Having a baby can be exciting, but it can also be stressful and bring many strong emotions. During the postpartum period, which is the time after you give birth, you may have mood swings, crying spells, or feel anxious. These feelings are common and are often called the postpartum "baby blues". The baby blues usually go away within a few days to a week.

If your symptoms are more severe and last longer than two weeks, you may have postpartum depression.

Postpartum depression is a common but serious mood disorder that can begin anytime within the first year after childbirth. Without treatment, symptoms may make it hard to care for your baby or manage daily tasks.

The exact cause is unknown, but postpartum depression likely results from a combination of factors, including:

• Sudden changes in hormone levels after pregnancy
• Physical changes, such as dropping thyroid hormone levels
• Lifestyle factors, such as fatigue, lack of sleep, limited support, or recent stressful events

Anyone can develop postpartum depression after childbirth. You might be at higher risk if you:

• Have a history of depression, bipolar disorder, or a family health history of these conditions
• Had a multiple birth (twins, triplets, or more)
• Gave birth while in your teens
• Had health problems during pregnancy
• Had preterm labor or other complications during childbirth
• Have a baby with special needs
• Have ever experienced domestic violence
• Are dealing with financial stress
• Had an unplanned pregnancy

Postpartum depression symptoms are more intense and last longer than the baby blues.

Symptoms may include:

• Feeling sad or empty most of the time
• Eating too much or too little
• Sleeping too much or too little
• Crying more than usual or for no clear reason
• Feeling unusually angry
• Pulling away from family and friends
• Feeling worried or anxious often
• Feeling little or no interest in your baby
• Constant doubts about your ability to care for your baby
• Thinking of harming yourself or your baby

If you have thoughts about suicide, or hurting yourself or your baby get help right away:

• Call 911 or go to your local emergency room
• Contact a crisis hotline. In the United States, you can reach the National Suicide and Crisis Lifeline at any time:
  • Call or text 988
  • Chat online with Lifeline Chat
  • TTY users: Use your preferred relay service or dial 711 then 988
• Veterans can contact the Veterans Crisis Line:
  • Call 988, then press 1
  • Text 838255
  • Chat online
• Call your mental health provider or other health care provider
• Reach out to a loved one or close friend

If these symptoms begin during pregnancy and continue after childbirth, it's called perinatal depression. Without treatment, it can affect bonding with your baby and may contribute to feeding or sleeping problems.

Very rarely, a new mother may develop postpartum psychosis, a medical emergency. Symptoms may include confusion, hallucinations (seeing or hearing things that aren't real), or dangerous behaviors. Call 911 or go to the nearest emergency room right away if this happens.

Your provider may diagnose postpartum depression using:

• Screening questions or questionnaires, such as those about your mood, sleep, and thoughts.
• A clinical evaluation based on your symptoms.
• Blood tests, if needed, to check for physical conditions such as thyroid disorders, that can cause or worsen depression.

If you think you have postpartum depression, talk with your provider. Treatments may include:

• Medicines, including antidepressants
• Talk therapy (counseling)

Tell your provider if you are breastfeeding so they can choose the safest treatment options.

Along with these treatment options, there are things you can do at home that may help you feel better, such as:

• Asking for help with caring for the baby and household chores
• Taking time for yourself
• Getting physical activity, such as walking
• Resting when the baby rests

You may be able to lower your risk for postpartum depression by:

• Talking with your provider during pregnancy about any history of depression
• Completing recommended screening questionnaires during pregnancy and after birth
• Getting support from family, friends, or support groups
• Attending early Physical changes so symptoms can be found and treated as soon as possible

Dept. of Health and Human Services Office on Women's Health