Being pregnant and having a baby can be an exciting time, but it’s important to recognize all the varying emotions that can come with a newborn. The perinatal (having to do with childbirth) time in a woman's life is a sensitive one.

It’s normal and common for women who are new mothers to feel apprehension, have some mood swings and be overwhelmed in the days following childbirth, but sometimes those symptoms become too much and begin impacting their ability to take care of the baby, function in daily living or enjoy life.

If you or a loved one might be experiencing a perinatal mood or anxiety disorder, such as postpartum depression or postpartum anxiety, the Women’s Behavioral Health experts at The Ohio State University Wexner Medical Center in Columbus, Ohio, want you to know you don’t have to suffer alone and that there are effective, evidence-based treatments to help you feel better.

We’re a leader in not only identifying and treating perinatal mental health conditions, but we’re one of the only academic health centers in the country actively researching better ways to serve pregnant and postpartum women. You’ll be in good hands with our maternal behavioral health specialists.

What is perinatal depression?

Perinatal depression is depression that begins during pregnancy or in the period following childbirth. Depression that develops after childbirth is called postpartum depression.

Postpartum depression is different from “baby blues,” which are mild symptoms of sadness, mood swings, crying and anxiety that many women experience in the days following childbirth. These usually subside in a week or two. When they don’t or they’re more severe, it could be postpartum depression.

Postpartum depression affects about 15% of women who have given birth, and it requires medical help to treat.

A more serious form of postpartum mood disorder is called postpartum psychosis, which causes delusions and hallucinations. It’s a psychiatric emergency and can require hospitalization.

If you have thoughts of harming yourself or someone else, or are in emotional distress, please call 911 or text the Suicide and Crisis Lifeline at 988.

How long does postpartum depression last?

Postpartum depression can last for months or years, but if it’s treated by a mental health professional, that time can be much less.

What is postpartum anxiety?

Postpartum anxiety is anxiety or excessive worrying that begins after having a child. It’s normal to have some worry after bringing home a new baby, but when those thoughts, often intrusive or irrational, become all-consuming, affecting your ability to sleep or care for yourself or your baby, you could have postpartum anxiety.

Roughly 15% of people who give birth experience postpartum anxiety. While the condition shares many symptoms with postpartum depression, it is a different perinatal mental health disorder.

How long does postpartum anxiety last?

Postpartum anxiety can last for months or longer, especially if you have a history of anxiety disorders. Treatment can help reduce recovery time significantly.

Causes and risk factors of postpartum depression and anxiety

There is no single definitive cause of these postpartum conditions, but they generally happen for a combination of reasons related to genetics, hormonal shifts and physical changes, and environment issues.

• Genetics – Postpartum depression and anxiety often run in families. If you have a loved one who experienced these conditions, you have an increased risk of experiencing one, too.
• Physical changes – Your hormones change greatly during pregnancy and drop sharply right after childbirth, which could contribute to postpartum depression and anxiety. Thyroid hormones could also play a role.
• Environment issues – Being sleep deprived or lacking outside support can also lead to struggles following childbirth, as can emotional responses.

Risk factors for postpartum depression and anxiety

While perinatal mental health conditions are common, there are certain risk factors that can increase your chance of developing one of these disorders.

Some risk factors include:

• You have a history of depression, anxiety or other psychiatric disorders.
• A close family member has experienced postpartum depression or anxiety.
• You experienced trauma while giving birth.
• Your newborn is sick or stayed in the neonatal intensive care unit.
• You had multiple babies at one birth.
• You’ve had recent stressors, including financial or in relationships.
• You lack a strong family and friend support system.
• Your pregnancy was unplanned or unwanted.
• You experience difficulties with breastfeeding.
• You have trauma or abuse in your past.
• You’ve struggled with infertility or pregnancy loss.

It’s important to remember that just because you have some of these risk factors, doesn’t mean you’ll develop postpartum depression or anxiety.

Symptoms of perinatal mental health conditions

Symptoms for postpartum depression or anxiety can often overlap, and they can start during pregnancy or in the weeks or months following childbirth. Also, not everyone experiences these conditions in the same way. It’s important to recognize the signs of these perinatal conditions, since early intervention and mental health treatment can lead to faster recovery times.

Symptoms of prenatal depression

When depression begins during pregnancy, symptoms include:

• Sadness or hopelessness
• Excessive worrying
• Out-of-character crying or extreme mood swings
• Fatigue and insomnia
• Decreased motivation and enjoyment of hobbies or favorite activities
• Difficult connecting with others, including your partner
• Memory problems, forgetfulness or difficulty concentrating

Symptoms of postpartum depression

When depression begins after you give birth, symptoms include:

• Sadness or hopelessness
• Irritability or mood swings
• Sleeping very little or too much
• Not eating enough or binge eating
• Excessive crying
• Feelings of worthlessness or guilt
• Withdrawing from loved ones
• Struggling to bond with your baby
• Intrusive thoughts of harming yourself or your baby

Symptoms of postpartum anxiety

Some symptoms that are unique to postpartum anxiety include:

• Staying awake all night fearful of what might happen to the baby
• Being terrified to leave the baby alone, even with a trusted adult
• Heart palpitations and difficulty sitting still
• Racing thoughts about worst-case scenarios
• Being controlling and irritable
• An inability to relax or stay calm
• Having irrational fears or avoiding certain activities, places or people

Symptoms of postpartum psychosis

• Hallucinations, which involve hearing or seeing things that aren’t there
• Delusions, which are firmly held beliefs that aren’t true
• Extreme mood swings between depression and mania (elated mood)
• Insomnia
• Disorganized thinking or behavior that doesn’t make sense
• Depersonalization, which can be described as an out-of-body experience
• Thoughts of self-harm or harming others, especially the baby
• Catatonia (a symptom cluster including remaining very rigid or still), which disrupts a person’s awareness of what’s around them

Postpartum psychosis is a medical emergency. Call 911 or go to the nearest Emergency Department if you or a loved one has symptoms and could harm the baby or others.

What’s the difference between postpartum depression and “baby blues?”

Many women experience mild symptoms of sadness, feeling overwhelmed, difficulty sleeping or anxiousness following childbirth. These negative emotions are often referred to as “baby blues” and go away on their own after a couple of weeks.

When they don’t subside or they begin to interfere with your ability to take care of your baby or yourself, you might need to see a doctor for postpartum depression. Those with postpartum depression feel better more quickly when they receive medical treatment.

Can postpartum depression be prevented?

Postpartum depression or postpartum anxiety can affect anyone who’s recently given birth. It’s not entirely preventable, but there are steps to take to decrease your risk of developing mental health conditions postpartum, or to lessen the severity of symptoms if you do. 

Actions that can help reduce the impacts of postpartum depression and anxiety include:

• Relying on a support network so you can make sure you get the necessary sleep, food, exercise and overall support to recover and take care of your family.
• Making time for yourself through self-care and by taking breaks.
• Setting realistic expectations when it comes to physical healing and returning to normal household or work duties.
• Getting a depression or mental health screening during pregnancy and after childbirth.
• Knowing your family medical history and consulting your doctor if you or a close family member has a history of mental health issues.
• Seeking help from your obstetrician or mental health provider if you’re worried about your symptoms.

Perinatal and postpartum depression and anxiety treatment at Ohio State

At Women’s Behavioral Health at the Ohio State Wexner Medical Center, we specialize in identifying and treating mental health conditions during pregnancy and postpartum. Because we’re one of only a few university centers in the country providing clinical care and conducting research to better inform that care, we’re able to provide the most innovative and productive therapies to get you back to enjoying your life and family.

Our comprehensive treatment planning, which often involves a combination of medication and psychotherapy (talk therapy), is tailored to the individual, always striving for the best outcomes for new parents and their baby.

• Medications – Antidepressants and anti-anxiety medications can be used to effectively treat perinatal mental health conditions. Antidepressants can take several weeks to work, so it’s important to allow time for them to work.
• Psychotherapy – Types of psychotherapy that can be effective include cognitive behavioral therapy and interpersonal therapy. We provide individual and group therapy.

Perinatal mental health services offered at Ohio State

• Preconception evaluation and counseling: We assist women who have a history of mental health conditions and are considering pregnancy.
• Pregnancy evaluation and treatment planning: We help women who are already pregnant to make well-informed and timely decisions about behavioral health care and medications, balancing the needs of both mother and baby.
• Postpartum prevention: Women with a history of depression or other mental health disorders are at increased risk to have significant emotional distress following delivery. Knowledge about medications and psychotherapy interventions, including during breastfeeding, provides the best opportunity to have a positive postpartum experience.
• Postpartum illness: We provide safe and effective treatment of mental health issues after delivery.
• Infertility: We help families cope with the stress and uncertainty of infertility and assisted reproductive treatment, such as in vitro fertilization (IVF).
• Pregnancy and infant loss: Miscarriages and pregnancy losses occur, and women who lose a child may experience not only the grief due to the loss but a sense of isolation from others who don’t understand. The supportive care we provide during this sensitive time is especially important.

How to help a loved one with postpartum depression or anxiety

If you know someone with a postpartum mood disorder, it can be difficult to know the best ways to help. Here are some tips:

• Ask them how they’re doing and be an attentive listener.
• Create a safe, nonjudgmental place for them to speak.
• Prepare meals or go grocery shopping.
• Support household chores or childcare needs.
• Encourage self-care and taking breaks.
• Recommend postpartum depression resources or information. POEM (Perinatal Outreach & Encouragement for Moms) and Postpartum Support International are two great resources.