What's Postpartum Depression And How Do I Cope With It?

If you're experiencing postpartum depression and have the urge to harm yourself or your child, please call or text 988 for immediate support. If you're living with postpartum depression and need support, contact the Postpartum Support International HelpLine at 1-800-4773 for resources. 

The months following welcoming a new child into the family can involve significant adjustment. A changing body, lack of quality sleep, and numerous other stressors lead some new parents to experience postpartum depression (PPD) in the year following childbirth or adoption. 

Depression is serious. However, misinformation and a pervasive stigma about postpartum depression's causes may cause some people to believe they are alone in their symptoms. Postpartum depression is a mental illness, not an indication of one's fitness as a parent. To reduce stigmas surrounding this condition, it can be essential to know how it develops, the symptoms to look out for, and ways to find support.  

How Many People Experience Postpartum Depression?

Postpartum depression is a common mental illness, and the National Institute of Mental Health (NIMH) encourages those experiencing it to seek professional support due to its prevalence and severity. Studies estimate that as many as 20% of new parents experience postpartum depression, though the prevalence may be higher. Non-gestational parents can also experience PPD following the birth of a child. 

People with a history of depression are more susceptible to acquiring postpartum depression. However, regardless of mental health status or prior diagnosis, anyone can live with this condition. 

When Does Postpartum Depression Occur?

Postpartum depression symptoms can begin any time during a child's first year of life or after the adoption of a child. Some symptoms may occur around four or five months with the new family member. Some new parents may struggle to find emotional support after nine months of pregnancy, labor, and welcoming a new human life. Others may go through an adoption process that can also cause symptoms of depression. 

What Are The Symptoms Of PPD?

It can be normal for people who give birth to experience sadness during the first two weeks after childbirth due to the hormonal shifts that occur during that period. The primary symptom during this time is an underlying sadness and lack of energy. However, this sadness immediately after birth is not necessarily a sign of PPD. 

Contrarily, postpartum depression is marked by persistent sadness past the initial two-week mark, with more functional difficulties. Some people with PPD may not experience sadness as a primary symptom, as the symptoms can be unique and varied, including but not limited to the following: 

• Anger, rage, or irritability

• Difficulty sleeping

• Restlessness 

• A lack of pleasure in previously enjoyed activities 

• A shift in appetite or behaviors around food

• Apathy or a sense of having a "flat" mood 

• Unexplained crying 

• Thoughts of hopelessness or worthlessness 

• Worrying, fear, or anxiety 

• Intrusive thoughts of severe harm or death coming to your new child 

• A lack of connection or love toward your new child 

• Difficulty bonding with your new child 

• Believing your new child isn't how you expected them to be 

• Believing your child would be better off without you 

In some cases, parents may struggle to attend to their children when living with PPD, which could lead to a delay in language development within the first year. With treatment, this delay may be preventable. 

In more extreme cases of untreated postpartum depression, typically associated with postpartum psychosis, symptoms and side effects of mental health conditions can include:

• Hallucinations

• Paranoia

• Thoughts of suicide or of harming the baby

• Confusion and disorientation 

Anyone who has thoughts of suicide or harming themselves or their infants can call 988 for immediate crisis support. 

Understanding PPD Symptoms 

Postpartum depression has symptoms similar to bipolar disorder, a mood disorder that can cause rapid mood swings. Get a proper diagnosis from your doctor if you are unsure what might be causing your symptoms. 

Note that some high-profile media stories highlight new parents experiencing postpartum psychosis, potentially giving the impression that if one does not experience extreme symptoms, they're not experiencing postpartum depression. However, postpartum depression symptoms occur on a spectrum, and someone may only experience a few of the symptoms that someone else experiences. If you're unsure if you're living with PPD, talking to a professional can be one of the most effective ways to be sure. 

Postpartum psychosis is rare in comparison with postpartum anxiety or postpartum depression. In addition, postpartum psychosis surfaces quickly after labor and birth. If you believe you may be living with psychosis, reach out to a professional as soon as possible, as psychosis can be severe and dangerous. 

How Is PPD Diagnosed? 

When a parent or caregiver seeks support with PPD, their healthcare professional may ask questions about the condition or request that they complete a depression screening questionnaire. Healthcare providers may want to know if parents have a history of depression or other mental illnesses. They might also ask if one has symptoms like extreme sadness, difficulty caring for the baby, or frightening thoughts. 

Be honest in your responses to your doctor's questions to get the most effective support and accurate diagnosis. Having PPD is not a flaw, and many support options are available for treatment. 

What Causes Postpartum Depression?

There isn't one single cause or predictor of postpartum depression. This condition is often caused by complex risk factors, including but not limited to the following. 

Hormones

Individuals undergo profound physical changes during pregnancy, impacting their feelings. During and after pregnancy, fluctuations of hormones can cause profound chemical changes in a person's body. These changes can cause significant disruptions to someone's life and ability to control their thoughts.

More specifically, the hormones estrogen and progesterone are significantly elevated during pregnancy. Within 24 hours of childbirth, the hormone levels drop in the body, leading to a quick fluctuation in mood. These hormones may be a significant contributor to sadness after birth. However, if this sadness persists for over two weeks, it may be a sign of PPD. 

In addition to hormonal challenges, individuals may experience challenges with their thyroid gland after pregnancy. Postpartum thyroiditis is a condition where the thyroid gland becomes inflamed after birth, potentially impacting mood. 

Lifestyle

Various challenges of parenting a new baby or child exacerbate the hormonal effects of PPD. These changes may include the following: 

• A lack of sleep
• The added stress of parenting a newborn
• Added challenges in the parental relationship
• Loss of flexibility and free time
• Lack of a support system
• Lack of time to exercise
• Poor nutrition
• Confusion about one's newfound role as a parent
• Loss of sense of self
• A desire or pressure to be the "perfect parent"
• Unexpected challenges after birth 

Social Factors

Teen parents and people living in poverty have higher rates of postpartum depression. The added stress experienced by these groups of people as they enter parenthood may exacerbate the other factors and lead to their increased risk of postpartum depression. To compound this situation, some teen parents lack the support of their own parents, a close loved one, or others in the family. A lack of support can further increase the risk of depression. 

Medical History And Genetics

As with other depressive disorders, there is a genetic component to PPD. Those with a personal or family history of depression or postpartum depression are at an elevated risk for this condition. Those who experience premenstrual dysphoric disorder (PMDD) before and during their regular menstrual cycles may also be at a higher risk. 

Fertility Challenges And Trauma 

Struggles with fertility and difficulty conceiving increase a person's likelihood of experiencing postpartum depression. In addition, a traumatic or medically complex birth experience can lead to the formation of this condition. 

Treatment Options For Postpartum Depression 

Many treatments are available to combat postpartum depression; you don't have to go through treatment alone. If you believe you are struggling with symptoms of depression, speak with your doctor about your symptoms. Your primary care provider can ask more detailed questions to see if a diagnosis of postpartum depression makes sense for your case. They may also refer you to a specialist in the condition to receive quick support. 

Some people can manage their postpartum depression with lifestyle adjustments, while others benefit from more comprehensive medical interventions to treat depression. Regardless, postpartum depression is often a chemical issue. It is not a personal failure if you struggle to improve your symptoms without medical support. PPD is temporary, so some parents take medication while coping with the symptoms. However, consult your doctor before starting, changing, or stopping any medication. Below are further support options for PPD. 

Ask For Support

Be open about your struggles with postpartum depression with other parents in your social circle. Your family and friends may want to help, but it may be challenging to understand if they haven't had PPD. If you don't have friends who are parents, contact your birth hospital or obstetrician and ask them about local parent and baby groups in the area. These groups may allow you to socially connect and talk about your experience with people who understand. 

While you may not know how to talk about PPD with your family, try to prioritize time with them. It might not be possible to partake in activities you enjoyed before your new child. However, gathering with others in a social setting can improve mental and physical health, so find ways to connect that don't require too much energy or time. 

Online support groups or education videos can also help those living with stress and depression after adding a child to the family. You may be able to find an online support group for those seeking support. Online support groups can be a convenient and time-saving option for you and your partner and may be a starting point if you don't have groups in your area. 

If local groups are available, consider a group specifically for those with PPD. These groups may help you learn more about postpartum depression and what it looks like in everyday life. In addition, you can connect with parents who have PPD and know what it feels like, even if their symptoms are different. Ask your local hospital, doctor, or obstetrician for help finding one in your local area.

Make Lifestyle Adjustments

Physical and emotional challenges can take a toll on a new parent. However, there are a few steps you can take to combat symptoms at home, including but not limited to the following: 

• Ask your partner to take an overnight feeding to help you get restorative sleep
• Schedule regular exercise
• Go on walks in the sun 
• Pay attention to your nutrition
• Avoid substance use 
• Eat a piece of dark chocolate 
• Do a puzzle 
• Write in a journal 
• Spend time in nature 
• Create a scrapbook about your new baby or child

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

Seek Professional Support 

In some cases, lifestyle adjustments may not be enough, and social support systems fall short. When this occurs, talking to a licensed therapist about your symptoms may be beneficial. Therapy can be an effective way to manage PPD, and a therapist can accompany you throughout the duration of your condition. Counseling has been proven significantly effective in treating postpartum depression. 

If you struggle to find a professional in your area, you may also benefit from working with a provider on an online therapy platform like BetterHelp. A trained online counselor can help you identify the root causes of your emotions, offer guidance to process them effectively and coach you on ways to improve specific aspects of your life impacted by PPD. Making time for self-care when you have a newborn can be challenging, so online therapy can break this barrier. You can schedule appointments when you know your infant may be sleeping, and you can attend from the comfort of your home. 

In addition to its benefits, online therapy has been proven effective for PPD. In one study, researchers implemented online therapy workshops for 403 mothers with PPD during the COVID-19 pandemic. Results indicated that those who engaged in the session were four times more likely to experience a clinically meaningful improvement in PPD symptoms than those assigned to the control group. The workshops took place over videoconferencing and included activities like group exercises, roleplay scenarios, identifying and changing thought patterns, and learning strategies to improve mood and anxiety.