Postpartum Depression: Causes, Symptoms, And Treatment For PPD

by Jodie Eisner, PsyD

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For many new moms, postpartum depression is not part of the birth plan. Preparing for lack of sleep? Check. Diapers at the ready? Double check. But a general sense of worthlessness, hopelessness, and deeper exhaustion than is manageable? For nearly one-fifth of new moms, these emotions are a surprising new reality.

The good news is, postpartum depression (often shortened to “PPD”) is highly treatable with therapy. Read on to learn about what the possible causes are for PPD, plus symptoms to keep an eye out for. And if you are, or your loved one is, already experiencing symptoms of PPD, learn more about treatment options – and get started by finding a perinatal therapist who can help.

Causes of postpartum depression

There's no single cause to pinpoint for postpartum depression. Rather, research shows that postpartum depression stems from a combination of factors.

Hormonal factors for PPD:  

  • Biological sensitivities to hormonal changes
  • Genetic vulnerability
  • A history of mood disorders, including (but not limited to) a history of depression, bipolar disorder, or a history of PPD from a previous pregnancy

Situational factors for PPD:

  • Societal pressures: The ingrained belief that having a new baby only brings happiness and positivity to life, and it is shameful to feel any other way
  • Individual beliefs and expectations about parenting: holding yourself to a high parenting standard becomes difficult, as parenting often goes nothing like you think it will
  • Fatigue and sleep deprivation: It’s no secret that new parents face sleep deprivation! This may take a toll on physical and mental health.
  • Complicated pregnancy situations: including not wanting or expecting the pregnancy, not having a healthy pregnancy, or having a complicated birth

In addition to the above, the perinatal period is also a time when new moms:

  • Receive a spate of new, concentrated attention (i.e., when pregnant)
  • Prepare for parenthood – most have dreams and expectations about what parenting will be like
  • Receiving explicit demands from society about “what they are supposed to do"
  • Put implicit demands on themselves about how they “should” prepare during their pregnancy for their new baby

On top of all this, many new moms experience a tangible difference between the fantasy and reality of motherhood, all while needing to learn new skills to manage the new demanding role.

When postpartum depression occurs

While this peak risk of 3 months is true for most women, postpartum depression can start days, or even months, after childbirth. Generally speaking, postpartum depression is considered as such if the symptoms occur within the first year after birth.

Between 20 and 25% of mothers with PPD have episodes lasting 6 months or longer.

Prevalence of postpartum depression

One 2013 study estimated between 14 and 21% of women in the perinatal stages experience postpartum depression.

Symptoms of postpartum depression

Postpartum depression may look different in one mom to the next. That said, they often include:

  • Lower overall mood: Feeling depressed for long periods of time
  • Lack of interest in the baby: Instead of feeling excited to care for your little one, feeling as if you don’t want to help out the majority of the time
  • Feeling extremely overwhelmed: Feeling fearful or anxious about providing for your little one
  • Inability to take care of oneself or family: Not eating, showering, or other basic activities of daily life
  • Isolation: Feeling alone or wanting to be alone
  • Mood swings: In addition to feeling depressed or low, also feeling extreme highs
  • Changes in appetite: Besides your body adjusting after pregnancy, feeling disgusted by the thought of eating or feeling unmotivated to take care of your body
  • Tangible sleep disturbances: Not being able to sleep even if your little one is sound asleep, having nightmares, or tossing and turning
  • Feelings of anger, guilt, or fear: Feeling these emotions the majority of the time, whether you feel them at yourself, your partner, or your baby
  • Difficulty concentrating or making decisions: Noticing cognitive changes in everyday life, such as the inability to make it through a task without distraction
  • Possible thoughts of harming the baby or yourself

How to treat postpartum depression

Therapy types for PPD

Effective therapy treatment options for postpartum depression include:

  • Cognitive behavioral therapy
  • Interpersonal psychotherapy
  • Dialectical behavioral therapy
  • Psychodynamic psychotherapy
  • Psycho-educational group therapy

Treatment for postpartum depression also includes accessing social support, and following any recommended medical interventions.

Preventative measures help reduce your risk of developing PPD

If possible, be proactive to prevent postpartum depression from taking over full-force. To do this, understand your risk by assessing your psychiatric history – as well as family history of mood disorders.

Higher risk women may also benefit from taking a preventative medication (often an antidepressant).

Cultivate a support group to lower your risk of developing PPD

You can decrease your risk of PPD by mobilizing a support network; this may include:

  • Family
  • Friends
  • Doulas
  • New mom groups
  • Childbirth education classes
  • Seeing a therapist
  • Taking care of your basic needs through having adequate nutrition, sleep, and exercise.  

How to help your partner through PPD

If your partner or loved one has PPD, here's what you can do to help:

  • Validate their experience and encourage them to seek care! PPD is treatable.
  • De-stigmatize – PPD is not their fault. Show compassion and empathy for what they are going through.
  • Normalize how hard motherhood can be. There is no manual for motherhood, and people often have to do some trial-and-error to figure out what works for them.
  • Let them sleep. Sleep disturbances are implicated in mood disorders (whether it’s sleeping too much, or not enough). Restorative sleep will help new moms better manage their moods and work through any anxiety or depression.

How to find a therapist for PPD

It’s most important to find a clinician who you trust and who has experience with perinatal conditions.

For the fastest symptom relief, working with a clinician who specializes in cognitive behavioral therapy or interpersonal psychotherapy may be especially valuable.

It is also helpful to explore your own beliefs about motherhood, and to look at what may be impacting your ability to bond. This can be achieved in individual therapy or in a group setting.

If you’re ready to start your search for a perinatal specialist who can treat postpartum depression, you can do so on Zencare below.