The truth behind why postpartum depression is so common and its causes

Many parents feel elation and joy when bringing a new baby home from the hospital. The car seat has been installed, the new outfits and extra diapers purchased, the nursery has been decorated. While the new role is certainly tiring, such parents often relish their time together with their new addition. 
But for many, the days following childbirth aren’t full of happiness alone. The joy is often still there, of course, but for women (and men) suffering with postpartum depression, there are also moments of intense sadness, loneliness, and even resentment, explains Dr. Fatima Naqvi, an OB-GYN and the interim system medical director of women’s health at the Atlantic Health System in New Jersey. 
Here’s what postpartum depression is, what causes it, and how to get the treatment you need if you experience it. 
Usually referred to as the “baby blues,” someone with postpartum depression often starts out feeling the mood swings, melancholy, and sudden exhaustion that follow childbirth for many mothers. While such emotions are common, they often begin to subside after a week or two of being home from the hospital. 
But such emotions can also morph into deeper feelings of gloom, anxiety or hopelessness and can last for much longer. When such emotions persist beyond two to three weeks following childbirth, the mother may have postpartum depression. 
This occurs during the first year of having a new baby in about one in eight women, per PRAMS data published by the U.S. Centers for Disease Control and Prevention. Though less common, “postpartum depression can also affect a parent who did not give birth such as their spouse or partner,” says Dr. Asima Ahmad, a physician, fertility expert and reproductive endocrinologist based in Chicago. Indeed, as many as one in 10 men experience it or something similar. 
Some of the symptoms that moms with postpartum depression experience include feeling angry or moody; feeling sad or hopeless; feeling guilty, shameful, or worthless; eating more or less than usual; sleeping more or less than usual; unusual crying or sadness; loss of interest, joy or pleasure in things they used to enjoy; withdrawing from friends and family; or experiencing thoughts of harming their baby or themselves, notes the U.S. Department of Health & Human Services’ Office of Women’s Health. 
Men with postpartum depression often experience different symptoms “ranging from excessive self-criticism, restlessness, irritability and aggression,” says Naqvi.
The exact cause of postpartum depression hasn’t been universally defined, but there are likely multiple factors at play. Jameca Woody Cooper, PhD, a psychologist and adjunct professor at Webster University in Missouri, explains that often the feelings associated with postpartum depression begin with hormonal changes associated with estrogen and progesterone levels being the highest they’ll ever be during pregnancy. When these levels drop back to normal after childbirth, most women experience at least some melancholy or sadness, but for some of them, “the significant hormonal shifts can also contribute to an increased risk of developing postpartum depression,” says Cooper. “New mothers need to be aware of these potential emotional and physical challenges during this time.”
Ahmad says the sudden lack of sleep and fatigue associated with caring for a baby, plus lost social and lifestyle opportunities and the new financial stressors, can also exacerbate matters. 
Naqvi says that whether a mother intended to have the child, whether they had a negative childbirth experience, or whether they have had a substance abuse problem or a history of mood disorders or depression can also contribute. 
Postpartum depression is diagnosed officially by a healthcare provider asking a set of specific screening questions and evaluating the answers. These questions also help doctors determine severity and whether the child is at risk for harm or if the mother is experiencing any suicidal ideation, explains Naqvi. 
Medical treatments commonly include pharmaceutical interventions such as oral or injectable antidepressants. “Cognitive behavioral therapy or acceptance and commitment therapy, have also been proven to be effective in addressing the symptoms of postpartum depression,” says Cooper. 
Beyond medical care, Ahmad says that self-care is also important. She explains that this means asking family and friends for support, getting plenty of rest, taking “you” time each day, prioritizing nutrition, getting in regular exercise, and above all, being honest with yourself, your partner and your doctor if you need help. 
“The sooner postpartum depression is identified and treated, the better the outcomes,” says Cooper. “Remember, asking for assistance demonstrates courage and resilience – with the right support and treatment, individuals with postpartum depression can recover and thrive as parents.”
If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org.