Mood and thoughts
Persistent sadness, hopelessness, little confidence in yourself or constant worry about caring for your child.
Depression · around childbirth
Perinatal depression: symptoms, treatment and help
Sadness, fear or emptiness during pregnancy or after birth deserves help. Read about treatment, medication and support for parent and baby.
You don't have to wait until you can no longer care for yourself or your baby. Depression around childbirth is treatable. The approach takes into account your history, sleep, safety and practical situation.
Zorgfuik provides general information and does not make a diagnosis. Discuss personal symptoms, treatment and medication with a qualified healthcare provider.
Sources checked for . General information; Have treatment during pregnancy and breastfeeding personally assessed.
Recognising depression during or after childbirth
Depression can start during pregnancy or in the weeks and months after giving birth. You hear terms like prenatal, perinatal, postnatal or postpartum depression. The formal classification sometimes uses narrower time limits than daily care. Symptoms that start later also deserve assessment.
It's not just about crying. You may experience emptiness, little pleasure, strong fear, guilt, or the idea that you are inadequate. Sometimes it is difficult to feel contact with the baby. That doesn't automatically make you a bad parent and doesn't mean the bond can't grow.
Sleep and energy
Not being able to sleep, even when someone else is caring for the baby, can provide additional information. Fatigue alone does not prove depression.
Daily functioning
Eating, showering, making decisions or keeping in touch becomes difficult. Get help before everything gets stuck.
Baby blues, anxiety, obsessive thoughts and depression
Baby blues or baby blues usually occur in the first few days and usually disappear within about ten days to two weeks. Depressive symptoms last longer or are more severe. In case of severe symptoms, do not wait until that period has expired.
Anxiety, obsessive-compulsive symptoms or trauma symptoms after a major birth can also occur, separately or in addition to depression. A doctor looks at the complete picture; a questionnaire alone does not provide a diagnosis.
Who can you contact?
Start with your GP and also tell your midwife, maternity care or youth health care what you notice. You don't have to choose between caring for yourself and caring for your baby: appropriate help supports both.
Depending on the severity and history, the GP can refer to a psychologist, psychiatrist or POP clinic. At a POP clinic, psychiatry, obstetric care and pediatrics work together on pregnancy and parenting. The precise organisation varies per hospital.
Tell your clinician about previous depression, mania, psychosis, previous symptoms surrounding childbirth and your current medications. Ask who keeps an overview if multiple healthcare providers are involved. Also have physical symptoms assessed; not every exhaustion after childbirth is due to depression.
What treatment can help?
Psychotherapy can help to tackle symptoms, worrying, behaviour and changes in your life. With CBT you investigate how thoughts and behaviour maintain symptoms. IPT focuses, among other things, on relationships, support and role changes. Discuss what is appropriate with a clinician who knows your situation.
Practical help and sleep protection are important, but do not replace treatment for depression. For more severe symptoms, medication or a combination may be necessary. Intensive care or admission is considered if insufficient safety or support is available at home.
If necessary, also ask for support in contact with your baby. The goal is not to have warm feelings on command. Finding quiet, feasible contact moments together can be part of care.
NIMH: Treatment Options. Read more about psychotherapy for depression.
Antidepressants during pregnancy and breastfeeding
An assessment concerns the risks of the drug and of insufficiently treated symptoms. Previous efficacy, risk of relapse, stage of pregnancy, other medications and the health of the baby count. A drug that previously helped well is not automatically replaced as soon as you become pregnant.
There are often options when breastfeeding. For example, sertraline is a drug that can be considered, but 'can be used' does not mean that it is the best choice for every parent and baby. Additional assessment may be necessary in the event of prematurity, illness or side effects in the baby.
Do not stop or switch yourself because of a positive pregnancy test or a warning online. Ask the prescriber and pharmacist for a joint plan, including checks and what to do in case of symptoms. Also discuss any supplements.
Mothers of Tomorrow Lareb: antidepressants and pregnancy and Thuisarts: medication and breastfeeding. More explanation about it types of antidepressants.
What can you and those around you do today?
- Make help concrete. Ask someone to bring a meal, do the laundry or go to the doctor.
- Plan defecation. Agree who will take care of the baby while you rest. If necessary, coordinate nutrition and night care with the healthcare providers involved.
- Limit expectations. Receiving visitors, a tidy house and quickly getting back to your old self do not take priority over recovery.
- Keep one line of contact open. Arrange with a trusted person to actively ask how things are going, even if you have little initiative.
- Let the partner also seek support. Partners and other parents may experience depressive symptoms or overload themselves and may ask for help.
A practical opening sentence: 'I notice that I don't feel well and it doesn't get better on its own. Can you help me make an appointment and take care of something at home in the meantime?'
Practical elaboration of NHS: postnatal depression and support.
Postpartum psychosis: seek help immediately
Rapidly increasing insomnia with strong agitation, confusion, unusual beliefs, voices or manic behaviour may indicate acute psychiatric disturbance. Postpartum psychosis isn't just a heavier version of baby blues. It can deteriorate rapidly and requires emergency assessment on the same day.
Immediately call your GP, out-of-hours GP service or your own crisis team. Make sure another trusted adult takes care of the baby safely. Do not leave the parent alone if it is unsafe; don't put yourself in danger.
After recovery, discuss which checks remain necessary and make a prevention plan early if you next wish to become pregnant. Questions for the doctor: who coordinates care, what do we agree on about sleep and medication, and who do we call at the first warning signs?
Frequently asked questions
What is the difference between baby blues and depression?
Baby blues usually occur shortly after delivery and usually disappear within ten days to two weeks. Persistent or severe symptoms require assessment; In case of severe symptoms, do not wait for that period.
Can depression start during pregnancy?
Yes. Depressive symptoms can arise during pregnancy or in the weeks and months after childbirth. Symptoms that start later also deserve attention.
Do unwanted thoughts mean I want to harm my baby?
Not automatically. Intrusive, unwanted thoughts are different from a wish or plan. Discuss them with a healthcare professional. In case of intention, loss of control or safety concerns, immediate help is needed.
Are antidepressants possible during breastfeeding?
There are often options. The choice depends, among other things, on the drug, previous effect and the health of the baby. Discuss this with the prescriber and pharmacist.
Should I stop taking medications if I am pregnant?
Do not stop or change yourself. Have the benefits and risks of medication and untreated symptoms assessed together and make a personal plan.
What is postpartum psychosis?
An acute psychiatric disorder after childbirth, for example with confusion, delusions, voices or manic behaviour. Call your GP or out-of-hours GP service immediately; if the parent or baby is in immediate danger, call 112.
What can loved ones do?
Offer concrete help with meals, housekeeping, appointments and safe care of the baby. Help organize rest and keep asking how things are going, without forcing recovery.
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