Am I Experiencing Peripartum Depression Symptoms?

Finding out that you will be a parent or recently becoming one may bring up complex emotions. As exciting as it can be to bring a new life into the world, the initial joy you might feel at the news of a pregnancy could rapidly turn into fear, hopelessness, loss of interest, sadness, or anxiety. After a baby is born, it's not unusual to hear that a parent has developed the “baby blues”. However, in some cases, these challenges can signal the presence of peripartum depression, also known as postpartum depression. Peripartum depression is a severe and potentially debilitating mental health condition, but one that can typically be treated with the help of a doctor and/or a mental health care provider.

What is peripartum depression?

Peripartum depression is a type of depression that can be experienced by birthing parents of any gender as well as their non-birthing partners, other caregivers, and adoptive parents. According to one study, anywhere from 6.5 to 20% of pregnant individuals experience postpartum depression—which is a clinical mental illness, not just a case of what is sometimes referred to as the “baby blues.” 

While many people are familiar with hormonal changes after childbirth, rapid hormonal changes actually begin at the start of pregnancy. When hormonal changes cause depressive symptoms from the beginning of the pregnancy and last after the child is born, this is called peripartum depression (or perinatal depression), a term that’s now more commonly used than postpartum depression. Mental health experts generally prefer the term peripartum depression because it more accurately reflects the hormonal changes over the life of the pregnancy than postpartum depression does. 

As with many mental disorders, the exact causes of peripartum depression are unknown. However, several risk factors are thought to contribute to the disorder. These include a history of depression; genetic influences; hormonal changes; stress during pregnancy, birth, and early caregiving; and other environmental factors.  

Toddlers and preschool-age children with parents who have depression of some type may be at increased risk of having poor self-control, cognitive difficulties, and difficulties with social interactions. School-age children and adolescents may be at increased risk for weakened adaptive functioning, conduct disorders, affective disorders, and anxiety disorders. Such potential risks to the child’s health is an additional reason that it’s typically recommended that you seek mental health care right away if you’re experiencing symptoms of peripartum depression. 

What are the symptoms of peripartum depression?

When symptoms of major depression occur during pregnancy or from one month to six months after the delivery, it can indicate a diagnosis of peripartum depression. According to a 2019 study, peripartum depression is the leading cause of disease burden for birthing parents and their families. It also reports that a gestational parent has a greater risk of being admitted to a psychiatric hospital within the first month after giving birth than at any other time in their life. 

Note that postpartum psychosis is another related condition that can affect a birthing parent in the two weeks following delivery. It’s characterized by delusions, hallucinations, hyperactivity, severe depression, decreased need for sleep, paranoia, and other related symptoms. It’s more likely to occur in those with a personal or family history of bipolar disorder or psychotic episodes. Seeking treatment right away is typically recommended for these symptoms or symptoms of postpartum/peripartum depression.

Non-gestational parents can also experience this condition

It’s worth noting that newer evidence suggests it’s not only gestational parents who may be at risk for developing a mental health condition like peripartum depression. Partners of any gender, adoptive parents, and other caregivers such as family, can also experience postpartum depression after a new baby or child has been brought home. 

According to an article in the US News and World Report, the APA reports that 4% of partners experience depression in their first year after their child's birth. Younger partners, those with significant financial burdens, and those with a history of depression are reported to be at increased risk. Non-gestational parents can also seek support and treatment when experiencing peripartum or postpartum depression or other mental health challenges.

Treatment options

The typical treatment for any type of depression is psychotherapy either on its own or combined with medication. Note that the sooner the affected person begins treatment, the more effective it may be. 

Depression medications

There are risks for pregnant and nursing parents and their babies if they take certain medications during this time. Because of these known risks, many doctors may recommend psychotherapy without medication as the first course of treatment for peripartum depression, especially if symptoms are mild. 

If a doctor does decide that medication is the right course of action for an individual experiencing peripartum depression, they will likely monitor its effects carefully. Remember that withdrawing from antidepressant medications too quickly could result in serious health consequences, which is why it’s critical to ask your doctor before stopping, starting, or changing your dose of any medication—especially while pregnant or nursing.

The first-line treatment for most types of depression, including peripartum depression, is usually psychotherapy, or talk therapy. Cognitive-behavior therapy (CBT) in particular may be able to help an individual find symptom relief and embark on the path toward healing. A therapist can give them a safe space to express their emotions without judgment, help them learn to recognize and adjust distorted thoughts, and recommend healthy coping mechanisms for difficult feelings associated with depression or parenthood.

Lifestyle changes 

A 2019 review of studies on the topic indicates that getting physical activity during and after pregnancy may help reduce the symptoms of peripartum depression. Even low-impact movement like going for a walk or a swim can be enough to produce mental health benefits. Another study suggests that eating a nutritious diet during pregnancy may be linked to decreased risk of mental health challenges after pregnancy. It notes that calcium, iron, and folate are nutrients that may be especially important for supporting positive mental health in gestational parents.

Crisis support 

In some cases of peripartum depression, symptoms can be severe. Some may experience suicidal thoughts, thoughts of harming themselves, or thoughts of harming their newborns. These thoughts or actions can require immediate medical intervention, so don’t hesitate to reach out for help.

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

Alternative counseling options 

Online therapy can represent a convenient alternative for receiving mental health care for those who are pregnant, have just given birth, and/or are a caregiver for a newborn. Instead of embarking on a regular commute to a therapist’s office, you can attend appointments to receive this type of health care from the comfort of your home, office, or another preferred space—all you need is an internet connection. 

Studies suggest that online therapy can be an efficacious treatment for those experiencing symptoms of peripartum depression, postpartum depression, or another depressive disorder. In a 2021 study, for example, researchers evaluated the effectiveness of online interventions in reducing symptoms of depression and anxiety in individuals with peripartum depression, and their findings suggest that it effectively reduced symptoms.

If you want to talk to an online therapist, you can sign up with a platform like BetterHelp for individuals or ReGain for couples to learn more about online therapy and receive support. You're not alone, and treatment is available.