A conversation about your mood, sleep, appetite, thoughts, and how you are functioning confirms the diagnosis when symptoms last more than two weeks and affect daily life.

Ruling out other causes

Sometimes thyroid problems or anemia after birth can mimic or worsen low mood, so these may be checked.

Screening is recommended at least once during pregnancy and again after birth, and any time you or those around you notice symptoms. You can raise it yourself at any visit.

Treatment

How is it managed?

It is very treatable. The main tools are talk therapy, medication, and support, often together, and they help the large majority recover.

Treatment paths

Psychotherapy, particularly cognitive behavioral therapy (CBT) or interpersonal therapy (IPT), is effective and often the first step for milder symptoms. Antidepressants, usually SSRIs, are common and can be taken while breastfeeding. Practical support, protecting sleep where possible, and connecting with others going through it all help.

Medication

SSRIs such as sertraline or escitalopram are common first choices, and sertraline is often preferred while breastfeeding because little passes into milk. Two medications are FDA-approved specifically for postpartum depression: brexanolone, an infusion given in a facility, and zuranolone, an oral pill taken once daily for 14 days, approved in 2023.

Monitoring

Your symptoms and response to treatment are followed, and the plan is adjusted, since it can take a few weeks to feel the full benefit of medication.

Can it recur?

It can recur in a future pregnancy, and a prior episode is the strongest risk factor, so a plan for early screening and support helps. After postpartum psychosis, the risk of a psychiatric episode with a future birth is high (around 30% to 50%), so planning with a specialist ahead of time is important.

What you can do

Can it be prevented?

  • Counseling if you are at higher risk

    For people at increased risk, such as a history of depression, structured counseling (CBT or IPT) during and after pregnancy can help prevent perinatal depression.

  • Continue effective treatment

    If you have depression or had postpartum depression before, staying on or planning treatment for a new pregnancy, with your provider's guidance, lowers the risk of relapse.

  • Build support and get screened early

    Lining up practical and emotional support, protecting sleep where you can, and being screened during and after pregnancy all help catch symptoms sooner.

Who is more at risk

Risk factors

A history of depression or anxiety
The single strongest risk factor, including depression during pregnancy or a prior postpartum depression.
Bipolar disorder
A history of bipolar disorder raises the risk, particularly of postpartum psychosis, and is important to share with your team.
Premenstrual mood symptoms and family history
Severe PMS or PMDD and a family history of mood disorders both increase risk.
Stress and lack of support
Stressful life events, relationship difficulties, financial strain, and a limited support system all add to the risk.
Pregnancy and birth factors
Pregnancy or birth complications, a baby with health problems, multiples, and an unplanned or teen pregnancy can each contribute.

Do not wait

When to call your provider or 911

  • Call or text 988 (the Suicide and Crisis Lifeline) or 911 immediately if you have thoughts of harming yourself or your baby, thoughts of suicide, or if you are seeing or hearing things that are not there.
  • Seek urgent care for severe confusion, paranoia, or not sleeping for days with agitation, which can signal postpartum psychosis.
  • Call your provider if low mood, anxiety, hopelessness, or difficulty bonding last more than two weeks or interfere with daily life.
  • Reach out if you feel disconnected from your baby, or simply not like yourself, even if you cannot name why.
  • For non-crisis support, you can also contact Postpartum Support International at 1-800-944-4773 (call or text), or ask your provider for a referral.

Talking to your team

Questions to ask your provider

  • Could what I am feeling be postpartum depression rather than the baby blues?
  • What treatment do you recommend for me: therapy, medication, or both?
  • If I am breastfeeding, which medications are safe?
  • Are the newer medications made for postpartum depression an option for me?
  • How long until I should start to feel better, and what if I do not?
  • Given my history, what can we do to prevent this in a future pregnancy?
  • Can you connect me with a therapist or a support group?

Keep reading

More on postpartum depression

All pregnancy guides articles

Good to Know

Postpartum depression FAQs

Common questions about postpartum depression, answered.

Is this just the baby blues?

The baby blues are common and mild: tearfulness, mood swings, and feeling overwhelmed in the first days, easing on their own within about two weeks. If your low mood is deeper, lasts longer than two weeks, or interferes with daily life and bonding, it is more likely postpartum depression, which deserves treatment.

Does having postpartum depression mean I am a bad mother or that I do not love my baby?

No, absolutely not. It is a medical condition caused by biological and life factors, not a reflection of your love or character. Many devoted parents experience it. Getting help is a sign of strength, not the opposite.

When is it an emergency?

If you have thoughts of harming yourself or your baby, thoughts of suicide, or you are seeing or hearing things that are not there, get help immediately: call or text 988, or call 911. Severe confusion, paranoia, or going days without sleep can signal postpartum psychosis, a medical emergency.

Can I take antidepressants while breastfeeding?

Yes, many antidepressants are considered compatible with breastfeeding. SSRIs like sertraline are often preferred because very little passes into milk. Your provider can help you weigh the options, and treating your depression benefits your baby too.

What treatments actually work?

Talk therapy (especially CBT or interpersonal therapy), antidepressants, and support all help, often combined. There are also two medications made specifically for postpartum depression, including an oral pill taken for 14 days. Most people improve with treatment.

Can it start before the baby is born?

Yes. Depression can begin during pregnancy, which is why the broader term is perinatal depression. If you feel this way while pregnant, do not wait until after birth to bring it up; it can be treated then.

Can my partner get postpartum depression?

Yes. Partners, including fathers, can become depressed after a baby arrives. It is real, it matters, and it is treatable. If your partner seems to be struggling, encourage them to be screened and supported too.

Will it happen again if I have another baby?

It can, and a prior episode is the biggest risk factor, but knowing that lets you plan. Early screening, continuing treatment, and lining up support all lower the risk. After postpartum psychosis, planning with a specialist before a future birth is especially important.

Where can I get help right now?

For a crisis, call or text 988, the Suicide and Crisis Lifeline, or call 911. For information, resources, and support groups, Postpartum Support International offers a helpline at 1-800-944-4773 (call or text). And your own OB or primary care provider can start treatment and referrals.

Medically Reviewed · Updated

Reviewed by Dr. Grace Lin, MD, FACOG · OB-GYN

Obstetrician-gynecologist focused on reproductive and sexual health for women: pregnancy, BV, yeast, trichomoniasis and HPV/cervical screening. Our editorial guidelines →

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