During and After Pregnancy
The National Women's Health Information Center
What is depression?
Depression can be described as feeling sad, blue, unhappy, miserable,
or down in the dumps. Most of us feel this way at one time or another
for short periods. But true clinical depression is a mood disorder
in which feelings of sadness, loss, anger, or frustration interfere
with everyday life for an extended time. Depression can be mild, moderate,
or severe. The degree of depression, which your doctor can determine,
influences how you are treated.
common is depression during and after pregnancy?
Depression that occurs during pregnancy or within a year after delivery
is called perinatal depression. The exact number of women with depression
during this time is unknown. But researchers believe that depression
is one of the most common complications during and after pregnancy.
Often, the depression is not recognized or treated, because some
normal pregnancy changes cause similar symptoms and are happening
at the same time. Tiredness, problems sleeping, stronger emotional
reactions, and changes in body weight may occur during pregnancy
and after pregnancy. But these symptoms may also be signs of depression.
There may be a number of reasons why a woman gets depressed. Hormone
changes or a stressful life event, such as a death in the family,
can cause chemical changes in the brain that lead to depression.
Depression is also an illness that runs in some families. Other
times, its not clear what causes depression.
During pregnancy, these factors may increase a womans chance
of depression or substance abuse
Family history of mental illness
Little support from family and friends
Anxiety about the fetus
Problems with previous pregnancy or birth
Marital or financial problems
Young age (of mother)
Depression after pregnancy is called postpartum depression or peripartum
depression. After pregnancy, hormonal changes in a woman's body
may trigger symptoms of depression. During pregnancy, the amount
of two female hormones, estrogen and progesterone, in a woman's
body increases greatly. In the first 24 hours after childbirth,
the amount of these hormones rapidly drops back down to their normal
non-pregnant levels. Researchers think the fast change in hormone
levels may lead to depression, just as smaller changes in hormones
can affect a woman's moods before she gets her menstrual period.
levels of thyroid hormones may also drop after giving birth. The
thyroid is a small gland in the neck that helps to regulate your
metabolism (how your body uses and stores energy from food). Low
thyroid levels can cause symptoms of depression including depressed
mood, decreased interest in things, irritability, fatigue, difficulty
concentrating, sleep problems, and weight gain. A simple blood test
can tell if this condition is causing a woman's depression. If so,
thyroid medicine can be prescribed by a doctor.
factors that may contribute to postpartum depression include:
tired after delivery, broken sleep patterns, and not enough rest
often keeps a new mother from regaining her full strength for weeks.
Feeling overwhelmed with a new, or another, baby to take care of
and doubting your ability to be a good mother.
Feeling stress from changes in work and home routines. Sometimes,
women think they have to be "super mom" or perfect, which
is not realistic and can add stress.
Having feelings of loss loss of identity of who you are,
or were, before having the baby, loss of control, loss of your pre-pregnancy
figure, and feeling less attractive.
Having less free time and less control over time. Having to stay
home indoors for longer periods of time and having less time to
spend with the your partner and loved ones.
What are symptoms of depression?
Any of these symptoms during and after pregnancy that last longer
than two weeks are signs of depression:
restless or irritable
Feeling sad, hopeless, and overwhelmed
Crying a lot
Having no energy or motivation
Eating too little or too much
Sleeping too little or too much
Trouble focusing, remembering, or making decisions
Feeling worthless and guilty
Loss of interest or pleasure in activities
Withdrawal from friends and family
Having headaches, chest pains, heart palpitations (the heart beating
fast and feeling like it is skipping beats), or hyperventilation
(fast and shallow breathing)
After pregnancy, signs of depression may also include being afraid
of hurting the baby or oneself and not having any interest in the
is the difference between baby blues,postpartum depression,
and postpartum psychosis?
The baby blues can happen in the days right after childbirth and
normally go away within a few days to a week. A new mother can have
sudden mood swings, sadness, crying spells, loss of appetite, sleeping
problems, and feel irritable, restless, anxious, and lonely. Symptoms
are not severe and treatment isnt needed. But there are things
you can do to feel better. Nap when the baby does. Ask for help
from your spouse, family members, and friends. Join a support group
of new moms or talk with other moms.
depression can happen anytime within the first year after childbirth.
A woman may have a number of symptoms such as sadness, lack of energy,
trouble concentrating, anxiety, and feelings of guilt and worthlessness.
The difference between postpartum depression and the baby blues
is that postpartum depression often affects a womans well-being
and keeps her from functioning well for a longer period of time.
Postpartum depression needs to be treated by a doctor. Counseling,
support groups, and medicines are things that can help.
psychosis is rare. It occurs in 1 or 2 out of every 1000 births
and usually begins in the first 6 weeks postpartum. Women who have
bipolar disorder or another psychiatric problem called schizoaffective
disorder have a higher risk for developing postpartum psychosis.
Symptoms may include delusions, hallucinations, sleep disturbances,
and obsessive thoughts about the baby. A woman may have rapid mood
swings, from depression to irritability to euphoria.
steps can I take if I have symptoms of depression during pregnancy
or after childbirth?
Some women dont tell anyone about their symptoms because they
feel embarrassed, ashamed, or guilty about feeling depressed when
they are supposed to be happy. They worry that they will be viewed
as unfit parents. Perinatal depression can happen to any woman.
It does not mean you are a bad or not together mom.
You and your baby dont have to suffer. There is help.
are different types of individual and group talk therapies
that can help a woman with perinatal depression feel better and
do better as a mom and as a person. Limited research suggests that
many women with perinatal depression improve when treated with anti-depressant
medicine. Your doctor can help you learn more about these options
and decide which approach is best for you and your baby. The next
section contains more detailed information about available treatments.
to your doctor or midwife if you are having symptoms of depression
while you are pregnant or after you deliver your baby. Your doctor
or midwife can give you a questionnaire to test for depression and
can also refer you to a mental health professional who specializes
in treating depression.
are some other helpful tips:
to get as much rest as you can. Try to nap when the baby naps.
Stop putting pressure on yourself to do everything. Do as much as
you can and leave the rest!
Ask for help with household chores and nighttime feedings. Ask your
husband or partner to bring the baby to you so you can breastfeed.
If you can, have a friend, family member, or professional support
person help you in the home for part of the day.
Talk to your husband, partner, family, and friends about how you
Do not spend a lot of time alone. Get dressed and leave the house.
Run an errand or take a short walk.
Spend time alone with your husband or partner.
Talk with other mothers, so you can learn from their experiences.
Join a support group for women with depression. Call a local hotline
or look in your telephone book for information and services.
Dont make any major life changes during pregnancy. Major changes
can cause unneeded stress. Sometimes big changes cannot be avoided.
When that happens, try to arrange support and help in your new situation
ahead of time.
How is depression treated?
There are two common types of treatment for depression.
therapy. This involves talking to a therapist, psychologist, or
social worker to learn to change how depression makes you think,
feel, and act.
Medicine. Your doctor can give you an antidepressant medicine to
help you. These medicines can help relieve the symptoms of depression.
Women who are pregnant or breastfeeding should talk with their doctors
about the advantages and risks of taking antidepressant medicines.
Some women are concerned that taking these medicines may harm the
baby. A mothers depression can affect her babys development,
so getting treatment is important for both mother and baby. The
risks of taking medicine have to be weighed against the risks of
depression. It is a decision that women need to discuss carefully
with their doctors. Women who decide to take antidepressant medicines
should talk to their doctors about which antidepressant medicines
are safer to take while pregnant or breastfeeding.
effects can untreated depression have?
Depression not only hurts the mother, but also affects her family.
Some researchers have found that depression during pregnancy can
raise the risk of delivering an underweight baby or a premature
infant. Some women with depression have difficulty caring for themselves
during pregnancy. They may have trouble eating and wont gain
enough weight during the pregnancy; have trouble sleeping; may miss
prenatal visits; may not follow medical instructions; have a poor
diet; or may use harmful substances, like tobacco, alcohol, or illegal
depression can affect a mothers ability to parent. She may
lack energy, have trouble concentrating, be irritable, and not be
able to meet her childs needs for love and affection. As a
result, she may feel guilty and lose confidence in herself as a
mother, which can worsen the depression. Researchers believe that
postpartum depression can affect the infant by causing delays in
language development, problems with emotional bonding to others,
behavioral problems, lower activity levels, sleep problems, and
distress. It helps if the father or another caregiver can assist
in meeting the needs of the baby and other children in the family
while mom is depressed.
children deserve the chance to have a healthy mom. All moms deserve
the chance to enjoy their life and their children. Dont suffer
alone. If you are experiencing symptoms of depression during pregnancy
or after having a baby, please tell a loved one and call you doctor
or midwife right away.
More Information . . .
You can find out more about depression during and after pregnancy
by contacting the National Women's Health Information Center (NWHIC)
at 1-800-994-9662 or the following organizations.
Institute of Mental Health, NIH, HHS
Phone: (301) 496-9576
Internet Address: http://www.nimh.nih.gov
Mental Health Information Center, SAMHSA, HHS
Phone: (800) 789-2647
Internet Address: http://www.mentalhealth.org
Phone: (800) 374-2721
Internet Address: http://www.apa.org
Mental Health Association
Phone: (800) 969-NMHA
Internet Address: http://www.nmha.org
Education for Parents
Phone: (805) 564-3888
Internet Address: http://www.sbpep.org
Phone: (805) 967-7636
Internet Address: http://www.postpartum.net
The Depression During and After Pregnancy FAQ has been reviewed
by Catherine Roca, Chief, Womens Programs, National Institute
of Mental Health, National Institutes of Health (NIH).
information presented on this site is intended solely as a general
educational aid, and is neither medical nor healthcare advice for
any individual problem, nor a substitute for medical or other professional
advice and services from a qualified healthcare provider familiar
with your unique circumstances. Always seek the advice of your physician
or other qualified healthcare professional regarding any medical
condition and before starting any new treatment.