Postpartum (postnatal) depression – how to cope

Postpartum depression isn’t a normal part of being a new parent – discover the facts, and treatments that help


What are the symptoms?

What causes it?

When to see a doctor 

How is PPD diagnosed?

What are the treatments?

Self-care tips

Where to get support

Lots of new parents feel down or overwhelmed in the days after childbirth. But if symptoms are severe and don’t go away, they may be signs of postpartum depression (PPD). Learn more about PPD and discover the proven ways to treat it.

Many parents find their mood is affected as they adjust to having a new baby. This is known as the baby blues and should clear within 2 weeks. 

Postpartum depression (PPD) is different. It’s not just part of being a new parent – it’s a mental health condition. 

As symptoms often start during pregnancy, healthcare professionals sometimes now use the term ‘perinatal depression’, which covers pregnancy and the first year after birth. PPD is also known as postnatal depression.

Around the world, about 10% of pregnant women and 13% of new mothers experience a mental health issue, usually depression. PPD can also affect fathers and partners. 

Some people feel ashamed about having these feelings, but PPD is a common condition that has nothing to do with your parenting skills, or how you feel about your baby – and it’s treatable, so don’t put off getting support. 


## What are the symptoms?

Postpartum depression is different to the ‘baby blues’ where many women can feel down, tearful or anxious during the early weeks after giving birth.

PPD symptoms can be long lasting and can include:

- often feeling sad and/or tearful
- feeling a sense of hopelessness
- feeling irritable towards your partner, baby or other children
- a loss of interest in the world, and in things you used to enjoy
- fatigue, sleepiness and low energy 
- having trouble sleeping at night – even when your baby is sleeping
- difficulty concentrating and making decisions
- changes in appetite
- negative thoughts, such as thinking you’re not a good mom
- feelings of guilty or shame
- feeling anxious that something bad may happen to your baby
- problems bonding with your baby and no enjoyment in being with them. 

Symptoms and their severity can change over time. Research suggests many people with PPD also have an anxiety disorder.

### Signs you may need urgent help 

Contact your healthcare professional right away if: 

- you have thoughts of harming your baby – this doesn’t mean you’ll hurt your baby, but they are a sign you need help
- you have thoughts about harming yourself or taking your own life
- you feel unable to look after yourself or your baby
- your mood has changed and you have a history of mental health illness
- you have delusions or hallucinations, such as seeing or hearing things you can not explain or have the feeling that you are not in control
- you think there’s an immediate risk to yourself or others.


Get help with this

## What causes it?
It’s thought that hormonal changes – the drop in levels of estrogen and progesterone after giving birth – may be a factor in postpartum depression, although it can be caused by many other things. 

As well as physical changes, the emotional demands of caring for a newborn can increase your risk. 

You’re also at higher risk if:
- you have a history of mental health issues, especially [depression](/health-library/conditions/depression)
- there’s a history of depression in your family
- you lack a support network of family or friends
- you’ve experienced recent stressful events such as pregnancy complications, or a bereavement 
- your baby was born prematurely or with special healthcare needs
- the pregnancy was unplanned
- you’re struggling to breastfeed.

Note that having a baby is a major event that can trigger depression, even if the above isn’t relevant to you.

Co-parents can also have symptoms – 10% of new fathers experience depression in the first year after their child is born. 


## When to see a doctor 
See a healthcare professional if you think you may have [symptoms of postpartum depression](/health-library/conditions/postnataldepression#symptoms) – they can assess you and give the support you need. 

You won’t be judged, or seen as a bad parent. Remember: PPD is an illness, and it’s unlikely to go away on its own, so it’s best for you and your child if you get support as quickly as possible. 


## How is PPD diagnosed?
Your healthcare professional will ask about your mental health history, and your symptoms. They may use a checklist that screens for depression as part of a regular postpartum check-up. 

Try to be as open as possible. Your healthcare professional may also carry out tests to check your physical health, and order blood tests to rule out thyroid conditions, which can cause similar symptoms. 


## What are the treatments?
With the right treatment and help, you can make a full recovery from postpartum depression. Your treatment plan may include:
- __psychotherapy__, such as cognitive behavioral therapy, to help you learn new ways of thinking and reacting 
- __medication__ – you may be prescribed antidepressants if your symptoms are moderate to severe. There are different types, including medicines specifically recommended for PPD. Your healthcare professional will work with you to find one that helps you and is safe to take, for example if you’re breastfeeding.

Carry on with your treatment plan even when you start to feel better – symptoms may come back if you stop too soon. 


## Self-care tips
It’s also important you take steps to look after yourself. These include:

- getting regular exercise and eating a balanced diet
- resting as much as you can – try to sleep when your baby sleeps
- making time to do things you enjoy
- asking for help with tasks
- sharing your feelings with those close to you
- if possible, avoiding major life changes such as moving house, for example – having a baby is a big adjustment, so try not to add more stress
- [joining a support group](https://www.livehealthily.com/health-library/conditions/postnataldepression#support) and connecting with other new parents.

### Can you prevent PPD?
Look after yourself during your pregnancy by practicing self-care, getting the support you need, and going to antenatal classes. 

Talk to your healthcare professional if you have a history of depression or mental health problems. Or if someone in your close family has experienced mental health conditions after giving birth. 


## Where to get support
Your healthcare team will be able to suggest local support groups, and there are also organizations that offer support and can connect you with other new parents experiencing PDD. These include:

- [Postpartum Support International](https://www.postpartum.net)
- [Office of Women’s Health (USA)](https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression)
- [Perinatal Advice & Depression Australia (PANDA)](https://panda.org.au/about/about-panda)
- [PND Awareness and Support UK](https://pandasfoundation.org.uk)


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References

Charlotte Haigh

Jo Wheatley

Dr Emily Blount

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