Post-partum depression

by Dr. Tanya Tulipan, Psychiatrist
Reproductive Mental Health Services, IWK Health Centre, Halifax

Post-partum Depression (PPD) is the most common medical complication of pregnancy.  About one in nine womxn will experience PPD, a condition so common that experts recommend that every new mom be screened for it.  And yet, only one in three womxn with PPD gets the help that they need.

Why is it so hard for womxn to get help?  One problem is getting an accurate diagnosis.  The symptoms of PPD include sadness, mood swings, irritability, sleep changes, appetite changes, low energy and motivation, guilt and low self-esteem.  Some of those symptoms can also be “normal” in a new mom. After all, who sleeps well with a baby? Many new moms say that they don’t have much energy, that they feel guilty a lot, and that they can be cranky sometimes.  Moms, their friends, their family, and their doctors can sometimes be dismissive of symptoms by saying, “it’s just the hormones,” or, “it’ll get better once the baby sleeps”. And sometimes that’s true. Other times, however, these are symptoms of a serious illness.

Fighting the stigma

There’s also the stigma of mental illness.  Even though PPD is a medical condition, a lot of people are worried to admit that they could have it.  Moms are worried that people will think that they are unfit mothers, or that they don’t love their babies.  Worse, what if they think that she has PPD and will hurt her baby? While it’s true that PPD, in its severe forms, can make it difficult for mothers to bond with their babies, it is a treatable condition.   It has nothing to do with your worth or ability as a mom.

It is really important to get the right diagnosis and treatment.  Depression is a serious illness no matter when it happens. When it happens to a mother, it affects not only her health, but also the health of her whole family.  Partners of depressed mothers are at risk of depression too. Babies with severely depressed moms, if it’s left untreated, can develop attachment disorders and are at long-term risk of mental illness.

What to do if you suspect you have PPD

So how does a mom figure out if she has PPD?  There are lots of ways to get help with that. A good place to start is with your family doctor, midwife or obstetrician.  You can also talk to your public health nurse, doula or family resource centre worker. They are trained to recognize the early signs of PPD, and know how to access care.  There are also online resources, like and Postpartum Support International at

Treatments may include medications and alternative therapies

If you are diagnosed with PPD, you will likely be treated by your family doctor, a therapist or a psychiatrist.  The two mains forms of treatment are psychotherapy (talk therapy) and antidepressant medication. Your care provider can help you figure out which treatment is best and safest for you and your baby.  Most antidepressants can be safely taken while breastfeeding.

Other activities that can help the psychotherapy and medication to work include exercise, yoga, mindfulness, meditation, and bright light therapy.  Getting as much as rest as you can, seeing friends, and making time to connect with your partner will also help in your recovery. These things are not enough on their own to treat PPD, but they do act as “boosters” and make up an important part of your treatment plan.

Pay attention to your body

If you have a new baby and you aren’t feeling like yourself, pay attention to those feelings.  Everyone gets tired and cranky sometimes. But if you notice that:

  • you are sad or irritable most of the time
  • you can’t sleep even when your baby sleeps
  • you aren’t feeling as connected to your baby as you thought you would be
  • you aren’t enjoying things the way that you used to
  • you feel very guilty, like a burden, or worthless
  • you have thoughts that your baby would be better off without you

Then please reach out for help.  Remember that PPD is a treatable medical condition.  You deserve to be healthy and to enjoy your family!