What are the symptoms of postpartum depression?

Is it the baby blues or postpartum depression?

The baby blues often start 2 to 3 days after birth. You may have mood swings, cry for no clear reason, feel anxious or overwhelmed, and sleep badly. These feelings come and go and usually get better on their own within a few days to 2 weeks.

Postpartum depression is stronger and lasts longer. The feelings don't lift after 2 weeks, and they make it hard to do everyday tasks. It most often starts 1 to 3 weeks after birth, but it can begin during pregnancy or up to a year after your baby is born.

What are the signs of postpartum depression?

You don't need every sign to get help. If several of these last more than 2 weeks, call your doctor, nurse or midwife:

• Feeling sad, hopeless, empty or low most of the day.
• Feeling angry, irritable or restless.
• Crying more than usual.
• Losing interest or joy in things you used to enjoy.
• Sleeping much more or less than usual, or not sleeping even when you get the chance.
• Eating much more or less than usual.
• Feeling guilty, ashamed or worthless, or that you're a bad parent.
• Having trouble focusing, remembering or making decisions.
• Pulling away from friends and family.
• Feeling disconnected from your baby, or not caring for them the way you expected.
• Thoughts of harming yourself or your baby.

What does postpartum anxiety feel like?

Anxiety disorders can happen during or after pregnancy, sometimes with depression and sometimes on their own. You may feel fearful or worried all the time, or be unable to stop worrying about your baby.

Anxiety can also show up in your body, with headaches, a pounding or skipping heartbeat, numbness, or fast, shallow breathing. Chest pain or trouble breathing should always be checked by a doctor, so don't assume it's only anxiety.

What are the signs of postpartum psychosis?

Postpartum psychosis is a rare but serious illness that affects about 1 in 1,000 mothers. It usually starts suddenly in the first 2 weeks after birth, often within hours or days. It is a medical emergency, so call 911 or your local emergency number. Signs include:

• Hearing, seeing or feeling things that aren't there.
• Strong beliefs or fears that are unlikely to be true.
• Feeling very high or overactive, talking fast or not needing sleep.
• Very low mood, or moods that swing quickly between high and low.
• Feeling very confused.

Who is more likely to get postpartum depression?

Any new parent can get it. About 1 in 8 new mothers report symptoms in the year after birth. Hormone levels drop sharply in the first 24 hours after birth, and tiredness, stress and a big life change add to it. Your risk may be higher if you:

• Had depression before or during pregnancy, or after an earlier birth.
• Have a family history of depression or bipolar disorder.
• Had a difficult or traumatic birth.
• Have little support from a partner, family or friends.
• Are dealing with money problems, relationship stress or domestic violence.
• Have a baby born early or with special health needs.
• Have a hard time breastfeeding.

How is postpartum depression treated?

Treatment usually means talk therapy, medicine, or both. Talk therapies such as cognitive behavioral therapy (CBT), which helps you change unhelpful thoughts and habits, work well. Your doctor can explain the options and help you choose, including if you're breastfeeding.

Call your doctor as soon as you notice symptoms. Don't wait for your postpartum checkup. Your doctor may also check your thyroid with a simple blood test, because thyroid levels can drop after birth and cause similar symptoms.

Many parents worry their baby will be taken away if they speak up. This is very rare. Your care team's job is to support you so you can care for your baby.

What can help while you recover?

Small steps can support your treatment. Tell someone you trust how you feel, and let people help with meals, chores and baby care. A short daily walk, rest when you can, and a parent support group can also help. Avoid alcohol and drugs as a way to cope.

In the US, the National Maternal Mental Health Hotline (call or text 1-833-852-6262) offers free, confidential support 24 hours a day, 7 days a week, in English and Spanish.