Having a baby is often described as one of the happiest times of life, but for many new parents it also brings exhaustion, anxiety and low mood. Postpartum depression is common, affecting roughly one in seven new mothers. It is not a personal failure or a sign of being a bad parent. It is a treatable medical condition, and getting help benefits both parent and baby.
Baby blues or postpartum depression?
The baby blues affect most new mothers. They usually start two to three days after birth and include mood swings, tearfulness, anxiety and trouble sleeping. They ease on their own within about two weeks.
Postpartum depression is more intense and lasts longer. It can start during pregnancy (when it is called perinatal depression) or any time in the first year after birth, and it does not get better on its own.
Signs of postpartum depression
- Persistent sadness, emptiness or hopelessness
- Crying often, sometimes without a clear reason
- Severe mood swings or irritability
- Losing interest in things you used to enjoy
- Difficulty bonding with your baby
- Withdrawing from family and friends
- Feeling worthless, guilty or like a bad parent
- Intense anxiety or panic attacks
- Trouble sleeping even when the baby sleeps, or sleeping far too much
- Changes in appetite
- Difficulty concentrating or making decisions
- Thoughts of harming yourself or your baby
Many parents also experience postpartum anxiety or obsessive-compulsive symptoms, such as constant worry or intrusive, frightening thoughts about the baby being harmed. Having these thoughts does not mean you will act on them, but they are a reason to seek help.
Postpartum psychosis: an emergency
A rare but serious condition, postpartum psychosis usually begins in the first two weeks after birth. Signs include confusion, seeing or hearing things that are not there, paranoia, extreme agitation, rapid mood changes and not sleeping at all. It is a medical emergency. Call 911 or go to the nearest emergency room immediately.
Risk factors
- A personal or family history of depression, anxiety or bipolar disorder
- Depression or anxiety during pregnancy
- Previous postpartum depression
- Stressful life events, financial strain or relationship difficulties
- Lack of support
- Complications in pregnancy or birth, or a baby in intensive care
- Difficulties with breastfeeding
- Unplanned pregnancy
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It can also happen to people with none of these risk factors. Partners and fathers can develop postpartum depression too.
Screening
Health professionals often use a short questionnaire called the Edinburgh Postnatal Depression Scale (EPDS). Many obstetricians screen during pregnancy and at the postpartum visit, and pediatricians may screen mothers at the baby’s early checkups.
Treatment
Talking therapy
Cognitive behavioral therapy (CBT) and interpersonal therapy are effective for mild to moderate postpartum depression and can be combined with medication for more severe symptoms. Many therapists now offer telehealth sessions, which can be easier with a newborn.
Medication
- SSRIs such as sertraline are commonly used and are generally considered compatible with breastfeeding. Your doctor will help weigh benefits and risks.
- Zuranolone is an oral medicine approved by the FDA in 2023 specifically for postpartum depression. It is taken once a day for 14 days and can work within days rather than weeks. It causes drowsiness, so people taking it should not drive for at least 12 hours after each dose.
Practical support
- Accept help with meals, housework and baby care
- Protect sleep, for example by sharing night feeds with a partner where possible
- Try to get outside and move a little each day
- Connect with other parents through support groups
- Be honest with your healthcare provider about how you feel
Help for partners and family
Watch for changes in mood, withdrawal or comments about feeling hopeless. Offer practical help, listen without judgment, and encourage the new parent to talk to a doctor. Partners should also look after their own mental health.
Where to get help
- Talk to your obstetrician, midwife, primary care doctor or pediatrician
- National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA (1-833-852-6262), free and confidential, 24/7, in English and Spanish
- 988 Suicide & Crisis Lifeline: call or text 988 if you are having thoughts of harming yourself
- In an emergency, call 911
The bottom line
Postpartum depression is common and treatable. If sadness, anxiety or numbness lasts more than two weeks after birth, or you have thoughts of harming yourself or your baby, reach out for help right away. Therapy, medication, including fast-acting new options, and practical support help most parents recover fully.
This article is for general information and does not replace medical advice. If you are in crisis, call or text 988 or call 911.