Depression During & After Pregnancy: You Are Not Alone

By: Natasha K. Sriraman, MD, MPH, FAAP

Have you been feeling deeply sad, anxious or overwhelmed since giving birth? Maybe you've had trouble sleeping or eating. You might feel like a robot who's just going through the motions – or you freak out when anyone gets near your newborn.

If some or all of these feelings ring true, I hope you'll be relieved to hear how often this happens to parents. Did you know that 50% to 80% of all people who deliver a child experience the mood shifts known as "the baby blues?" And that 1 in 8 will develop a more serious case of postpartum depression?

These facts can be scary and confusing, especially right after your baby arrives. Your plans for blissful bonding with your child may feel like they've gone out the window—and every day seems like an eternity.

As a mom who went through PPD herself without fully recognizing it, I've made it my mission to learn about the life shifts that happen around pregnancy, delivery and those first few weeks of parenting. All of us need help getting through the intense emotions and dramatic changes that are part of becoming a parent.

How will I know if it's postpartum depression?

Lots of new parents ask me about the baby blues, depression and how to tell the difference. I explain that mood swings are very common after giving birth, especially in the first 2 weeks. What separates the blues from postpartum depression (PPD) is the length of time you're suffering and how severely you're affected.

Hormonal shifts that happen right after birth can make you feel incredibly sad, tearful, overwhelmed and confused. Pair this with the 24/7 challenges of caring for an infant and you have the perfect storm of biological triggers that can lead to mood changes.

The baby blues tend to disappear after a few days or weeks, and while they can be frightening, getting enough rest and accepting plenty of family and social support helps most parents recover. But if the raw feelings and fatigue just won't go away, you may be experiencing PPD.

Many new parents also experience anxiety that goes well beyond just being nervous about having a baby. In fact, the excessive and continued worrying of post-partum anxiety is as common as PPD, and may even happen at the same time.

Can depression start before my baby arrives?

Absolutely. Even though we hear a lot about postpartum mood swings, many pregnant people become depressed before giving birth. The name for this is perinatal depression, and it is similar to PPD in terms of the symptoms you feel and the treatment you may need.

What does postpartum depression look like in real life?

Parents who develop depression before or after giving birth experience deep sadness, confusion, loss of energy and a sense of hopelessness about the future. You may have angry outbursts or moments when everything gets under your skin.

Difficulty sleeping is another sign of depression—and while it's always hard to get enough rest with a new baby, depression makes it especially hard for you to fall asleep and stay there. You may wake feeling you've never even gotten a wink, leaving you to struggle through your day without the energy and positive mood that make parenting so much easier.

Changes in appetite and eating habits also come with depression. Many new parents don't feel like eating at all, or they binge on carb-laden snacks for energy or comfort. Caffeine, sugar and other short-term boosts can make matters worse, since they can disrupt your sleep and cause your energy to crash multiple times during the day.

Depression can also make you feel agitated and mistrustful, pushing you over the edge when anyone tries to help with the baby or handle simple chores around the house. Feelings of guilt, shame and blame can even make you feel you don't deserve help—and this is when things can take a turn for the worse.

Why should I prioritize my own health when there's sooooo much else on my plate?

First, because your health is absolutely essential to your baby's health, growth and development (and your family's well-being, too). Second, because you deserve to be healthy and happy, especially right now.

If you're feeling guilty as you read this, I encourage you to offer yourself the same compassion you'd give your loved ones if they were in your shoes. Parenting isn't about burying your needs while caring for everyone else's. It's a continuous flow of giving and receiving. Needing help doesn't make you weak—but seeking out help is a profound act of strength.

Does postpartum depression only affect first-time parents?

Like many moms, I experienced PPD after the birth of my second child. It wasn't simply because I suddenly had two kids in diapers or was struggling to get quality sleep. The adjustments that new parents go through with each birth can be complex and intense, so if you're wondering why you're struggling to cope as your family grows, realize you're one of many, many experienced parents who do.

Do adoptive parents sometimes get depressed?

Naturally they do—because creating or adding to a family always means grappling with strong emotions and demanding new routines. Caring for a newborn is no less challenging for adoptive parents than for birth parents. And the long, often exhausting process of adopting a child can produce such high levels of stress that many parents feel completely worn out by the time their baby arrives.

If you've just adopted a child and you're feeling depressed, please don't tell yourself you "shouldn't be reacting this way." Your family is counting on you to get the help you need.

Where can I find effective treatment for postpartum depression?

Consider starting with your pediatrician, who truly understands what you're going through, both medically and personally. If you feel more comfortable approaching your ob-gyn or primary care doctor, that's fine too. It is also good to talk with someone close to you who you trust, like a partner, parent, friend or family member, how you're feeling. The main thing is not to chalk it up to a normal part of parenthood. Seek care as soon as you can, since depression rarely disappears on its own. You're not supposed to tough it out alone.

Treatment for PPD or perinatal depression may include talk therapy, support groups, and discussions with friends and family about what you need while recovering. Light exercise and calming practices such as yoga and meditation can help. You may also receive a prescription for antidepressants, many of which are safe to take while breastfeeding.

Keep in mind that these medications provide short-term support while you regain your balance. They're not a crutch, just one part of the treatment plan that millions of people follow when they're experiencing depression.

What if I'm worried about my partner's mental health?

Partners get depressed, too, so if you see your mate suffering some of the same symptoms I've outlined here, please don't stay silent. The two of you are a team, both essential to your family's health. Your pediatrician or primary care doctor can help you find seeking care, whether it's for one or both of you.

What should I do if I'm experiencing dangerous thoughts?

If you are considering harming yourself or your baby, immediately call the National Suicide Prevention Lifeline at 1-800-273-8255 or 9-1-1. Don't wait, because these thoughts are a sign that you need expert help right now.

The National Maternal Mental Health Hotline is available 24/7 by calling 1-833-943-5746. And for non-emergency resources and support, you can contact Postpartum Support International. Call or text "Help" to 1-800-944-4773.

Remember

Your child's routine check-ups are an opportunity to talk with the pediatrician about how you are coping with new parenthood. However, don't hesitate reach out any time about feelings of sadness and anxiety after the birth of your baby.

More information

• Ask the Pediatrician: Is it normal to feel completely overwhelmed after having a baby?
  
• Infants, Families Affected By Parent's Perinatal Depression: AAP Policy Statement