Common Signs And Symptoms Of Postpartum Depression

Welcoming a new child into your family can be a joyful event, but it can also come with challenges. Many new parents have a hard time feeling the happiness and excitement they’ve been expecting due to postpartum depression (also known as PPD). But how can you tell whether you have ordinary stress about your newborn or PPD? This article will review the most important warning signs of postpartum depression so you can recognize them.

The symptoms of postpartum depression are similar to those of major depressive disorder, including persistent negative feelings like sadness, guilt, worry, or emptiness. Many of these feelings may be related to your child. For example, you may have difficulty forming an emotional bond or feel guilty because you’re convinced you’re a bad parent. Though this condition can be very difficult to grapple with, it’s treatable and usually temporary.

Is it postpartum depression or am I just sad?

The experience of having a child can be confusing and stressful, not to mention marking a major life change. So, perhaps it’s not surprising that many people experience emotional difficulties immediately afterward. Symptoms like mood swings, sadness, crying, irritability, and insomnia are very common during the first few days after childbirth. 

Based on estimates from the National Institutes of Health, 50% or more of new mothers experience postpartum depression. Some sources put the figure at 70-80%. For most people, though, these symptoms resolve on their own within a week or two.

Note that PPD doesn’t always begin immediately after birth. A study from the American Journal of Obstetrics and Gynecology reported that although symptoms typically emerge within the first six weeks following delivery, around 22% of people didn’t encounter them until eight weeks or more afterward. In some cases, PPD can show up months later. And roughly 11% of participants developed symptoms during pregnancy.

Recognizing and treating PPD as soon as possible may be a major factor in promoting healthy long-term outcomes. Any or all of the following may be signs of postpartum depression:

Depressed mood most of the day

Most people feel sad, depressed, or flat, at least some of the time. This may be especially true when you’re running on very little sleep and stressed about caring for a tiny, fragile human being. However, if this low mood is lingering for most of your waking hours, it could be a symptom of PPD.

Lack of pleasure and enjoyment

Depression doesn’t always manifest in the form of active feelings such as sorrow. It can also appear as a lack of happiness (known as anhedonia), in which you’re no longer able to enjoy things that normally make you feel good. This may be accompanied by a lack of desire to do much of anything since you no longer expect things to give you pleasure. A formal diagnosis of PPD requires either this symptom or the first symptom to be present, along with at least four others.

Feelings of guilt, shame, and worthlessness

The desire to be a good parent is often tied directly to a person’s sense of personal worth and identity. Unfortunately, this means that postpartum depression can sometimes put a severe strain on your self-esteem. People with this condition often feel like “bad parents,” causing them to feel intense guilt or even to regard themselves as worthless.

Difficulty bonding with your baby

This could be considered a particular example of the feelings of numbness, irritability, and anhedonia described above. But it’s worth singling out because it can be one of the most disorienting and guilt-inducing elements of PPD. Because your ability to feel positive emotions is disrupted, you may not feel the sense of affection and tenderness that you expect to feel for your baby. The child may feel more like a burden or a source of irritation, which in turn can provoke shame and self-recrimination.

Loss of energy

Excessive feelings of fatigue or tiredness may also be present in PPD. Adjusting to life with a newborn child is often tiring, but the emotional drain of depression may make you feel even lower in energy than you’d expect based on your baby’s care needs.

Sleep disruption

Mental fatigue can be exacerbated by the fact that postpartum depression may disturb your sleep habits. For some people, this can mean an inability to fall asleep even when they’re exhausted and the child is snoozing. Others might find themselves sleeping far more than normal, to the point where they’re spending all day in bed.

Slowed movement and thought

Technically known as “psychomotor retardation,” this is a common symptom of depression in which your mind and body seem to be functioning more slowly than usual. You might feel “fuzzy” or “out of it” because it’s taking you longer to perform tasks, think things through, and form sentences. This could be due to depression-related impairment of your brain’s dopamine-based motivational system.

Restlessness

Not everyone whose cognition is disrupted by postpartum depression experiences psychomotor retardation. Others may have psychomotor agitation, in which mental and physical activity seems to be cranked up to higher-than-normal levels. This could make you feel anxious and cause you to have trouble sitting still. You might notice yourself pacing, talking too rapidly, suddenly starting and abandoning tasks, and experiencing racing thoughts.

Weight fluctuation

Rapid weight changes are not uncommon in PPD. This disorder can suppress your appetite or lead you to eat excessively in an attempt to self-soothe. And feelings of lethargy, apathy, or restlessness might change your levels of physical activity. If you gain or lose more than 5% of your weight within one month, it could be a sign of postpartum depression.

Thoughts of harming yourself or your child

People with intensely negative feelings after childbirth may focus those emotions on themselves, leading to suicidal thoughts.* In other cases, feelings of despair or rage may be turned outward, prompting some parents to think of hurting their babies or older children.

*If you’re having thoughts like this, please seek help immediately — there are many resources available to help you through this, with volunteers ready to talk. You can reach the 988 Suicide & Crisis Lifeline through this link or by dialing 988, or you can text HOME to the number 741741 to reach the Crisis Text Line.

Risk factors for postpartum depression

How can you tell if you’re at risk for postpartum depression? This question can be a bit difficult to answer because the precise causes of PPD aren’t fully understood. However, researchers have identified several notable risk factors for postpartum depression, including:

• A prior history of depression or other mental illness
• Trauma from past sexual abuse
• A difficult, risky, or stressful pregnancy and birth
• Becoming pregnant at a young age
• Substantial hormone changes following childbirth
• Lack of social, financial, and material support
• Poor nutrition

If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.

You may also be more likely to develop postpartum depression when caring for your child is particularly challenging. If your infant cries excessively and is hard to calm down, or if they have difficulties with consistent appetite and sleep, the added stress could contribute to PPD. The same is true for medical conditions or pregnancy complications that result in special care needs for your child.

How common is postpartum depression?

When you’re living with postpartum depression, you may feel isolated and inadequate. People with this condition often feel guilt because they lack the emotions they’re expected to feel after bringing a child into their lives. You may find comfort in knowing you’re far from the only one going through this. A 2015 population sample estimated that 10-15% of mothers experience PPD every year.

Though popular conceptions of postpartum depression usually focus on the person who has given birth, this condition can also affect the other parent. Having a new child to care for can be an emotional and physical challenge for anyone. One study suggested that PPD may affect as many as 10% of new fathers and is more common when the spouse is also depressed.

Avoiding and managing postpartum depression

If you think you might have PPD, or you’re worried you’re at risk for it, what should you do to keep yourself mentally healthy? The following factors are all likely to help:

• Staying in close contact with relatives, friends, and other sources of psychosocial support
• Healthy eating, including a diet high in vegetables, legumes, fruits, nuts, fish, and dairy
• Physical exercise — this may be even more effective if you begin an exercise regime during pregnancy
• Sleep habits that allow you to get enough rest
• Breastfeeding your child whenever possible

Treating postpartum depression with therapy

A systematic review of 40 scientific trials found substantial evidence that cognitive-behavioral therapy was effective at both preventing and treating postpartum depression. When living with PPD, talking with a therapist may be crucial for restoring your mental health. Online therapy is often more manageable for new parents confronting the everyday difficulties of caring for a new child. This method allows you to attend sessions from home rather than trying to fit a commute to a therapist’s office into your hectic schedule.

Online cognitive-behavioral therapy may be a newer treatment approach, but a substantial body of research shows that it’s every bit as effective as traditional therapy. Some controlled trials have shown that it can work specifically for PPD. Web-based therapy may be a convenient way to reduce symptoms of anxiety and depression while improving parent-child relationships.