Welcoming a new baby to the family can come with a lot of emotions. While a slight shift in mood after giving birth is common — sometimes called the "baby blues," due to hormone changes — it's usually temporary and mild.
But sadness that is long-lasting and severe can be something called postpartum depression (PPD), or if it starts while pregnant, perinatal depression, per the American Psychiatric Association (APA).
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PPD is a mood disorder that can happen to any parent that's welcomed a new baby, whether they've physically given birth or not, per the Mayo Clinic. And the condition can be tough to navigate.
"The sadness I felt as a new mom could only be described as a bottomless pit of darkness," says LaKia Colquitt, MSW, LSW, a therapist at Intuit Healing in Chicago. "I felt unworthy, unloved, tired and increasingly sad," she says. And while cognitively, she knew having her daughter was a wonderful gift, emotionally, "it felt like an almost unbearable burden," Colquitt says.
Thankfully, the support Colquitt felt from her loving family helped her get through that difficult time.
Here, learn how to recognize signs of PPD or perinatal depression in someone you love, along with the best ways to support them — including what not to say and do.
How to Know if a Loved One Has PPD
There are a few different steps you can take to discover whether a loved one has PPD or perinatal depression. These include:
1. Distinguishing Between PPD and the 'Baby Blues'
The "baby blues" are common in the days after giving birth, according to the Mayo Clinic. But the mood swings, weepiness, insomnia, irritability and cluster of other negative emotions associated with the "baby blues" are short-lived, ending about two weeks after delivery, according to the American Pregnancy Association.
Time frame is one way to tell the difference between "baby blues" (which is not a disorder) and PPD or perinatal depression (which is), says Jessica Sorensen, LCSW, a licensed clinical social worker and therapist specializing in perinatal mental health at Noticing Growth.
In other words, if your "baby blues" symptoms last longer than two weeks, it could be PPD. Or if symptoms began while pregnant, it could be perinatal depression, per the APA.
Symptoms can even appear for up to three years after giving birth, according to a November 2020 study in Pediatrics.
2. Recognizing PPD Symptoms
Offering support starts with recognizing someone may have PPD (and not just the typical fatigue and overwhelm that can come with parenthood).
"Symptoms can vary from person to person," says Emily Guarnotta, PsyD, a certified perinatal mental health provider, owner of The Mindful Mommy and co-founder of Phoenix Health. "But generally the most common signs are a sad mood that persists most days for at least two weeks," she adds.
Other PPD and perinatal depression symptoms include the following, per Guarnotta:
- A lack of interest in activities that previously brought joy
- Changes in sleep patterns (i.e., sleeping more or less than usual)
- Changes in eating patterns (i.e., eating more or less than usual)
If you're a loved one looking from the outside in, Sorensen says you might also notice:
- They're really overwhelmed, anxious or agitated
- They may be unable to care for themselves
- They aren't bonding with the baby
- They have physical symptoms like headaches or constipation
Thoughts of suicide, self-harm or causing harm to the baby are also possible symptoms, according to the Mayo Clinic.
Warning
Some symptoms call for immediate action. If the soon-to-be or new parent in your life talks about harming themselves or their baby, take them to the emergency room or call 911, according to UnityPoint Health. You can also call 988, the National Suicide and Crisis Lifeline.
And while mild symptoms may require less urgency, it doesn’t mean your loved one should wait for their next scheduled doctor visit to bring up concerns, per the American College of Obstetricians and Gynecologists (ACOG).
Encourage soon-to-be and new parents feeling depressed/anxious to make an appointment with their doctor sooner rather than later.
3. Knowing Who It Affects
PPD is a common experience: About 1 in 8 people who give birth will have symptoms of the disorder, according to research from the Centers for Disease Control and Prevention (CDC).
But this condition doesn't just affect people who give birth. Partners, parents of newly adopted children, non-gestational carriers and others who welcome a new child home can have PPD. "It's considered a universal experience," Sorensen says.
The wide range of people affected by PPD "tells us that it's caused by more than just hormonal shifts that happen after giving birth," Guarnotta says. Many factors may play a role, including genetics, biological changes, sleep deprivation and more, she says.
Also worth noting: Some parents' PPD may look different than others. For example, "studies show that fathers with PPD are more likely to present with irritability and anger," Guarnotta and a small June 2021 study in the American Journal of Men's Health say.
But keep in mind that any parent with PPD can feel angry or irritable, regardless of their role in the family unit.
5 Ways to Help People With PPD
1. Plan Ahead
If your loved one is currently pregnant, "a great help is planning ahead and creating a postpartum support plan," Sorensen says.
The plan should focus on four areas of basic needs: sleep, nutrition, movement and emotional support. To develop it, talk to an expecting partner, family member, friend or professional about how to tackle the following questions, Sorensen suggests:
- "Who would you like to come support you when you're postpartum?"
- "What boundaries do you have in mind for visitors?"
- "What's a good plan for sleep? If you find it difficult to sleep, how can you carve out chunks of time for naps?"
- "What are healthy snacks that you like? What about make-ahead meals?"
- "How will you be able to get outside and get fresh air (recovery permitting)?"
- "What are the signs you tend to show when you're overwhelmed?"
If there's a plan in place to weather the final days of pregnancy, the fourth trimester and beyond, it can make the early days with a baby not as overwhelming — especially if tasks that used to feel easy now feel difficult.
Tip
If you're looking to offer support after the baby is born, keep these four pillars in mind: sleep, nutrition, movement and emotional support, Sorensen says. These can narrow down how you may help.
2. Offer Practical Help
Helping with errands or chores is a great way to show you care. Consider stopping by with a meal, or offering to stay and do a load of laundry. Maybe even offer to watch the baby while they get some worry-free zzzs, Sorenson suggests.
"Just make sure to give them a heads-up before stopping by," Colquitt says.
To make it a visit that's helpful (instead of an added burden), make it clear it's not necessary to tidy up on your behalf, or change out of spit-up-covered clothes.
"Give them a hug, ask if the baby has eaten and encourage them to take an uninterrupted bath or shower, while you care for the baby," Colquitt suggests. Don't add to their overwhelm by offering suggestions or asking lots of questions, she says.
"The best thing they can do is relax and know that someone cares enough to give them a much-needed break," Colquitt says.
If it's your partner dealing with PPD, offer to take the night shift of getting up with the baby, or lighten their burden in other ways, without expecting anything in return.
And if you live far from a loved one with PPD, send a text to say you're thinking of them. Or reach out to say you've lined up a dinner or grocery delivery for their upcoming week.
3. Offer a Listening Ear and Plenty of Empathy
Some people with PPD may benefit most from someone to talk to, Guarnotta says. "Listening and expressing understanding can go a long way," she adds.
That can mean sitting next to them while they cry, or sitting in silence together, which offers your loved one a safe space to express how they feel, Sorensen says. Statements like, "I'm always here if you want to talk" can help start conversations, she says.
"It's important to note that many parents with PPD feel like they have to put on a brave face," Guarnotta says. While people may seem fine, they could be struggling internally. "It's not enough to just assume that a parent who has it all together is OK," she adds.
If your loved one tells you they have PPD, make it clear how strong and brave they are, Guarnotta suggests.
"You may want to instill hope that the person will feel better soon, but be careful with this," she warns. Some statements indicating PPD is just a temporary situation can come off as dismissive (more on that next).
4. Avoid Comparisons, Judgment and Dismissal
Stay away from "statements that could be perceived as dismissing what the person is going through," Guarnotta says, such as:
- "This is just a phase."
- "Don't feel bad."
- "Think about all the good you have in your life."
- "You should be grateful to be a parent."
- "You'll feel better if you do X, Y or Z."
- "My friend had a bad birth experience, and she did X."
- "When I was a parent, here's what I did."
There's a good reason people turn to these common sentiments and phrases. "We have this urge to fix things, and we want to try to make it better," Sorensen says.
But instead of helping, this kind of language minimizes the person's struggle and can lead to shame, feelings of unworthiness or despair, both Guarnotta and Colquitt say.
Instead, look for ways to show that you love the person and are committed to their wellbeing. Try to fight any urge you have to offer solutions — unless your partner, friend or relative asks for advice, Sorensen says.
A better approach than a "fix-it" mentality? Leave space for your loved one to share their feelings, and then validate those feelings. "Providing that empathetic listening is going to be so helpful," Sorensen says.
Plus, affirmation can go a long way. "Remind your loved one they're doing the best they can," Colquitt says.
5. Connect Someone Who Has PPD With Professional Help
"Sometimes people with PPD have trouble opening up, or cannot put into words how they're feeling," Guarnotta says.
Being a listening ear is great, but because you cannot formally diagnose your loved one (unless you're a trained doctor), connecting them with a professional may be the best way to help.
Offer to talk to their doctor for them, Guarnotta suggests. Or, help them find a therapist and schedule or even accompany them to the appointment, she adds.
From there, treatment for PPD looks similar to treatment for depression. Alongside therapy, doctors may prescribe an antidepressant like Brexanolone (Zulresso) — which specifically treats PPD, per the Mayo Clinic.
(Note: Treatment may look a little different for someone still pregnant, as certain medications should be avoided during this time.)
You can also help normalize PPD by sharing information about the condition with your friends and loved ones.
"As far as we have come, there is still so much stigma around PPD and perinatal depression. The more we talk about it, the more parents will feel comfortable opening up and getting the help they need and deserve," Guarnotta says.
- Mayo Clinic: "Postpartum depression"
- American Pregnancy Association: "Baby Blues"
- Pediatrics: "Trajectories of Maternal Postpartum Depressive Symptoms"
- UnityPoint Health: "Postpartum Depression"
- American College of Obstetricians and Gynecologists: "Postpartum Depression"
- Centers for Disease Control and Prevention: "Depression Among Women"
- American Journal of Men's Health: "“I Wanted to Be There as a Father, but I Couldn’t”: A Qualitative Study of Fathers’ Experiences of Postpartum Depression and Their Help-Seeking Behavior"
- American Psychiatric Association: "Perinatal Depression"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.