Postpartum Depression. Signs, Symptoms, and When to Start Therapy.
You just had a baby, and in the midst of the excitement of this new chapter, you are noticing feelings you did not expect: unexplained fear, sadness, and anger, or like you are watching your life from far away. If that is you, you are not broken, you are not a “bad mom,” and you are definitely not alone.
What is postpartum depression?
Postpartum depression (PPD) is a kind of depression that shows up during pregnancy or anytime in the first year after birth. It affects your mood, body, and thoughts. It is more than just feeling tired or emotional.
Common experiences include:
Feeling sad, empty, or numb most days
Crying a lot and not knowing why
Anxiety that will not turn off
Feeling guilty or like a bad parent
Feeling disconnected from your baby or your own life
Hospitals like Mayo Clinic and Cleveland Clinic say the same thing: postpartum depression is common, serious, and treatable. It is not a character flaw.
What are the types of postpartum depression?
You will see three main groups of mood changes in the postpartum period.
Postpartum blues or baby blues
Baby blues are very common in the first 1 to 2 weeks after birth. You might have:
Mood swings
Tearfulness
Feeling overwhelmed
Irritability
Baby blues usually start a few days after birth and slowly improve on their own within about two weeks. Therapy can still be a great place to process this too! Becoming a new parent is life-changing. It is both exciting and hard, and it never hurts to have a safe space to process the emotions connected to your journey!
Postpartum depression
Postpartum depression is stronger and lasts longer than baby blues. Symptoms last more than two weeks, make it hard to function, and do not go away with a nap or a good day.
PPD can start during pregnancy, soon after birth, or slowly build in the first year.
Postpartum psychosis
Postpartum psychosis is rare but very serious. It is an emergency and needs hospital care right away. It can include hallucinations, delusions, extreme confusion, or thoughts of harming yourself or your baby. If you see these signs, call emergency services or go to the ER.
Who is affected by postpartum depression?
PPD can affect:
Birth mothers
Surrogates and gestational carriers
Adoptive parents
Non birthing parents and partners
It shows up across all ages, incomes, and backgrounds. Having a baby does not protect you from depression.
How do I know if I have baby blues or postpartum depression?
Baby blues:
Start within a few days
Go up and down
Improve within about two weeks
Postpartum depression:
Lasts more than two weeks
Feels heavier or more hopeless
Gets in the way of daily life and bonding
How long does postpartum depression last?
There is no one timetable. With postpartum depression therapy and sometimes medication, many parents find relief within a few months, but factors like physical health, overall stress triggers, and your support system can impact this.
What factors increase my risk of being depressed after the birth of my child?
Anyone can have PPD and there is no one “cause.” Risk factors of increased likelihood of PPD include:
Having a history of depression, anxiety, OCD, PMDD, or bipolar disorder
Has had PPD after a previous pregnancy
Feeling alone or unsupported
Having relationship or money stress
Has had a traumatic birth or NICU stay
Having a baby with medical or feeding challenges
Struggling with perfectionism or people pleasing
These are risk factors, not guarantees. They simply mean it is extra important to plan for support.
Symptoms and Causes
What are the symptoms of postpartum depression?
Symptoms can include:
Sadness, emptiness, or numbness most days
Irritability, anger, or a short fuse
Anxiety or panic attacks
Sleep problems, even when you could sleep
Loss of interest in things you used to enjoy
Trouble bonding with your baby
Guilt or feeling like you are a failure
Changes in appetite
Trouble focusing or making decisions
Intrusive scary thoughts
Thoughts of self harm or wishing you were not here
What causes postpartum depression?
There is no single cause. Most experts see postpartum depression as a mix of:
Hormonal shifts after birth
Changes in brain chemistry from stress and sleep loss
Previous mental health struggles
Life stress, trauma, and lack of support
You did not do anything wrong to cause this. Your brain and body are trying to cope with a huge change.
Can postpartum depression affect my baby?
Long term untreated PPD can affect bonding, baby sleep, feeding rhythms, and overall stress in the home. However, if you get support and pursue healing at your own pace to get yourself to a space in which you can be present for your child in healthy ways, your child is going to be just fine. When you get support, your baby benefits too. Repair and showing up over time matter more than being a perfect parent. No parent is perfect, and modeling how to get help is so healthy for your children to see and be a part of throughout their life.
Diagnosis and Tests
How is postpartum depression diagnosed?
A provider such as an OB, midwife, primary care doctor, psychiatrist, or therapist will:
Ask about your mood, anxiety, sleep, energy, and daily life
Ask about your bond with your baby and any scary thoughts
Review your medical and mental health history
Sometimes order blood work to rule out things like thyroid issues or anemia
How do doctors screen for postpartum depression?
Many clinics use simple questionnaires such as the Edinburgh Postnatal Depression Scale. You may fill one out in pregnancy, at a postpartum checkup, or at a baby well visit. High scores tell the provider you may need more support.
Management and Treatment
How is postpartum depression treated?
Treatment often includes a mix of:
Postpartum depression therapy
Medication when needed
Support groups
Lifestyle and practical changes
At Emberly Counseling, we use trauma informed approaches like CBT, EMDR, and IFS parts-informed work, adapted for the perinatal period.
What medications can I take for postpartum depression?
Only a prescriber can choose medication for you, but in general:
Many antidepressants are considered safe to use while breastfeeding
A small amount can pass into milk, but risks are usually low
Your provider will weigh the risk of medication against the risk of untreated depression
Therapy and medication often work well together. At Emberly Counseling we cannot prescribe, but we can help you talk through options and prepare for appointments.
What are ways to cope with postpartum depression?
Along with therapy, helpful coping steps include:
Breaking tasks into tiny steps
Using a simple daily routine
Asking for specific help from loved ones
Limiting social media comparison
Practicing gentler self talk
Doing small things that feel soothing like stepping outside or drinking water
What happens if postpartum depression isn't treated?
If PPD is not treated, it can:
Last longer and hit harder
Increase the risk of future depression
Strain relationships and co parenting
Make bonding with your baby harder
This is not to scare you. It is to say that your pain deserves attention.
Lifestyle and practical tips
Some everyday changes that support recovery:
Protect any sleep you can get (even if it’s just a few hours here and there- this is normal as a new parent, and this season of such little sleep will pass- and your body will also adapt).
Keep easy snacks and water nearby
Move your body in gentle ways
Don’t hold yourself to an unrealistic standard of perfection
Build a small circle of people you can be honest with
These are not cures, but they make therapy and other supports more effective.
Coping and support
Good support has three layers:
Professional support from a therapist or doctor
Personal support from family and friends who can help with chores and care
Peer support from other parents who understand
If you don’t have external support, a therapist can help you explore ways to find it. If all you can do is show up to a session and say, "I am not okay," that is enough.
Outlook / Prognosis
What is the outlook for women with postpartum depression?
The outlook is very hopeful. Most people with postpartum depression feel much better with treatment. Recovery is not a perfect straight line. There are good days and hard days, and over time, there are more good ones.
Prevention
Can postpartum depression be prevented?
We cannot fully prevent PPD, but we can lower the risk by:
Seeing a therapist in pregnancy
Making a postpartum plan for meals, chores, and night help
Setting boundaries around visitors and social expectations
Learning early signs of PPD so you can reach out sooner
Living With
When should I seek professional medical treatment for symptoms related to postpartum depression?
Reach out to a doctor or therapist if:
Your mood is low most days for more than two weeks
Anxiety or scary thoughts are hard to control
You feel like you are just surviving each day
You have thoughts of self harm or harming your baby
You do not need to wait until you are in crisis.
Do I have postpartum anxiety or postpartum depression?
Many people have both. Postpartum anxiety looks more like constant worry and physical tension. Postpartum depression looks more like sadness, numbness, and low motivation. Therapy for postpartum depression and anxiety usually addresses both.
How can I help someone with postpartum depression?
You can:
Believe them and avoid minimizing
Offer practical help like meals or childcare
Encourage them to talk with a doctor or therapist
Check in regularly, even with simple texts
If they mention self harm or harming the baby, take it seriously and help them reach professional or emergency help.
Postpartum Depression FAQs
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Hormones shift, sleep falls apart, life stress rises, and old wounds or patterns can get triggered. All of that can come together in a way that overwhelms your system.
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PPD can start in pregnancy, right after birth, or anytime in the first year. It does not always show up right away.
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With support, many people feel relief over a few months. Without support, it may last longer. However, many factors impact this shifting the timeline for each person. Reaching out early usually makes recovery easier.
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Tell someone you trust, schedule an appointment with a provider, be honest about how bad it feels, and let therapy be a place where you do not have to hold it all by yourself.
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Very common! Studies suggest around 1 in 7 to 1 in 9 new mothers, plus many partners, experience postpartum depression. You are not alone in this.
Postpartum Depression Therapy Session
In a postpartum depression therapy session, you can expect:
A gentle check in about how you have been
Simple grounding so your nervous system can settle a bit
Time to unpack what feels heaviest right now
One or two small, doable ideas to try between sessions
You do not have to show up with everything figured out. You can come exactly as you are...joining from telehealth wherever is most convenient for you, and your baby can even join session with you if that is what is most doable for your right now! If you are in Pennsylvania and looking for support with postpartum depression, therapy at Emberly Counseling can be a place to breathe again and feel less alone.
