Postpartum Depression: How to Recognize the Signs
Here’s what to do if you’re struggling to adjust.

Bringing home and starting a new life with a baby is often considered one of the most amazing milestones in adulthood, so feeling any sort of sadness or dissatisfaction might make you feel ashamed or guilty.
But sadness after having a baby is more common than you might think, and many women feel some extent of postpartum blues in the year after delivery. Postpartum blues may come and go shortly in the weeks after childbirth, but postpartum depression is different. It can start any time in the first year after giving birth (it may not happen ASAP), may last months or longer, and is severe enough to prevent new moms from bonding with their babies.
“After having a baby, there are so many drastic changes to life, to your body, and life as you once knew it,” says Khadijah Watkins, MD, a psychiatrist at Weill Cornell Medicine.
The exhaustion and swirl of emotions associated with caring for a newborn can be a huge adjustment for many women, and it may affect self-esteem and stress management. Rapidly fluctuating hormone levels in the postpartum period can also make new moms more vulnerable to depression.
Symptoms of postpartum depression include the following:
Sadness
Anxiety
Despair
Irritability
Difficulty bonding with the baby
A lack of interest in things
And feeling unable to care for the baby or that nothing they do is “enough.”
Treating postpartum depression can include some combination of psychotherapy, medication, group therapy, and family therapy. Whether in a one-on-one or group setting, talk therapy may last just a few weeks or several months or longer.
“One of the challenges when you have postpartum depression is you feel like you are alone,” says New York City-based psychologist Ben Michaelis, PhD, “so having a group of other women that are experiencing similar symptoms can be quite therapeutic.”
Medications for postpartum depression are similar to those used for treating depression, but special consideration is given if the mother is breastfeeding. Certain antidepressants are safer to use while breastfeeding than others. (Learn more about the different types of antidepressants here.)
“The key thing is that there’s no one way to be a mom and there’s one way to be a new parent,” says Jennifer Hartstein, PsyD, a psychologist in New York City. “They’re going to have really great moments and really bad moments, and that’s okay, too.” If the bad moments start to outweigh the good, however, don’t hesitate to reach out for support.
Dr. Hartstein is the owner of Hartstein Psychological Services, a group psychotherapy practice in New York City.
Ben MichaelisDr. Michaelis is a clinical and media psychologist in New York City.
Khadijah WatkinsDr. Watkins is an assistant professor of psychiatry in the division of child and adolescent psychiatry at Weill Cornell Medicine and an assistant attending psychiatrist at NewYork-Presbyterian Hospital.
1
00:00:00,000 --> 00:00:02,600
[MUSIC]
2
00:00:02,600 --> 00:00:05,200
For women who are struggling
with postpartum depression,
3
00:00:05,200 --> 00:00:06,658
don't be afraid to ask for help.
4
00:00:06,658 --> 00:00:10,894
If something doesn't feel right, if you
don't feel right there's no harm in that.
5
00:00:10,894 --> 00:00:16,084
[MUSIC]
6
00:00:16,084 --> 00:00:20,859
Postpartum depression can present as
sad mood, really a lot of irritability,
7
00:00:20,859 --> 00:00:25,530
having a hard time bonding with their
babies, lack of interest in things.
8
00:00:25,530 --> 00:00:27,160
Really feeling like you're
doing everything you
9
00:00:27,160 --> 00:00:29,690
can to take care of yourself, to take care
of your family, take care of your baby.
10
00:00:29,690 --> 00:00:32,730
And then, feeling like it's not enough.
Women that have postpartum
11
00:00:32,730 --> 00:00:34,620
blues are usually able to function.
12
00:00:34,620 --> 00:00:38,560
Postpartum depression is usually more
severe, and it's more persistent.
13
00:00:38,560 --> 00:00:42,850
So, it can take longer, and it can really
affect their ability to bond with the baby
14
00:00:42,850 --> 00:00:46,140
and take care of the baby's needs.
After delivering a baby, women
15
00:00:46,140 --> 00:00:51,870
are particularly vulnerable to developing
depression due to the rapid and dramatic
16
00:00:51,870 --> 00:00:55,043
fluctuation of the hormone levels.
Postpartum depression doesn't happen
17
00:00:55,043 --> 00:00:56,554
right after you have your baby, I mean,
18
00:00:56,554 --> 00:00:59,370
there's that whole year period where
everbody's changing and growing.
19
00:00:59,370 --> 00:01:02,630
So, it can happen at any
point in that 12 months.
20
00:01:02,630 --> 00:01:03,990
After the birth of my daughter,
21
00:01:03,990 --> 00:01:08,000
I went through a prolonged two year
22
00:01:08,000 --> 00:01:12,650
depressive episode which may or
may not still be effecting me.
23
00:01:12,650 --> 00:01:15,958
It goes up and down.
After having a baby there are so
24
00:01:15,958 --> 00:01:21,450
many drastic changes to life, and to
your body, and life as you once knew it.
25
00:01:21,450 --> 00:01:25,890
It often is missed that this is
developing into a true depression.
26
00:01:25,890 --> 00:01:30,676
And there are lots of efforts now to
screen women for postpartum depression at
27
00:01:30,676 --> 00:01:34,808
their OBGYNs, at the pediatricians,
at the first early visits.
28
00:01:34,808 --> 00:01:38,879
Because it is not as apparent to the
person or the family members that this is
29
00:01:38,879 --> 00:01:40,440
truly a depression.
So
30
00:01:40,440 --> 00:01:45,470
postpartum depression is treated through
a combination of psychotherapy, and
31
00:01:45,470 --> 00:01:49,260
medication, and group therapy,
and sometimes family therapy.
32
00:01:49,260 --> 00:01:53,310
Postpartum depression is treated using a
class of medications that you would use to
33
00:01:53,310 --> 00:01:58,860
treat depression such as selective
serotonin reuptake inhibitors or SSRIs.
34
00:01:58,860 --> 00:02:01,340
The treatment for postpartum depression
35
00:02:01,340 --> 00:02:04,500
would depend on whether a woman
wants to breastfeed or not.
36
00:02:04,500 --> 00:02:08,600
There are a few medications within that
class that are safer in breastfeeding
37
00:02:08,600 --> 00:02:11,189
than the others.
One of the challenges when you have
38
00:02:11,189 --> 00:02:13,561
postpartum depression is
you feel like you're alone.
39
00:02:13,561 --> 00:02:18,379
So having a group of other women that
are experiencing similar symptoms can be
40
00:02:18,379 --> 00:02:21,181
quite therapeutic.
I think the key thing is,
41
00:02:21,181 --> 00:02:24,192
there's no one way to be a mom, and
there's no one way to be a new parent.
42
00:02:24,192 --> 00:02:26,831
And I think all moms
need to recognize that.
43
00:02:26,831 --> 00:02:30,155
And they're gonna have really great
moments and really bad moments, and
44
00:02:30,155 --> 00:02:31,320
that’s okay too.
45
00:02:31,320 --> 00:02:34,992
But not to hesitate to ask for help if
the bad moments are outweighing the good.
46
00:02:34,992 --> 00:02:39,956
[MUSIC]
Postpartum depression. Washington, DC: American College of Obstetricians and Gynecologists. (Accessed on January 10, 2021 at https://www.acog.org/Patients/FAQs/Postpartum-Depression.)
Postpartum depression: beyond the basics. Waltham, MA: UpToDate. (Accesed on November 29, 2017 at https://www.uptodate.com/contents/postpartum-depression-the-basics.) Postpartum depression facts. Washington, DC: National Institute of Health. (Accessed on January 10, 2021 at https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml.) Postpartum psychiatric disorders. Boston, MA: MGH Center for Women’s Mental Health. (Accessed on January 10, 2021 at https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/?doing_wp_cron=1511919133.5311920642852783203125.) What is postpartum depression & anxiety? Washington, DC: American Psychological Association. (Accessed on January 10, 2021 at http://www.apa.org/pi/women/resources/reports/postpartum-depression.aspx.)