"I've just had a baby, everyone is celebrating — so why do I feel so sad?" — a typical thought for a mother experiencing postpartum depression. Statistically, 15–20% of women who give birth suffer from postpartum depression (NICE, WHO 2023).

This is not "baby blues" — it is a clinical condition requiring treatment.

Baby Blues vs. Postpartum Depression

Baby Blues (in 50–80% of women): begins 2–3 days after birth, lasts 1–2 weeks. A natural response to hormonal changes. Symptoms: tearfulness, anxiety, fatigue. Does not require treatment; resolves on its own.

Postpartum depression: begins after 2 weeks from birth, lasts for months. Meets the criteria of clinical depression (DSM-5). Symptoms are more severe:

  • Persistent sadness, hopelessness (more than 2 weeks)
  • Difficulty bonding with the baby
  • Appetite disturbance (decreased or increased)
  • Sleep disturbance (independent of the baby's schedule)
  • Feeling like a "bad mother"
  • Difficulty concentrating
  • Thoughts of harming oneself or the baby

Risk Factors

  • Past history of depression
  • Stressful birth experience
  • Lack of social support
  • Financial difficulties
  • Relationship problems
  • Depression during pregnancy
  • Hormonal sensitivity (history of PMS)
  • Genetics (family history of depression)

Postpartum Psychosis — A Medical Emergency

A rarer condition (1–2 per 1,000 births) but serious. Symptoms: hallucinations, delusions, confusion, insomnia. This is a condition requiring emergency hospitalization. It typically begins within 2 weeks.

Treatment

NICE and APA recommendations:

Mild to moderate postpartum depression:

  • CBT or interpersonal therapy (IPT)
  • Social support (group therapy)
  • Regular physical activity
  • Restoring sleep routine (with partner's help)

Moderate to severe:

  • Psychotherapy + antidepressant
  • Safe medications exist for breastfeeding women (sertraline)

For severe cases: hospitalization, antidepressants + in some cases ECT.

Postpartum Depression in Fathers

Research has shown that fathers can also experience postpartum depression (8–10%). Symptoms are more often expressed as: withdrawal, isolation, irritability, avoidant behavior. In the family both the mother and the father should be assessed.

Why Is It So Hard to Ask for Help?

  • The belief that "a good mother shouldn't feel this way"
  • Hoping that "it's hormones, it'll pass on its own"
  • Stigma and family attitudes of "she's faking it"
  • Practical reasons (caring for the baby, lack of time)
  • Fear of passing medication to the baby through breast milk (a misconception)

Practical Steps

  1. See a pediatrician or gynecologist — they screen using the Edinburgh Postnatal Depression Scale
  2. Evaluation by a psychiatrist or clinical psychologist
  3. Mobilize family support — childcare needs to be shared
  4. Join online groups — mothers with similar experiences

An important message: suffering from postpartum depression does not make you a bad mother. Getting treatment is the best gift — for yourself and for your child.