Three months after the birth of her first child, Shoshana Bennett went to her OB-GYN, desperate for help. "If life is going to be like this, I don't want to be here anymore," she told him.
The year was 1983, and the medical profession's understanding of the severe depression that affects one out of seven parents after childbirth was limited. “He laughed and said, ‘All new mothers feel this way. Go do something nice for yourself and it will pass,'” recalls Dr. Bennett, who has since earned a PhD in psychology and become a clinical psychologist and expert in postpartum conditions.
Doctors have come a long way toward understanding, treating, and counseling patients about postpartum depression (PPD), but many people still enter pregnancy and postpartum with questions: When does postpartum depression start? When does it end? How long does postpartum depression last? How do I know if I have PPD?
Postpartum depression can actually start anytime in your baby's first year, and as Dr. Bennett experienced, it can last for years. PPD can also raise your risk of other mental health disorders later in life. Here's more about what pregnant people, new parents, and caregivers should know about the postpartum depression timeline and when to get help.
When Does Postpartum Depression Start?
On average, postpartum depression (PPD) usually begins in the first three weeks after having a baby, according to the American College of Obstetricians and Gynecologists (ACOG). But it can start to surface well before or after that.
In some cases, depression can set in before you give birth and carry over into the newborn period. In fact, anyone with symptoms of depression or anxiety, either before or during pregnancy, has an increased risk of PPD. “Any symptom that may arise postpartum can begin in pregnancy,” says Dr. Bennett.
For other people, PPD symptoms arise just after labor and delivery. “In my case, once the placenta was delivered, I plummeted into a deep severe state of depression,” says Dr. Bennett.
Importantly, PPD isn't just something that very new parents can experience. It can start anywhere and anytime during your child's first year, says ACOG.
What Causes PPD?
Although there's no singular cause for PPD, experts believe a steep drop in the hormones estrogen and progesterone following childbirth may be to blame, kickstarting depression in the same way smaller hormonal changes prompt premenstrual mood changes.
Signs of Postpartum Depression (PPD)
People diagnosed with PPD may have some or many of the following symptoms:
Depressed moodLoss of interest in previously enjoyed activitiesSleep disturbances and/or fatigueAppetite changesLoss of concentrationFeelings of guilt or worthlessnessMood swings or irritabilityObsessional thoughts about their baby's careThoughts of harming their babySuicidal thoughts (affecting up to one in five people with PPD)
In addition to educating yourself, it's helpful to prep your partner or any other support people in your life to ensure they're aware of the signs and symptoms of PPD. That way, they can help you find professional carem should you need it.
It's often very difficult for someone in the thick of PPD to recognize that they need help and to reach out for it, so it's crucial that people closest to you be aware of what may be passing “baby blues” and what could be more serious.
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How Long Does Postpartum Depression Last?
Unlike occasional “baby blues,” PPD lasts for at least two weeks but may linger for months or even years. “I started to regain myself when my daughter was 2-and-half years old,” says Dr. Bennett. “My hair started to curl again, and I started to taste food and see color again.”
Research suggests that the longer a person experiences PPD after giving birth, the more likely they are to experience chronic depression. For instance, one study found that the majority of people who experienced severe depression at two and eight months postpartum continued to experience symptoms of depression more than 10 years later.
While research is lacking on the mental health experiences of trans and non-binary parents, some research suggests that the feelings of isolation that many trans and non-binary people experience point to a possible higher risk of PPD as well.
For that reason, it's best to consult a doctor about any PPD symptoms as soon as they arise. "As with any disorder, the sooner PPD gets treated, the better the prognosis is for the parent and the entire family," says Dr. Bennett.
Does Postpartum Depression Affect Non-Gestational Parents?
Research shows that around 8% to 10% of new fathers experience PPD, with the disorder often striking later during the first year of their baby's life. In one study of gay fathers specifically, the incidence of PPD was shown to be even higher, around 12%. Adoptive parents can also experience a form of PPD, often referred to as post-adoption depression.
In partners and among parents who have not given birth, PPD can be caused by sleep deprivation, among other factors. “PPD is very relational in how it impacts couples,” says Brandon Eddy, PhD, marriage and family therapist and assistant professor at the University of Nevada, Las Vegas. People with partners who have PPD are more likely to experience PPD themselves, experiencing it up to 50% of the time.
The postpartum timeline for partners can be very similar to that of the gestational parent. "The first few weeks are a difficult adjustment for both parents, but if people find themselves still really struggling and depressed after that then they should seek treatment immediately," says Dr. Eddy.
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Finding the Right PPD Treatment for You
The most effective treatment for PPD is a combination of psychotherapy and medication, says Dr. Eddy. Many other therapies, such as talk therapy, cognitive behavioral therapy, and group therapy can be effective as well. "Not all patients need medication," notes Dr. Eddy.
Dr. Bennett also emphasizes the importance of working with a practitioner who specializes in maternal mental health, if possible. If you don't have access to a mental health professional who works with postpartum parents, start by talking to your pregnancy care provider.
Many pregnancy care providers are trained to provide the basics in postpartum mental health support, and even if they cannot help you personally, they should be able to refer you to a specialist. There's also help online: You can call the Postpartum Support International (PSI) helpline at 800-944-4773 or text 503-894-9453 for free and confidential support. PSI also offers a directory for you to find a trained provider near you, connect with a local peer mentor, or join an online support group.
And remember, while it can feel challenging to take steps for yourself when you're already dealing with so much as a new parent, a huge part of taking care of your baby is making sure you are as physically and mentally healthy as possible too. So reach out for help if you are struggling, because it's not just important for you, it's important for your family as well.
"There's no better gift to your child than a happy, healthy, grounded parent," says Dr. Bennett.
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