Signs of postpartum depression
What is postpartum depression?
Also known as postnatal depression, postpartum depression (PPD) is a type of depression that can occur after having a child. PPD is much more 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.
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 go unnoticed or 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.
Postpartum depression may occur together with a number of other conditions, e.g. an anxiety or depressive disorder, diabetes or thyroiditis. The relationship between depression and other conditions is complex.
What are the signs of postpartum depression?
Signs of postpartum depression are generally present for more than two weeks. A parent with postnatal depression will often start to experience symptoms within the first month of having a child, but they can develop any time in the first 12 months, or even during the pregnancy itself.
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:
- 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.
A parent with postpartum depression may also experience 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.
For more information on the diagnosis and treatment of depression, see our general resource on depression.
Risk factors for postpartum depression
It is not known exactly what causes PPD. Some articles 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:
- 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 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
Also known as postnatal or puerperal psychosis, this is a relatively rare mental health condition that affects approximately 1 in 1000 women after childbirth. It 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.
- Unusually low mood (depression) or high mood (mania); moods may swing between the two
- Sleep disturbances
- Loss of inhibition
- Hallucinations, e.g. hearing voices
- Loss of contact with reality
If signs of postnatal psychosis are present, emergency medical care should be sought.
- A personal or family history of postpartum psychosis
- Bipolar disorder
- Less commonly, severe depression
Signs of postpartum depression FAQs
Q: Are there any signs of postpartum depression before birth?
A: Postnatal depression often develops within the first four weeks after giving birth, but symptoms 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.
Q: What are the signs of postpartum depression in males?
A: 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.
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. 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.
American Family Physician. “Depression in Women: Diagnostic and Treatment Considerations.” July, 1999. Accessed June 21, 2018. ↩ ↩
UptoDate. “Patient education: Depression in adults (Beyond the Basics).” June 13, 2017. Accessed June 20, 2018. ↩
The Primary Care Companion for CNS Disorders. “Depression and Anxiety Following Early Pregnancy Loss: Recommendations for Primary Care Providers.” January, 2015. Accessed June 20, 2018. ↩