Postpartum Depression Is Underreported

By Richard Asa and Temma Ehrenfeld @temmaehrenfeld
February 08, 2023
Postpartum Depression Is Underreported

Don’t hide your postpartum depression symptoms. There’s new help for women who have lingering mood symptoms before or after a birth.

If you’re feeling depressed during your pregnancy or following birth, don’t keep it a secret.

Having a child should bring joy. But it is also a big challenge to your body, self-confidence, and relationships. It’s common to get the baby blues for about two weeks. After that, you’ll be sleep-deprived, and you may worry about your baby, feel you’re not getting enough help (or the right kind of help), and sometimes wonder if you can handle all this.

Postpartum depression is more severe. But women often don’t recognize quickly that it’s happening. Be your own best friend: Ask for help if you’ve fallen into a mood that isn’t like your usual state for more than two weeks at a stretch.


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Help for postpartum depression

The U.S. Preventive Services Task Force (USPSTF), a panel of experts, recommends two areas of therapy for new mothers who become depressed. Cognitive behavioral therapy focuses on changing thought patterns. Therapy can also delve into how you are relating to others.

The Food and Drug Administration has also approved a medication specifically for postpartum depression. It must be injected while you are under medical supervision.

Your OB/GYN, nurse, or medical provider will probably ask if you are experiencing depression symptoms, such as feeling numb when you are with your baby.

An earlier USPSTF report suggested that doctors screen new mothers for depression because it is so common and undertreated. Up to one in seven women develop symptoms during pregnancy or the first year after delivery, but up to half of those women may hide their feelings.

Do you have just the “baby blues”?

During your pregnancy, female hormone (estrogen and progesterone) levels are at their highest. Levels drop to normal within the first 24 hours after you give birth. Thyroid hormone levels also drop after childbirth. Sudden changes in these hormones may lead to depression.

Around three to five days after birth, the hormonal changes can cause crying, anxiety, irritability and restlessness, or a feeling of being overwhelmed. That feeling, called baby blues, hits up to 80 percent of mothers. It might last for a few hours a day and fade within about two weeks.

Symptoms of postpartum depression

If your baby blues lasts longer than two weeks, talk to your doctor. Don’t wait for your next checkup.

Symptoms of postpartum may include:

  • You cry often, feeling hopeless, sad, worthless, or alone in life.
  • You question whether you made the right decision to have your baby and think you’re not doing a good job.
  • You don’t feel close to your baby.
  • You lose your appetite.
  • You have panic attacks, with heavy breathing.
  • You’re angry and ready for a fight.

Postpartum depression can set in up to a month after delivery and last for years. Although it was thought to end after a year, evidence based on almost 5,000 mothers has found that as many as a quarter of mothers struggled with their mood three years after delivery.

Risk factors for postpartum depression

If you have bipolar disorder, depression, or anxiety, your risk of mood changes following birth rise by about a third. If you had depression symptoms after a previous birth, it’s also likely to happen again. Family history of postpartum depression counts, too.  

Your baby needs you to speak up. Your depression affects your family. Evidence suggests, for example, that a mother’s depression interferes with breastfeeding and makes her less likely to notice and respond to a happy baby face.

Studies have shown that depression during pregnancy can increase the risk of problems during delivery and lead to low birth weights and premature babies.


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February 08, 2023

Reviewed By:  

Christopher Nystuen, MD, MBA and Janet O'Dell, RN