PSI HelpLinePostpartum Support International — call or text 1-800-944-4773. Free, confidential, English & Spanish.In crisis? Call or text 988.
Postpartum depression is a medical condition — not a moral failure
Postpartum depression (PPD) affects approximately 1 in 7 birthing parents — making it the most common complication of pregnancy and childbirth. It can start during pregnancy (prenatal depression) or anytime in the first year after birth. It is not caused by something you did or didn’t do, and it does not mean you don’t love your baby. It is a medical condition driven by a combination of hormonal shifts, sleep deprivation, life stress, and individual vulnerability — and it is highly treatable.
AI-assisted content — clinician review required. This page was assembled with AI assistance using evidence-based sources. It is for education only and does not replace professional medical advice.
What postpartum depression looks like
PPD is more than sadness. It can show up as numbness, rage, disconnection, or an overwhelming anxiety that something terrible is about to happen. Symptoms typically last longer than two weeks and interfere with daily functioning.
Emotional
- Persistent sadness, emptiness, or feeling numb
- Crying more than usual, or inability to cry when you feel you should
- Feeling overwhelmed, hopeless, or worthless
- Intense guilt — feeling like a bad parent
- Loss of interest or pleasure in things you used to enjoy
- Difficulty bonding with or feeling connected to your baby
- Irritability, anger, or rage that feels disproportionate
Physical & cognitive
- Exhaustion beyond what sleep deprivation explains
- Changes in appetite — eating much more or much less
- Insomnia (even when the baby sleeps) or sleeping excessively
- Physical symptoms: headaches, stomachaches, muscle pain
- Difficulty concentrating, making decisions, or remembering things
Behavioral
- Withdrawing from partner, family, or friends
- Avoiding the baby, or being afraid to be alone with the baby
- Thoughts of escape — wanting to run away or not wake up
- In severe cases, thoughts of harming yourself or the baby
Risk factors
Anyone can develop PPD, but these factors increase vulnerability. Having risk factors does not mean you will develop PPD — and many people develop it without any obvious risk factors.
- Previous history of depression, anxiety, or other mood disorders
- History of perinatal mood disorders in a prior pregnancy
- Family history of mood disorders or perinatal depression
- Lack of social support or partner support
- Stressful life events during pregnancy or postpartum
- Pregnancy or birth complications; NICU stay
- History of trauma, including childhood adversity
- Unplanned or unwanted pregnancy
- Financial stress or housing instability
- Difficulty with breastfeeding (can be both cause and symptom)
- Thyroid dysfunction (should be ruled out medically)
Treatment that works
With appropriate treatment, the vast majority of people with postpartum depression recover fully. Earlier intervention tends to go better — if you recognize yourself in the symptoms above, please reach out to your healthcare provider.
Psychotherapy
Cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) have the strongest evidence for perinatal depression. Therapy can be individual or group-based, and can start during pregnancy or postpartum. Many therapists now offer telehealth, which can be especially valuable when leaving the house with a newborn feels impossible.
Medication
SSRIs (like sertraline and escitalopram) are the most commonly prescribed antidepressants for perinatal depression and are generally considered compatible with breastfeeding. Your provider can help you weigh the risks and benefits — the risk of untreated depression to you and your baby is also part of that equation. Never stop medication abruptly without medical guidance.
Peer support
Postpartum Support International (PSI) runs free support groups (online and in-person) specifically for perinatal mood disorders. Connecting with other parents who understand what you're going through can reduce isolation and shame. PSI's NH chapter can connect you to local groups.
Practical & lifestyle support
Sleep (protected and prioritized), physical activity, nutrition, sunlight, and practical help with the baby are all evidence-based adjuncts to formal treatment. You can't therapy your way out of sleep deprivation — asking for and accepting help is a clinical intervention, not a luxury.
Crisis & support resources
If you or someone you know is in crisis, help is available right now. You don’t need to be in immediate danger to call — these lines are for anyone who needs support. If there is immediate danger, call 911.
Postpartum Support International (PSI) HelpLine
1-800-944-4773Call or text. Available in English and Spanish.
NH Rapid Response Access Point
833-710-647724/7 access to NH mobile crisis teams and behavioral health services.
National Maternal Mental Health Hotline
1-833-852-62621-833-TLC-MAMA. Free, confidential, 24/7, English and Spanish.