Diagnosis

Your doctor will usually talk with you about your feelings, thoughts and mental health to distinguish between a short-term case of postpartum baby blues and a more severe form of depression. Don't be embarrassed. Share your symptoms with your doctor so that a useful treatment plan can be created for you.

As part of your evaluation, your doctor may:

  • Ask you to complete a depression-screening questionnaire
  • Order blood tests to determine whether an underactive thyroid is contributing to your signs and symptoms
  • Order other tests, if warranted, to rule out other causes for your symptoms

The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is often used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Treatment

Treatment and recovery time vary, depending on the severity of your depression and your individual needs. If you have an underactive thyroid or an underlying illness, your doctor may treat those conditions or refer you to the appropriate specialist. Your doctor also may refer you to a mental health provider.

Baby blues

The baby blues usually fade on their own within a few days to one to two weeks. In the meantime:

  • Get as much rest as you can
  • Accept help from family and friends
  • Connect with other new moms
  • Create time to take care of yourself
  • Avoid alcohol and recreational drugs, which can make mood swings worse

Postpartum depression

Postpartum depression is often treated with psychotherapy (also called talk therapy or mental health counseling), medication or both.

  • Psychotherapy. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health provider. Through therapy, you can find better ways to cope with your feelings, solve problems, set realistic goals and respond to situations in a positive way. Sometimes family or relationship therapy also helps.
  • Antidepressants. Your doctor may recommend an antidepressant. If you're breast-feeding, any medication you take will enter your breast milk. However, some antidepressants can be used during breast-feeding with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants.

With appropriate treatment, postpartum depression usually goes away within six months. In some cases, postpartum depression lasts much longer, becoming chronic depression. It's important to continue treatment after you begin to feel better. Stopping treatment too early may lead to a relapse.

Postpartum psychosis

Postpartum psychosis requires immediate treatment, often in the hospital. Treatment may include:

  • Medication. When your safety is assured, a combination of medications — such as antidepressants, antipsychotic medications and mood stabilizers — may be used to control your signs and symptoms.
  • Electroconvulsive therapy (ECT). If your postpartum depression is severe and does not respond to medication, ECT may be recommended. During ECT, a small amount of electrical current is applied to your brain to produce brain waves similar to those that occur during a seizure. The chemical changes triggered by the electrical currents can reduce the symptoms of psychosis and depression, especially when other treatments have failed.

Treatment for postpartum psychosis can challenge a mother's ability to breast-feed. Separation from the baby makes breast-feeding difficult, and some medications used to treat postpartum psychosis aren't recommended for women who are breast-feeding. If you're experiencing postpartum psychosis, your doctor can help you work through these challenges.

Lifestyle and home remedies

Postpartum depression isn't generally a condition that you can treat on your own — but you can do some things for yourself that build on your treatment plan and help speed recovery.

  • Make healthy lifestyle choices. Include physical activity, such as a walk with your baby, in your daily routine. Try to get adequate rest. Eat healthy foods and avoid alcohol.
  • Set realistic expectations. Don't pressure yourself to do everything. Scale back your expectations for the perfect household. Do what you can and leave the rest.
  • Make time for yourself. If you feel like the world is coming down around you, take some time for yourself. Get dressed, leave the house, and visit a friend or run an errand. Or schedule some time alone with your partner.
  • Avoid isolation. Talk with your partner, family and friends about how you're feeling. Ask other mothers about their experiences. Breaking the isolation may help you feel human again.
  • Ask for help. Try to open up to the people close to you and let them know you need help. If someone offers to baby-sit so you can take a break, take them up on it. If you can sleep, take a nap, or maybe you can catch a movie or meet for coffee with friends.

Remember, the best way to take care of your baby is to take care of yourself.

Coping and support

The already stressful, exhausting period following a baby's birth is more difficult when depression occurs. But remember, postpartum depression is never anyone's fault. It's a common medical condition that needs treatment.

So, if you're having trouble coping with postpartum depression, talk with a therapist. Ask your doctor or therapist about local support groups for new moms or women who have postpartum depression.

The sooner you get help, the sooner you'll be fully equipped to cope with depression and enjoy your new baby.

Preparing for your appointment

After your first appointment, your doctor may refer you to a mental health provider who can create the right treatment plan for you. You may want to find a trusted family member or friend to join you for your appointment to help you remember all of the information discussed.

What you can do

Before your appointment, make a list of:

  • Any symptoms you've been experiencing and for how long
  • All of your medical issues, including physical conditions or mental health disorders, such as depression
  • All the medications you take, including prescription and over-the-counter medications as well as vitamins and other supplements, as well as their doses
  • Questions to ask your doctor

Questions to ask your doctor include:

  • What is my diagnosis?
  • What treatments are likely to help me?
  • What are the possible side effects of the treatments you're proposing?
  • How much and how soon do you expect my symptoms to improve with treatment?
  • Is the medication you're prescribing safe to take while breast-feeding?
  • How long will I need to be treated?
  • What lifestyle changes can help me manage my symptoms?
  • How often should I be seen for follow-up visits?
  • Am I at increased risk of other mental health problems?
  • Am I at risk of this condition recurring if I have another baby?
  • Is there any way to prevent a recurrence if I have another baby?
  • Are there any printed materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

A doctor or mental health provider who sees you for possible postpartum depression may ask:

  • What are your symptoms, and when did they start?
  • Have your symptoms been getting better or worse over time?
  • Are your symptoms affecting your ability to care for your baby?
  • Do you feel as bonded to your baby as you expected?
  • Are you able to sleep when you have the chance and get out of bed when it's time to wake up?
  • How would you describe your energy level?
  • Has your appetite changed?
  • How often would you say you feel anxious, irritable or angry?
  • Have you had any thoughts of harming yourself or your baby?
  • How much support do you have in caring for your baby?
  • Are there other significant stressors in your life, such as financial or relationship problems?
  • Have you been diagnosed with any other medical conditions?
  • Have you ever been diagnosed with any mental health conditions, such as depression or bipolar disorder? If so, what type of treatment helped the most?
Aug. 11, 2015
References
  1. Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed July 16, 2015.
  2. Depression during and after pregnancy. WomensHealth.gov. https://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.html. Accessed July 1, 2015.
  3. Postpartum depression. American Psychological Association. http://www.apa.org/pi/women/resources/reports/postpartum-dep.aspx. Accessed July 16, 2015.
  4. Frequently asked questions. Labor, delivery, and postpartum care FAQ091. Postpartum depression. American College of Obstetricians and Gynecologists. http://www.acog.org/-/media/For-Patients/faq091.pdf?dmc=1&ts=20150716T1631486138. Accessed July 16, 2015.
  5. Postpartum depression facts. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml. Accessed July 16, 2015.
  6. Roy-Byrne PP. Postpartum blues and unipolar depression: Epidemiology, clinical features, assessment, and diagnosis. http://www.uptodate.com/home. Accessed July 21, 2015.
  7. Roy-Byrne PP. Postpartum blues and unipolar depression: Prevention and treatment. http://www.uptodate.com/home. Accessed July 21, 2015.
  8. AskMayoExpert. Depression during pregnancy and postpartum. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  9. Marder S. Postpartum psychosis: Epidemiology, clinical manifestations, assessment, and diagnosis. http://www.uptodate.com/home. Accessed July 22, 2015.
  10. Marder S. Treatment of postpartum psychosis. http://www.uptodate.com/home. Accessed July 22, 2015.
  11. Butler Tobah YS (expert opinion). Mayo Clinic, Rochester, Minn. July 27, 2015.
  12. American Academy of Pediatrics. Intrapartum and postpartum care of the mother. In: Guidelines for Perinatal Care. 7th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; Washington, D.C.: American College of Obstetricians and Gynecologists; 2012.
  13. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. July 29, 2015.