While pregnancy, childbirth, and the postpartum period are often joyful times, many moms also deal with intense, negative emotions during and after pregnancy. They may experience lingering sadness, anger, or a disconnect from their baby.
Once known as postpartum depression, it’s now called peripartum depression or perinatal depression because it may begin during pregnancy.
With peripartum depression, symptoms can be severe, last weeks or months, and cause functional impairment. It’s a serious mental health condition that requires treatment to get better.
Knowing when to seek help for peripartum depression is important. Left untreated, peripartum depression could put both you and your baby’s development and life at risk.
What Is Peripartum Depression?
Peripartum depression or perinatal depression is depression that manifests during pregnancy or up to one year postpartum. The medical term is major depressive disorder (MDD) with peripartum onset.
The condition was previously known as postpartum depression. But for many people, symptoms begin during pregnancy itself — hence the current terms peripartum or perinatal.
People with peripartum depression experience significant levels of distress. The condition can affect their ability to function.
Is Peripartum Depression the Same as the Baby Blues?
Peripartum depression is very different than the “baby blues.”
The baby blues are symptoms like irritability, anxiety, fatigue, and unexplained crying that happen after childbirth. According to the American Psychological Association, up to 85% of new mothers experience these mood changes.
The baby blues don’t stop you from taking care of yourself or your baby. They also tend to go away on their own within a week or two after birth.
Peripartum depression, on the other hand, can make it difficult for mothers to take care of themselves and their baby. The symptoms also last longer than two weeks.
How Common Is Peripartum Depression?
Peripartum depression is very common. According to the National Alliance on Mental Illness (NAMI), 1 in 7 women experiences a major depressive episode during or after pregnancy. As many as half of those episodes happen during pregnancy.
All too often, women with peripartum depression suffer in silence because it’s a largely undiagnosed condition. A 2024 study in BMC Public Health reported that 50% of women had undiagnosed postpartum depression.
A failure to screen for peripartum depression can lead to undiagnosed cases. Also, many people often don’t say anything about peripartum depression because they don’t want others to think they’re a “bad mother.” They may feel guilty, ashamed, or embarrassed by what they’re feeling.
But you’re not a bad mother if you have peripartum depression, and you shouldn’t feel ashamed. Peripartum depression isn’t your fault and is very common. The best thing you can do for you and your baby is to seek treatment and reach out for support.
When Should You Seek Help for Peripartum Depression?
If you’re experiencing peripartum depression, it’s important to seek help right away.
Symptoms of peripartum depression are more severe than those associated with baby blues. Peripartum depression symptoms are emotionally and physically debilitating, making it hard for you to care for yourself and your baby. And they last longer than typical baby blues — sometimes up to two years postpartum.
What Are the Symptoms of Peripartum Depression?
It’s important to tell your ob-gyn or doctor if you have unusual thoughts or feelings during pregnancy or after giving birth. These include:
- Changes in appetite.
- Fear of hurting the baby or yourself.
- Feeling angry.
- Feeling empty or numb.
- Frequent crying and sadness, often for no reason.
- Increased fatigue or loss of energy.
- Lack of interest in activities that you once enjoyed.
- Not feeling connected to your baby.
- Thinking you’re not a good mom.
- Thoughts of death or suicide.
- Trouble sleeping or sleeping too much.
- Withdrawing from loved ones.
What is postpartum psychosis?
Postpartum psychosis is a rare psychiatric emergency that can occur after childbirth. People with postpartum psychosis may experience:
- Confusion.
- Delusions (false thoughts or beliefs).
- Hallucinations (seeing or hearing things that aren’t there).
- Mania (an elated feeling that may be out of touch with reality).
- Paranoia.
- Severe mood changes.
According to NAMI, postpartum psychosis occurs in 1 to 2 out of 1,000 women.
When to call your provider about peripartum depression
Call your health care provider right away if:
- You have had several of the symptoms above for more than two weeks.
- You have thoughts of suicide or thoughts of harming your child.
- Your symptoms are getting worse.
- You’re experiencing hallucinations.
- You’re having problems with daily activities or taking care of yourself or your baby.
How Is Peripartum Depression Treated?
Treatment for peripartum depression can include psychotherapy, medicine, or a combination of both.
Another important but often overlooked factor is the level of support after childbirth. Reaching out to loved ones and friends for help during this difficult time can go a long way.
Proper treatment can help resolve the symptoms of peripartum depression in most people.
Therapy for peripartum depression
Also known as talk therapy or counseling, therapy usually involves meeting with a licensed medical professional to discuss what you’re feeling. Types of effective talk therapy include:
- Cognitive behavioral therapy (CBT) — This treatment centers around changing thoughts and behaviors to help manage a condition. CBT is often used for treating anxiety and depression.
- Interpersonal therapy — Also common for depression treatment, interpersonal therapy focuses on social and personal relationships. It aims to help people improve communication in their relationships and develop support systems, among other goals.
Support groups and parenting classes may also help you manage your symptoms and better care for your baby.
Medications for peripartum depression
Your health care provider may also recommend medications to help with your symptoms. These include:
Antidepressants
Your doctor may prescribe an antidepressant to treat your depression. You can use them alone or in combination with therapy. Common antidepressants for peripartum depression include:
- Selective serotonin reuptake inhibitors (SSRIs).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs).
- Tricyclic antidepressants (TCAs).
Antidepressants usually take time to work — a month or longer in most cases.
As with any medication, antidepressants have risks and benefits. During pregnancy and while breastfeeding, weigh these against the risks of untreated depression and anxiety. Let your doctor know if you’re pregnant and planning to breastfeed.
Brexanolone
Brexanolone was the first drug designed specifically for peripartum depression. Unlike existing antidepressants, brexanolone mimics a hormone naturally produced in the body.
Brexanolone requires an IV infusion that occurs during a stay in the hospital. You should talk to your ob-gyn about whether brexanolone is right for you.
Zuranolone
Zuranolone is the first oral medication approved for peripartum depression in the United States. It acts similarly to brexanolone in the body. You take it once daily for two weeks.
At UPMC Magee-Womens, we provide care for women with peripartum depression. We can provide the care you need to relieve your symptoms. For more information on the services we provide, visit our website.
Editor's Note: This article was originally published on , and was last reviewed on .
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Pathophysiological Mechanisms Implicated in Postpartum Depression. Frontiers in Neuroendocrinology. January 2019. Link.
What is Postpartum Depression? American Psychiatric Association. Link.
Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression. Morbidity and Mortality Weekly Report. May 15, 2020. Centers for Disease Control and Prevention. Link.
Depression Among Women. Centers for Disease Control and Prevention. Link.