Recognizing the Signs of Postpartum Depression

Know what to look for and when to get treatment

During pregnancy, your body goes through a lot of changes. And afterward, there’s a lot to adjust to. From feeling uncertainty about how to care for your baby to hormonal fluctuations, the new routine can feel overwhelming and bring about something called the “baby blues.” This common condition causes mild symptoms like mood swings and crying. It typically crops up a few days after childbirth and resolves within 2 weeks as women adjust.

However, when symptoms are more severe and long-lasting, they can be part of a condition known as postpartum depression.

Postpartum depression can happen to anyone — even if you have a good support system. And it’s more than just being sad. Here’s what to look for (and when to seek help).

What is postpartum depression?

Postpartum depression, or PPD, is a mood disorder that occurs after childbirth. Symptoms can range from mild to severe. This condition is common, affecting up to 1 out of 7 women.

“Postpartum depression may be mistaken for baby blues at first — but the symptoms are more intense and last longer,” says Noormehak Badechha, PsyD, psychologist at Geisinger.

Similar to postpartum depression is a condition called postpartum anxiety, also known as PPA.

Both can cause a range of symptoms.

What are the symptoms?

Symptoms of PPD and PPA can be similar and include:

Persistent sadness
Irritability and mood swings
Difficulty bonding with your baby
Loss of interest in things you used to enjoy
Withdrawing from loved ones
Tiredness and lack of energy
Lack of sleep or sleeping too much
Appetite changes
Restlessness
Panic attacks
Excessive worry

More severe symptoms include:

Thoughts of harming yourself or your baby
Recurring suicidal thoughts

PPD can be long-lasting and doesn’t go away on its own.

“Untreated PPD or PPA may last for months or longer,” Dr. Badechha says.

Symptoms can be brought on or worsened by:

Changes in your hormones
Sleep deprivation
Lack of social support
Pain

And if you’ve had postpartum depression before, you’re more likely to have it again.

How is it diagnosed?

It can be normal to feel overwhelmed after giving birth. But those feelings should go away as you settle into a new routine.

“Thinking that these symptoms are a normal part of the postpartum journey can lead to a delay in diagnosis,” says Dr. Badechha. “They’re not normal, especially if they last for more than 2 weeks.”

There’s no one test to diagnose postpartum. However, your healthcare provider will perform an evaluation at your visits after you give birth. They may perform a pelvic exam and talk with you about how you’ve been feeling since delivery. They will ask you a series of questions using something called the Edinburgh Postnatal Depression Scale (EPDS).

The EPDS is a 10-question screening tool that scores each question from 0 to 3. The higher the score, the more severe the symptom. You'll be asked about behaviors and trends over the past week, like whether you’ve felt anxious or sad and how often.

Scoring 14 or more typically means you have postpartum depression. “Assessments using the EPDS up to a year after giving birth can help someone from falling through the cracks and getting the help they need,” notes Dr. Badechha.

What treatments are available?

If you’ve been diagnosed with postpartum depression or anxiety, there’s good news. With treatment, PPD and PPA can be managed. Available treatments for postpartum depression include:

Medication

To help reduce feelings of depression or anxiety, taking antidepressants can help. Your healthcare provider can work with you to understand your goals and help you find the right medication to help reduce symptoms.

Talk therapy

Another method to effectively treat postpartum? Talk therapy. Seeing a therapist regularly can help you develop coping skills and work through feelings. “You may also want to consider finding a support group of other new parents to help you build connections and share experiences,” Dr. Badechha says.

Self-care

It may seem difficult, but taking care of yourself when you have a new baby is key. Even small additions can help you feel your best. Not sure where to start? Consider these:

Recharge with a short nap when possible
Delegate tasks to others, like a partner or friend
Move your body for a few minutes a day
Eat a balanced diet
Talk to friends and family to avoid isolation

When to seek help

Talk to your healthcare provider if symptoms are long-lasting, not going away or getting worse. And if you have thoughts about harming yourself or your baby, call 911 or seek immediate professional help.

“Please seek the help you need so you can have the postpartum you want,” says Dr. Badechha. “Struggling mentally is not normal, and you can get the support you need.”