Signs of Postpartum Depression

Also known as postnatal depression, postpartum depression (PPD) is a type of depression that can occur with having a baby. PPD is much more severe than the mild “baby blues” that many new mothers experience for a few days or a couple of weeks after giving birth to their child. Postpartum depression is a serious medical condition that can interfere with a parent’s ability to care for themself and their baby, and often requires treatment by a doctor. 1 2 3 4 5

Depression after the birth of a child is relatively common and is thought to affect approximately one in every 10 women. However, it may be difficult to recognize. Signs and symptoms of postpartum depression may be subtle and go unnoticed, may be mistaken for other conditions, or may be hidden out of a fear of being judged or stigmatized for not being a good, happy parent. 6 2 3 5

Postpartum depression can also affect partners of women who have recently given birth, as well as people who have recently adopted a child. It can affect any new parent, including fathers. 1 3

Postpartum depression may occur together with a number of other conditions, e.g. anxiety or another depressive disorder, diabetes or thyroiditis. The relationship between depression and other conditions is complex. 7

Good to know: Though it is not classified as postpartum depression, many women may also experience intense emotional distress, depression and/or anxiety after a miscarriage or abortion. 8

A parent with postnatal depression will often start to experience symptoms within the first month of having a child. However, symptoms can develop any time in the first 12 months, e.g. after four or six months. 9 Symptoms of depression may also develop during the pregnancy itself, before delivery. Signs of postpartum depression are generally present for more than two weeks.

While they may vary from person to person, as well as differ in form and severity, some of the more common signs and symptoms of postnatal depression, like other types of depression, include: 6 2 3 4 10 11

• Persistent low mood; this may take the form of sadness, hopelessness, emptiness, irritability, frustration, anger, a feeling of being overwhelmed, or other negative emotions
• Loss of interest or pleasure in activities that used to be enjoyable, including sex
• Strong feelings of guilt or worthlessness
• Tiredness and lack of energy and motivation
• Trouble concentrating and making decisions
• Memory problems
• Overwhelming worry or anxiety
• Restlessness or trouble sitting still
• Withdrawal from loved ones
• Disrupted sleep patterns, including difficulty falling asleep or sleeping too much
• Changes in appetite
• Persistent headaches, other pains, or digestive trouble without a clear physical trigger

It is important to keep in mind that some of the symptoms listed above, e.g. tiredness, disrupted sleep patterns and low sex drive, are normal after having a baby – and not necessarily indicators of PPD. If any symptoms are troubling you, try using the Ada app for a free assessment.

A parent with postpartum depression may also experience difficulty bonding with their baby, 12 recurrent thoughts of harming their baby, as well as recurrent thoughts of death or suicide. In severe cases, there may be suicide attempts. If a person shows signs of crisis – obvious indicators that they are strongly affected by depression or at risk of suicide – it is important to call a doctor, emergency services provider or suicide prevention line without delay.

Good to know: PPD can occur up to a year after giving birth. If symptoms of depression persist or first develop more than 12 months after childbirth, it could be an indication that another type of depression or condition is present, and a licensed medical professional should be consulted to ensure effective treatment is received. 13 14 Read about different types of depression.

It is possible for any new parents, including dads, whether biological or adoptive, to experience postpartum depression. It is thought that as many as one in 10 new fathers may experience the condition. 15 16

Signs of PPD in men are largely the same as those listed above, though there may be a few differences between the sexes. For example, where women may experience sadness and seem withdrawn, their male counterparts may instead experience irritability and aggression. See this resource on signs of depression for more information. 15 16

Many men avoid seeking medical help as they may feel they are failing to fulfil parental responsibilities. However, seeing a doctor is important to manage PPD. 15 16

The causes of PPD are not fully understood. Some articles in the media suggest that postpartum depression may be caused by hormonal changes after birth, but there is not sufficient evidence to support this idea. The strongest risk factors for developing postpartum depression are thought to include: 6 2 3 4

• A personal or family history of mental health conditions, e.g. depression or bipolar disorder
• Lack of social support, i.e. friends and family
• A poor relationship with one’s partner
• Significant stress or major life events, e.g. death of a loved one or a major move, during or after the pregnancy

Other risk factors may include:

• The pregnancy being unplanned
• Being unemployed
• Not breastfeeding
• A complicated birth
• The baby having health challenges or special needs
• Thyroid problems during pregnancy
• Experiencing other health challenges during or after the pregnancy
• One’s partner being depressed
• Substance abuse

Good to know: Parents who have twins or triplets are thought to be at a higher risk of developing postpartum depression, due to the increased challenges of caring for two or more babies at the same time. 17

Postpartum depression, like other types of depression, is considered a treatable condition. For detailed information on depression tests, diagnosis and treatment options, including psychotherapy and antidepressant medication, see this resource on depressive episodes.

Also known as postnatal or puerperal psychosis, this is a relatively rare mental health condition that affects approximately 1 in 1000 women after childbirth. Postpartum psychosis is not the same as postpartum depression.

Postpartum psychosis can be extremely serious, and is considered to be a psychiatric emergency that typically requires urgent hospital treatment. With appropriate treatment, most women make a full recovery. 2 18

Postnatal psychosis typically develops in the first weeks after childbirth. Symptoms include: 2 18

• Unusually low mood (depression) or high mood (mania); moods may swing between the two
• Agitation
• Confusion
• Sleep disturbances
• Loss of inhibition
• Paranoia
• Delusions
• Hallucinations, e.g. hearing voices
• Loss of contact with reality

If signs of postnatal psychosis are present, emergency medical care should be sought.

Risk factors that may increase the likelihood of developing postpartum psychosis include: 2 18

• A personal or family history of postpartum psychosis
• Bipolar disorder
• Schizophrenia
• Less commonly, severe depression

Q: Are there any signs of postpartum depression during pregnancy, before birth?
A: Postnatal depression often develops within the first four weeks after giving birth, but symptoms of depression can also develop during the pregnancy itself and continue after birth, or appear any time in the first 12 months after the child is born. 4 10

Q: Can anger be a sign of postpartum depression?
A: Yes, persistent anger can sometimes be a sign of postnatal depression. See the section on signs of postpartum depression above for more information, or try using the Ada app for a free symptom assessment.

Q: What are the signs of postpartum depression in males?
A: As explained above, postpartum depression can also affect partners of women who have recently given birth, and a father may develop similar symptoms and signs of depression in the first few weeks or months after his child is born. The condition can affect any parents, including those who adopt. 1 3

Q: How common is postpartum depression?
A: PPD is relatively common, estimated to occur in as many as one in ten new mothers and fathers. 15 16 19 20

Q: What are the early warning signs of postpartum depression?
A: While the first signs of PPD differ from person to person, these may include:

• Persistent low mood
• Tiredness
• Loss of interest in activities that used to be enjoyable

See the section on signs of postpartum depression above for more information, or try using the Ada app for a free symptom assessment.

Q: Postpartum depression vs. depression – what is the difference?
A: Postpartum depression is a type of depression that can occur in new parents, within 12 months of having a child. 21

Q: Why does postpartum depression occur?
A: It is not fully understood why some parents develop postpartum depression. However, certain risk factors, including the following, may increase the risk of the condition occurring: 6 2 3 4

• History of depression or other mental health conditions
• Inadequate social support
• High levels of stress

For more information, see the section on risk factors for PPD above.

Q: Can you get postpartum depression after a miscarriage or abortion?
A: Though not classified as the same condition, many women may experience distress, anxiety and/or depression after a miscarriage or abortion. 8

Q: What if my partner, relative, or friend has signs of postpartum depression?
A: It is important to broach the subject very carefully and tactfully and encourage the person to talk about how they are feeling. Listening without judgment may be helpful, and, if it seems appropriate, the person could be encouraged to speak to their GP or another medical practitioner. In addition, they could be encouraged to take small steps to help themselves, such as taking breaks and eating a balanced diet. It is important to be reassuring and patient with the person at all times. 22

If a person shows signs of crisis – obvious indicators that they are strongly affected by depression or at risk of suicide – it is important to call a doctor, emergency services provider, or suicide prevention line without delay.