Postpartum Depression
Frequently Asked Questions Expand All
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About 2–3 days after childbirth, some people begin to feel depressed, anxious, and upset. They may feel angry with the new baby, their partners, or their other children. They may also
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cry for no clear reason
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have trouble sleeping, eating, and making choices
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question whether they can handle caring for a baby
These feelings, often called the baby blues, may come and go in the first few days after childbirth.
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The baby blues usually get better within a few days or 1–2 weeks without any treatment.
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Postpartum depressionis a type of depression that causes intense feelings of sadness, anxiety, or despair that keep people from being able to do their daily tasks.
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Postpartum depression can occur up to 1 year after having a baby, but it most commonly starts about 1–3 weeks after childbirth.
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Postpartum depression probably is caused by a combination of factors. These factors include the following:
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Changes in hormone levels—Levels of estrogen and progesterone decrease sharply in the hours after childbirth. These changes may trigger depression in the same way that smaller changes in hormone levels trigger mood swings and tension before menstrual periods
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History of depression—People who have had depression at any time—before, during, or after pregnancy—or who currently are being treated for depression have an increased risk of developing postpartum depression.
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Emotional factors—Feelings of doubt about pregnancy are common. If the pregnancy is not planned or is not wanted, this can affect the way a couple feels about the pregnancy and the fetus. Even when a pregnancy is planned, it can take a long time to adjust to the idea of having a new baby. Parents of babies who are sick or who need to stay in the hospital may feel sad, angry, or guilty.
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Fatigue—Fatigue (being very tired) may be a major contributor to postpartum depression. Many people feel very tired after giving birth, and it can take weeks to regain strength and energy. Recovery can take even longer after cesarean birth.
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Lifestyle factors—Lack of support from others and stressful life events, such as a recent death of a loved one, a family illness, or moving to a new city, can greatly increase the risk of postpartum depression.
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Call your obstetrician–gynecologist (ob-gyn) or another health care professional right away If you think you may have postpartum depression, or if your partner or family members are concerned that you do. Do not wait until your postpartum checkup to talk with your ob-gyn.
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Postpartum depression can be treated with medications, including zuranolone and antidepressents. Talk therapy also is used to treat depression, sometimes with medications.
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Zuranolone is the first medication approved by the U.S. Food and Drug Administration for treating postpartum depression in adults. It is taken by mouth for 14 days.
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Yes. Common side effects include dizziness, fatigue, drowsiness, diarrhea, cold-like symptoms, and urinary tract infections (UTIs). Also, you should use birth control during treatment and for 1 week after the last dose. It’s important to avoid pregnancy because this medication may cause harm to a fetus. In addition, you should avoid
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driving or other tasks that require you to be alert (avoid these tasks for 12 hours after each dose)
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alcohol, opioid medication, some antidepressants, and some medications for anxiety, seizures, and other problems with the nervous system
Talk with your ob-gyn about all the medications you take.
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Zuranolone passes into breast milk. It’s not clear how the medication affects milk production or breastfed babies. If you are breastfeeding, talk with your ob-gyn about your options. You may be able to continue breastfeeding for the 14 days of treatment. Or you may decide to pause breastfeeding and go back to it after you are 1 week past your last dose of zuranolone.
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Antidepressants are medications that work to balance the chemicals in the brain that control moods. There are many types of antidepressants. Drugs sometimes are combined when needed to get the best results. It may take 3–4 weeks of taking the medication before you start to feel better.
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Antidepressants can cause side effects, but most are temporary and go away after a short time. If you have severe or unusual side effects that affect daily life, call your ob-gyn or another health care professional. You may need to try another type of antidepressant. If your depression worsens soon after starting medication or if you have thoughts of hurting yourself or others, call your ob-gyn, another health care professional, or emergency medical services right away.
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Antidepressants pass into breast milk. The levels of medication found in breast milk generally are very low. Breastfeeding has many benefits for both you and your baby. Deciding to take an antidepressant while breastfeeding involves weighing these benefits against the potential risks of your baby being exposed to the medication in your breast milk. Talk with your ob-gyn about breastfeeding while you’re taking an antidepressant.
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In talk therapy (also called psychotherapy), you and a mental health professional talk about your feelings and discuss how to manage them. Sometimes, therapy is needed for only a few weeks, but it may be needed for a few months or longer.
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You may have one-on-one therapy with just you and the therapist or group therapy where you meet with a therapist and other people with conditions similar to yours. Another option is family or couples therapy, in which you and your family members or your partner may work with a therapist.
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If you have a history of depression at any time in your life or if you are taking an antidepressant, tell your ob-gyn early in your prenatal care. Ideally, you should tell them before you get pregnant. They may suggest that you begin treatment right after you give birth to prevent postpartum depression.
If you were taking antidepressants before pregnancy, your ob-gyn can help you decide whether to continue taking medication during your pregnancy.
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Support groups can be found at local hospitals, family planning clinics, or community centers. The hospital where you gave birth or your ob-gyn may be able to help you find a support group. Useful information about postpartum depression can be found on the following websites:
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Antidepressants: Medications that are used to treat depression.
Baby Blues: Normal feelings of sadness, fear, anger, or anxiety that start about 3 days after childbirth and usually get better within 1 to 2 weeks without any treatment.
Birth Control: Devices or medications used to prevent pregnancy. Also called contraception.
Cesarean Birth: Birth of a fetus from the uterus through an incision (cut) made in the abdomen.
Estrogen: A sex hormone made in the ovaries.
Fetus: The stage of human development beyond 8 completed weeks after fertilization.
Hormone: A substance made in the body that controls the function of cells or organs.
Menstrual Periods: The monthly shedding of blood and tissue from the uterus. Also called menstruation.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with medical and surgical training and education in the female reproductive system.
Postpartum Depression: A type of depressive mood disorder that develops in the first year after the birth of a child.
Prenatal Care: Health care during pregnancy.
Progesterone [proh-JES-tuh-rohn]: A sex hormone that is made in the ovaries and prepares the lining of the uterus for pregnancy.
Psychotherapy: Talking with a licensed mental health care professional to find ways to cope with or change troubling emotions, thoughts, and behaviors.
Urinary Tract Infection (UTI): An infection in any part of the urinary system, including the kidneys, bladder, or urethra.
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This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.
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