What is postpartum depression? Who’s most at-risk of developing it?

A slew of developments in women's healthcare emerged in 2023: In May, the Food and Drug Administration (FDA) approved the first-of-its-kind drug to treat menopausal hot flashes. In June, it approved the first over-the-counter birth control pill.

The latest development is zuranolone, brand name Zurzuvae. On August 4, 2023, the FDA approved Zurzuvae, the first pill specifically for postpartum depression. Before then, healthcare professionals had to administer intravenous injections for this potentially life-threatening condition.

These announcements in women’s health also come at a time when states are considering the legality of abortion access — including bans on the abortion pill — since the Supreme Court overturned Roe v. Wade on June 24, 2022.

What is postpartum depression?

The FDA defines postpartum depression as a major depressive episode that occurs after a woman gives birth. The onset is usually within the first month after childbirth, but women remain at risk for up to a year afterwards. And although “postpartum” refers to the time after giving birth, this type of depression can also begin in the later stages of pregnancy.

Perinatal depression encompasses minor or major episodes of depression anytime during pregnancy or up to a year after giving birth.

What are the symptoms of postpartum depression?

Symptoms include feelings of sadness, guilt, and worthlessness. In extreme cases, it can include thoughts of self-harm, or harming one's child.

The Office on Women's Health (OWH) differentiates postpartum depression from the “baby blues,” is a term people use to describe mood swings and feelings of worry and anxiety that are common after giving birth. Baby blues typically resolve on their own within two weeks, according to the Centers for Disease Control and Prevention (CDC). Postpartum depression is more serious and longer-lasting, and should be treated by a healthcare professional.

The OWH advises that women who feel emotionless or sad all or most of the time for longer than two weeks, either during or after pregnancy, should reach out for help. Postpartum depression can last months or years after giving birth.

How long can postpartum depression last?

According to the CDC, postpartum depression can last months or years after giving birth. If left untreated, postpartum depression can interfere with a mother’s ability to bond with and care for her baby. It not only affects her health — it can harm the infant's physical and emotional growth.

How many women get postpartum depression?

A 2018 CDC survey across 31 sites included in its Pregnancy Risk Assessment Monitoring System found that an average of 13.2% of women experienced postpartum depressive symptoms after giving birth. The data, collected from 29 states, New York City, and Puerto Rico, showed variance in the prevalence of postpartum depression, from 9.7% of women in Illinois to 23.5% in Mississippi. The average across all locations was 13%.

Who is most at-risk for developing postpartum depression?

Although not representative of the entire country, the same CDC survey showed that the prevalence of postpartum depressive symptoms was greater in younger women. 22% of women ages 19 and younger reported symptoms. Among older survey respondents, those numbers dropped: 17.8% of women ages 20–24, 11.9% of those who were 25–34, and 10.8% of those 35 and older reported symptoms.

Non-Hispanic American Indian/Alaska Native women reported the highest rate, at 22.0%. This was followed by non-Hispanic Asian/Pacific Islander women at 19.2%, non-Hispanic Black women at 18.2%, Hispanic women at 12.0%, and non-Hipsanic white women at 11.4%.

Other factors that may increase the risk of developing postpartum depression include a history with depression, experiencing intimate partner or domestic violence, or living at or near the poverty line: women who received benefits from the government’s nutrition program for Women, Infants, and Children (WIC) reported higher rates (17.0%) compared to those who did not (11.2%).

Do healthcare providers screen for postpartum depression?

The CDC recommends that healthcare providers screen pregnant and postpartum women for depressive symptoms so they can treat issues as soon as possible, refer them to helpful resources, and follow up on their progress. Yet about 1 in 5 women were not asked about depression during a prenatal visit.

The CDC also advises that pregnant or postpartum women who are feeling overwhelmed or depressed make an appointment to speak to their healthcare provider as soon as possible.

If you are struggling with mental health issues, call the SAMHSA National Helpline, 1-800-662-HELP (4357), a free, confidential, 24/7, year-round treatment referral and information service. Or, call the 988 Suicide and Crisis Lifeline. If you are thinking about harming yourself or attempting suicide, tell someone who can help immediately and call 911.

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