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H H S Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health

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Depression During & After Pregnancy: A Resource for Women, Their Families, & Friends

Perinatal Depression – It’s More Than the Baby Blues

Many new mothers experience the Baby Blues. This is a very common reaction during the first few days after delivery. Symptoms include crying, worrying, sadness, anxiety, mood swings, trouble concentrating, difficulty sleeping, and not feeling yourself.

The Baby Blues is not the same as Perinatal Depression and does not require medical attention. With time, patience, and the support of family and friends, symptoms linked with the Baby Blues will usually disappear within a few days or within 1 to 2 weeks. If they don’t, it may be a sign of a bigger problem, and you should seek medical help

What Causes Perinatal Depression?

There are a number of reasons why you may get depressed. As a woman, your body undergoes many changes during and after pregnancy. You may experience mood swings. A new baby will change your sleeping schedule and your lifestyle. In addition, there are many pressures to be the perfect mother.

Some women have family members with depression, some women have had depression in their own past, and for some women, the cause is unclear. But for every woman who suffers Perinatal Depression, the causes are as unique as she is.

Who Is at Risk?

Perinatal Depression can affect any woman — regardless of age, race, income, culture, or education. It affects women who breastfeed and those who don’t. It affects women with healthy babies and those whose children are ill. It affects first-time mothers and those with more than one child. It affects women who are married and those who are not. Women who had problems during pregnancy—and those who didn’t— may experience depression. Because Perinatal Depression is a health problem, it is not the fault of any woman.

A family history of depression or bipolar disorder, a history of alcohol or drug abuse, a recent stressful event, relationship or financial problems, or a previous pregnancy with Perinatal Depression increases a woman’s chances of having Perinatal Depression.

Types of Perinatal Depression

Even before the arrival of the baby, some women experience Depression During Pregnancy. Pregnant women commonly face a large number of challenges, including morning sickness, weight gain, and mood swings. Symptoms such as feeling really tired, appetite changes and poor sleep are often dismissed as “just part of pregnancy,” but if the things you do every day are affected, you should consider seeking help. Whether the pregnancy was planned or unexpected, the changes that your body and emotions go through during pregnancy are very real — and so are the risks of Perinatal Depression during this time.

Depression During and After Pregnancy

About one in eight women suffers a form of Perinatal Depression known as Postpartum Depression. Symptoms can begin at birth or any time in the first year after giving birth.

Common symptoms for perinatal depression include:

  • Sad feelings
  • Feeling very anxious or worrying too much
  • Being irritable or cranky
  • Trouble sleeping (even when tired) or sleeping too much
  • Trouble concentrating or remembering things
  • Trouble making decisions
  • Loss of interest in caring for yourself (for example, dressing, bathing, fixing hair)
  • Loss of interest in food, or overeating
  • Not feeling up to doing everyday tasks
  • Frequent crying, even about little things
  • Showing too much (or not enough) concern for the baby
  • Loss of pleasure or interest in things you used to enjoy (including sex)

A very small number of women (one or two in 1000) suffer a rare and severe form of Perinatal Depression called Postpartum Psychosis. Women who have a bipolar disorder or other psychiatric problem may have a higher risk for developing this form of Perinatal Depression.

Symptoms of Postpartum Psychosis may include:

  • Extreme confusion
  • Hopelessness
  • Cannot sleep (even when exhausted)
  • Refusing to eat
  • Distrusting other people
  • Seeing things or hearing voices that are not there
  • Thoughts of hurting yourself, your baby, or others

If you or someone you know fits this description, please seek medical help immediately. This is a medical emergency requiring URGENT care.

Image of a pregnant woman.

I was so excited I decorated the nursery months before the baby arrived. But when she came, it was not a dream. I had no energy to smile or even to cry. I didn’t even want to pick her up. This was not how I thought it was going to be, and I was ashamed of how I felt.

I just wish that I could laugh and be happy. When will my sadness go away?