Delayed Postpartum Depression: Recognizing the Signs and Seeking Help

Postpartum depression typically manifests within the initial six weeks post-childbirth, but it can also arise later. Diagnosing it can be difficult, and much-needed treatment is often missed. New moms might feel like they should be better adjusted, but symptoms can make it difficult to bond with their new baby. Learn the signs and steps you can take to prevent, cope, and treat delayed postpartum depression.

What is delayed postpartum depression (DPPD)?

Growing evidence is showing that postpartum depression doesn’t follow a strict timeline. In general, the first six weeks are often the most likely for symptoms to develop. However, delayed onset can occur, where symptoms arise months later. Delayed postpartum depression (DPPD) can occur even a year after childbirth, and in some cases, beyond that.

How long does DPPD last?

The duration of DPPD is different for everyone. It depends on many factors, like its severity, treatment, and individual circumstances such as life stressors, lifestyle, and health status. It can last from a few months to two years, depending on the available support and treatment interventions. Fortunately, with effective treatment, sufferers can often experience improvements, but the timing varies per person and situation.

Baby blues vs. delayed postpartum depression

It’s common to feel a dip in mood or feel sad within the first two weeks of giving birth. You might notice more irritability, tearfulness, mood swings, or just feeling overwhelmed. These feelings are part of the baby blues and usually resolve naturally, depending on your support system and situation. In general, it's more common to experience baby blues compared to postpartum depression.

DPPD, on the other hand, can pop up weeks or months after birth. The symptoms are usually persistent and more severe, interfering with daily tasks and bonding with the baby.

Postpartum psychosis vs. delayed postpartum depression

While rare, postpartum psychosis can develop within the first few weeks after childbirth. Unlike DPDD, which has symptoms similar to depression, this is an even more severe mental health condition. Symptoms may include hallucinations, delusions, confusion, and extreme mood swings. Immediate medical attention is essential to avoid risks to the mom and baby.

Symptoms of delayed postpartum depression

DPPD shares symptoms with postpartum depression, including:

Treatment for delayed postpartum depression

Just like with any form of depression, treatment plays a crucial role in alleviating symptoms and facilitating recovery. Here are some prevalent treatment approaches worth exploring:

Talk therapy

Research continuously shows that talk therapy is extremely beneficial for people with depression. For DPPD, cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT) can help new parents develop better tools for coping with stress and managing negative thought patterns. Plus, having a therapist offers an alliance and added support system for speaking freely about the difficulties of parenthood — something many new parents feel they have to hide.

Medication

In some cases, antidepressants might be prescribed to new parents struggling with late-onset postpartum depression. They work to reduce symptoms, making it easier to carry out daily tasks. Talk therapy is often recommended alongside medication so that new coping strategies can also be learned. Speaking to your doctor about it is the first step toward learning if this is a good option for you.

Prevention and coping strategies

It’s important to consistently check in with yourself, and your doctor, to screen for signs of depression throughout pregnancy and after childbirth while working on self-care. Slowly adopting healthier habits and working to find a community of support can help prevent and cope with depression.

Add stress-relieving activities

There are certain stressors in life we don’t have much control over, but there might be one or two things you can do daily to help yourself manage life’s difficulties. What works will be different for everyone, but you can schedule a few minutes daily to try different practices. For example, a 5-minute meditation or breathing and progressive muscle relaxation exercises. You can also work on setting boundaries to care for your needs, delegate more tasks when possible, and see loved ones as much as you can.

Slowly tweak habits

No one’s lifestyle changes overnight, it’s all about tiny tweaks to your current habits for long-term change. For example, rather than trying to 'eat healthy,' think about one manageable step toward eating more nutritiously. That could mean adding another serving of vegetables to every lunch or going for a light walk after dinner for better digestion. The smaller, more practical, and enjoyable it is, the more likely you’ll stick with it.

Build a personal support system

Countless people live without a tight-knit community around them, increasing feelings of loneliness and sadness. But that doesn’t mean it’s impossible to build a network. It might be uncomfortable, but putting yourself in a vulnerable position often is. Look for in-person meetups for new parents or join hobby groups that include parents and kids. If you have babysitting help, try an activity you enjoy where you can meet others, like a photography, dance, or pottery class.

Try support groups

A sense of community and social support is one of the most important areas you can focus on to improve your mental health. A safe space to share your concerns, and see others struggling with the same issues, can increase your social bonds and sense of security that nothing’s 'wrong' with you.

Many online or in-person support groups are free of charge, which makes this type of support accessible for parents struggling with finances. There are also groups facilitated by a licensed practitioner that can be much cheaper than one-to-one therapy.

Causes and risk factors of postpartum depression (PPD)

PPD is caused by a combination of different factors. For example, some influences include stress and a lack of support.

Hormonal changes can also contribute since estrogen and progesterone are heavily impacted by childbirth. They rise during pregnancy, followed by a rapid decline after delivery. These hormonal shifts affect neurotransmitter activity, such as serotonin and dopamine, which can lead to mood disturbances until hormones rebalance.

A personal or family history of mental health issues can also increase the odds of experiencing PPD. Using substances, such as alcohol or drugs, heightens the risks of late-onset postpartum depression, as well.

There are further stressors that are generated specifically from pregnancy or childbirth. This includes body image concerns, unrealistic expectations of motherhood, unplanned pregnancies, pregnancy complications, and childbirth trauma.

Paternal postpartum depression

While not often talked about or recognized in many cultures, new dads can also experience depression after a baby is born. Fathers who experience paternal postpartum depression (PPPD) have similar symptoms to maternal PPD. This includes persistent sadness, irritability, and difficulty bonding with the baby — and it can occur in approximately 8% of fathers.

PPPD may arise from a variety of factors, such as a lack of sleep, changed relationship dynamics, and other added stressors to do with becoming a parent. Just like moms, dads experiencing PPPD symptoms may benefit from getting professional help, setting self-care routines, and building a community of support.

For both moms and dads experiencing emotional difficulties in the postpartum period, it’s important to notice if it’s just the temporary baby blues or more. With depression, symptoms can begin soon after birth or develop gradually, but start to take over to the point where you feel you can’t bond with your baby or manage daily tasks. It doesn’t matter if it starts right after childbirth or months later, depression can develop at any time.

Once you notice the signs, take a moment to think about what needs aren’t being met. It might be support, an outlet to let out your frustrations, rest, or more alone time. Either way, reaching out to friends, family, and professionals can offer you the resources you need to manage postpartum depression and begin the healing process.