What is Postpartum Depression?

“Postpartum” refers to the period after giving birth, which typically includes a year after childbirth. Postpartum depression is common — about 1 in 8 women report symptoms of postpartum depression like sadness, anxiousness, or feeling overwhelmed. 

The feelings can occur at any time. If they last longer than two weeks, you may have postpartum depression. Sometimes these feelings begin while you are pregnant, which is often described as perinatal depression. Perinatal depression includes the period during pregnancy and up to 1 year postpartum.

What are the Signs and Symptoms of Perinatal and/or Postpartum Depression?

Everyone experiences perinatal and/or postpartum depression differently, but here are common signs and symptoms:

• Feeling angry or moody
• Feeling sad or hopeless
• Feeling worthless, guilty, or shameful
• Sleeping more or less than usual
• Eating more or less than usual
• “Crying spells,” meaning crying more than usual
• Isolating from friends, family, or others
• Loss of pleasure, joy, or interest in things you once enjoyed
• Feeling like you are not connected to your baby or that you can't care for your baby
• Thoughts of wanting to harm yourself or the baby, or thoughts of suicide

What are the Risk Factors for Perinatal and/or Postpartum Depression?

You may be more likely to develop perinatal and/or postpartum depression if you:

• Have a family history of depression
• Experienced depression before becoming pregnant
• Experienced perinatal depression during a prior pregnancy
• Didn't stay on your antidepressant medication during pregnancy or after birth
• Experienced abuse during childhood or experienced intimate partner violence
• Have a history of pregnancy loss or infertility
• Experienced complications during pregnancy or delivery, including traumatic birth experiences
• Experienced difficulties with breastfeeding, or feeding the baby
• Experienced difficulties with sleeping or insomnia
• Have limited support from family, friends, or your partner
• Have stress related to relationship difficulties, financial difficulties, or other stressors
• Have a baby born prematurely and/or with special health care needs

What are the Signs and Symptoms of Postpartum Anxiety?

Common signs and symptoms of postpartum anxiety include:

• “Racing thoughts” meaning having many or rapid thoughts in your head 
• Sleep disruption such as waking up early or having problems falling asleep 
• Constantly worrying or feeling as if your fears will happen 
• Physical symptoms such as nausea, vomiting, shakiness, sweating, racing heart, and hyperventilation 
• Experience of panic disorder, which includes panic attacks (shortness of breath, sensation of choking, intense fear of death or dying) 
• Experience of obsessive or recurrent unwanted thoughts or images of harm or even death (for you or your baby) 

What are the Risk Factors for Postpartum Anxiety?

Having a new baby, especially if you are a first-time parent, can trigger worry. You may be more likely more likely to develop postpartum anxiety if you:

• Experienced the loss of an infant during pregnancy or after birth
• Had a history of an eating disorder or disordered eating
• Experienced prior anxiety and or mood disorders
• Experienced intense mood changes during your period
• Had not continued with anti-anxiety medications during your pregnancy or after giving birth

What is Postpartum Psychosis?

“Psychosis” occurs when someone loses touch with reality. Postpartum psychosis is an emergency which can be very dangerous for a mother and her baby, as the risk of suicide and/or infanticide increases. The risk of abusing, neglecting, or accidentally harming other children is also increased during an episode of postpartum psychosis. Postpartum psychosis is considered a medical emergency so 911 should be called immediately. Postpartum psychosis is not as common as postpartum depression or anxiety, as it impacts 1-2 women per 1,000 births. Symptoms may begin suddenly, but may also not be present during the episode, there may be times when the individual appears well. Symptoms usually occur within 1-2 weeks after childbirth.

What are the Signs and Symptoms of Postpartum Psychosis?

Postpartum psychosis signs and symptoms include:

• Irritability, inability to sleep, or restlessness
• Unusual or unpredictable behavior
• Hearing voices, seeing things, believing things that are not true, feeling like others are out to get you
• Moods that change very quickly such as being very sad, very energetic, or very excited
• Thoughts of wanting to hurt yourself or the baby

What are the Risk Factors for Postpartum Psychosis?

Some women can experience postpartum psychosis without any risk factors. These risk factors can increase a woman's risk for developing postpartum psychosis:

• A history of bipolar disorder, schizophrenia, or schizoaffective disorder
• A history of postpartum psychosis in a previous pregnancy
• A family history of postpartum psychosis or bipolar disorder
• Not taking your prescribed psychiatric medications while pregnant

Therapy

Counseling or therapy sessions with a mental health professional can help you understand your emotions, develop coping skills, and methods to improve your symptoms. Therapy or counseling can occur individually, in a group, or with your partner.

Medication

Some women may need a psychiatrist or other prescriber to manage their symptoms. Medication options can include those for mood disorders, anxiety, and psychosis. Medications combined with therapy have been shown to be more effective for treating depression and anxiety compared to having therapy alone. Medications are recommended when depression and anxiety symptoms are moderate or severe.

Support Groups

Support groups can be part of your treatment process. You can participate in a support group and engage in therapy. Support groups can be led by mental health professionals, members of the faith community, or other women who have experienced maternal mental health conditions.

Social Support

Spending time with other mothers, family, friends, and others can be helpful.

You can call your doctor any time. Your OB should have given you a 24-hour number to call to reach them with questions and concerns.

You can also call or text the MOMS Line 24/7 at 866-364-MOMS (6667) or the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) for help at any time. Search for providers via this link Unite Us Public Resource Directory.

Substance use

Drinking alcohol; smoking, vaping, or other tobacco use; and using marijuana or other drugs can hurt your baby's health, especially while you're pregnant. Any substance you put into your body reaches your baby through the placenta, and can result in stillbirth or withdrawal symptoms once the baby is born. Your baby may also be born early, at a low weight, or have birth defects.

You should also limit or stop drinking beverages with caffeine (including coffee, energy drinks, and pop) while pregnant. Pregnant women who drink caffeine are more likely to have smaller babies.

Getting help with substance use

While many pregnant mothers are able to quit or cut back on substance use during pregnancy, you also need and deserve support if you want to stop but are unable to. Be honest with your doctor and other people you trust about substance use — they can only help you if they know about it.

Chicago and Illinois residents can get free help with opioid misuse (drugs like Oxycontin, Vicodin, and Fentanyl), as well as medication to help you quit using.

Learn more about substance use and your pregnancy:

• Alcohol and breastfeeding
• Marijuana and pregnancy
• Tobacco and pregnancy
• Opioids and pregnancy