Perinatal depression refers to depression occurring during pregnancy or after childbirth. The use of the term perinatal recognizes that depression associated with having a baby often begins during pregnancy (National Institute of Mental Health, 2024). Perinatal depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference and/or anxiety, as well as changes in energy, sleep, and appetite. It carries risks for the mother and child.
An estimated one in seven women experiences perinatal depression (Centers for Disease Control and Prevention, 2024).
For most pregnant and postpartum individuals, having a baby is a very exciting, joyous, and often anxious time. But for people with perinatal depression, it can become very distressing and difficult. Pregnancy and the period after delivery can be a particularly vulnerable time. Mothers often experience biological, emotional, financial, and social changes during this time (World Health Organization, 2023). Some individuals can be at an increased risk for developing mental health problems, particularly depression and anxiety.
The U.S. Preventive Services Task Force updated recommendations emphasize routine screening for depression and anxiety in pregnant and postpartum individuals (USPSTF, 2023).
Not Just the ‘Baby Blues’
Up to 85% of all new mothers experience the “baby blues,” a short-lasting condition that does not interfere with daily activities and does not require medical attention (Johns Hopkins Medicine).
Perinatal depression is different from the “baby blues” in that it is emotionally and physically debilitating and may continue for months or more.
Impact on Mother and Baby
Untreated perinatal depression is associated with preterm birth, low birth weight, and impaired maternal-infant bonding, as well as long-term cognitive and emotional effects in children (Slomian et al., 2023).
It also increases the risk for developmental delays and impaired social functioning in offspring.
Prevalence and Disparities
An estimated 10–15% of White women experience postpartum depression, with higher rates among racial/ethnic minorities (Bauman et al., 2023; Robertson & Wells, 2023). Recent research confirms persistent disparities among Latina and African American women, influenced by structural inequities, discrimination, and access barriers (Lara-Cinisomo et al., 2023; Bauman et al., 2023).
Fathers / Co-Parents: Approximately 8–10% of fathers experience postpartum depression, particularly when maternal depression is present.
Symptoms of perinatal depression include (APA, 2022):
- Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite
- Trouble sleeping or sleeping too much
- Fatigue
- Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech
- Feelings worthlessness or guilt
- Difficulty concentrating
- Thoughts of death or suicide
- Crying for “no reason”
To be diagnosed with perinatal depression, symptoms must begin during pregnancy or within one year following delivery.
Anxiety and Comorbidity
Many individuals with perinatal depression also experience anxiety disorders. Recent research confirms high comorbidity between depression and anxiety in the perinatal period (Howard & Khalifeh, 2024).
The U.S. Preventive Services Task Force (2023) now recommends routine anxiety screening in adults, including perinatal populations.
There is no single diagnostic test; diagnosis requires clinical evaluation. Assessment should include psychiatric and medical evaluation (e.g., thyroid dysfunction). Primary care, OB-GYN, and mental health clinicians play a central role, with increasing emphasis on integrated behavioral health in obstetric care (Byatt et al., 2023).
Treatment
Treatment can include:
- Talk therapy (psychotherapy)
- Medication
- Social support and lifestyle interventions.
Medication and New Advances
Antidepressants (SSRIs, SNRIs, etc.) remain first-line for moderate to severe cases. Recent advances include rapid-acting neuroactive steroid treatments (e.g., zuranolone, brexanolone), representing major progress in postpartum depression care (Meltzer-Brody et al., 2023).
Self-Help and Support
Support groups, family engagement, and community-based interventions are critical. Programs like Postpartum Support International (local support groups, and online support) provide accessible care.
How Partners, Family and Friends Can Help
Strong support from partners, family and friends is very important. Here are some suggestions from Moms’ Mental Health Matters, a National Institutes for Health initiative, for how loved ones can help:
- Know the Signs. Learn to recognize the symptoms of depression and anxiety and if you see signs, urge her to see a health care clinician.
- Listen to Her. Let her know you want to hear her concerns. For example, "I notice you are having trouble sleeping, even when the baby sleeps. What's on your mind?"
- Give Her Support. Let her know she's not alone and you are here to help. Try offering to help with household tasks or watching the baby while she gets some rest or visits friends.
- Encourage her to seek help if needed. She may feel uncomfortable and not want to seek help. Encourage her to talk with a health care clinician. Share some information on peripartum conditions. Offer to make an appointment for her to talk with someone.
Crisis Support
- National Maternal Mental Health Hotline
- Call or text 1-833-TLC-MAMA (1-833-852-6262) Free, confidential hotline for pregnant and new moms in English and Spanish, 24/7 - 988 Suicide & Crisis Lifeline
- Call or text 988
Risk factors include:
- Prior psychiatric history
- Trauma and adverse life events
- Limited social support
- Socioeconomic stressors
Latina and minority women are disproportionately exposed to these risk factors due to structural inequities (Lara-Cinisomo et al., 2023).
Protective factors include strong social support, which is associated with reduced symptom severity
Although estimates vary, a 2016 study found that about 16% of women experience an anxiety disorder during pregnancy and about 17% experience it during the postpartum period (Fairbrother 2016). After giving birth, some women develop intense anxiety, with rapid heart rate, a sense of impending doom and irrational fears and obsessions. Feeling guilty and blaming oneself when things go wrong, and worrying and feeling panicky for no good reason are signs of anxiety in the peripartum period (MGH Center for Women’s Mental Health).
Treatment may include medication and therapy, alone or in combination.
Bipolar disorder has two phases, the depression phase (the ‘lows’) and the manic phase (the ‘highs’). When the ‘lows’ and ‘highs’ happen at the same time, it is considered a ‘mixed’ episode. Bipolar disorder can emerge during pregnancy or the postpartum period. Risk factors include a previous mood disorder and family history of mood disorders.
Symptoms of depression and mania:
- Severe sadness and irritability
- Elevated mood
- Rapid speech and racing thoughts
- Little or no sleep and high energy
- Impulsive decisions and poor judgment
- Delusions that can be grandiose or paranoid
- Hallucinations – seeing or hearing things that are not present
Treatment can include mood stabilizers and antipsychotic medications (Yonkers 2004) along with therapy.
Postpartum psychosis is an extremely rare but serious condition — it occurs in only one or two out of every 1,000 deliveries. The symptoms of peripartum psychosis are extreme and may include insomnia, excessive energy, agitation, hearing voices, and extreme paranoia or suspiciousness. Many women with postpartum psychosis have a personal or family history of bipolar disorder. Symptoms of postpartum psychosis can be a serious medical emergency and require immediate attention.
These conditions require prompt psychiatric evaluation and treatment.
Physician Review
Ruby C. Castilla-Puentes, M.D., Dr.P.H., M.B.A.
Member, APA Council on Communications
Member, APA Spanish Language Communications Working Group
President, APA Hispanic Caucus
President and Founder WARMI – Women’s Mental Health
May 2026
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787
- Bauman BL, Ko JY, Cox S, et al. (2018). Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018. MMWR Morb Mortal Wkly Rep, 2020;69:575–581. DOI: http://dx.doi.org/10.15585/mmwr.mm6919a2
- Byatt, N., et al. (2023). Enhancing perinatal mental health care: Integration of behavioral health into obstetric care. Obstetrics & Gynecology Clinics of North America. https://doi.org/10.1016/j.ogc.2023
- Centers for Disease Control and Prevention. (2024). Symptoms of Depression Among Women (Reproductive Health). https://www.cdc.gov/reproductive-health/depression/
- Howard, L. M., & Khalifeh, H. (2024). Perinatal mental health: A review of progress and challenges. Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(24)
- Lara-Cinisomo, S., Clark, C. T., & Wood, J. (2023). Increasing access to perinatal mental health care among Latina women. Archives of Women’s Mental Health. https://doi.org/10.1007/s00737-023
- Meltzer-Brody, S., et al. (2023). Brexanolone and zuranolone in postpartum depression: Advances in rapid-acting treatments. New England Journal of Medicine / JAMA Psychiatry updates. https://www.nejm.org
- National Institute of Mental Health. (2024). Perinatal Depression. https://www.nimh.nih.gov/health/publications/perinatal-depression
- Robertson, K., & Wells, R. (2023). Black with “Baby Blues”: A Systematic Scoping Review of Programs to Address Postpartum Depression in African American Women. Maternal and Child Health Journal, 27(3), 413–425. https://doi.org/10.1007/s10995-023-03589-5
- Slomian, J., Honvo, G., Emonts, P., et al. (2023). Consequences of maternal postpartum depression: Updated review of maternal and infant outcomes. BMC Pregnancy and Childbirth.
- U.S. Preventive Services Task Force. (2023). Screening for Anxiety Disorders in Adults: US Preventive Services Task Force Recommendation Statement. JAMA, 2023;329(24):2163–2170. https://jamanetwork.com/journals/jama/fullarticle/2806250
- U.S. Preventive Services Task Force. (2023). Screening for Depression and Suicide Risk in Adults: Updated Recommendation Statement. JAMA, 2023;329(23):2057–2067. https://jamanetwork.com/journals/jama/fullarticle/2806144
- World Health Organization. (2023). Maternal mental health and child health and development: Evidence brief. https://www.who.int/publications