A Postpartum Depression Timeline: When It Starts and How Long It Can Last
From the last trimester of pregnancy to a year after giving birth, experts shed light on when postpartum depression symptoms can appear in new parents.
Three months after the birth of her first child, Shoshana Bennett went to her OB, desperate for help. "If life is going to be like this, I don't want to be here anymore," she told him. The year was 1983, and the medical profession's understanding of the severe depression that affects 1 out of 7 new moms was limited. "He laughed and said, 'All new mothers feel this way. Go do something nice for yourself and it will pass,'" she recalls.
Dr. Bennett's years-long struggle with what is now known as postpartum depression (PPD) prompted the special education teacher to return to school and earn a Ph.D. in psychology. She's since helped pioneer the field of maternal mental health, publishing four books on the subject, including Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety, and speaking on the topic around the world to help women cope with persistent feelings of emptiness and sadness brought on by the mood disorder.
Pregnant women who are at increased risk for developing PPD—such as those with a history of depression, PMS or PMDD—may want to look out for the first signs and symptoms and keep in mind the average timeline for postpartum depression.
When Does Postpartum Depression Start?
Despite its name suggesting otherwise, postpartum depression can begin shortly before giving birth—"Any symptom that may arise postpartum can begin in pregnancy," says Dr. Bennett—or kick in as late as one year post delivery. "In my case, once the placenta was delivered, I plummeted into a deep severe state of depression."
Though there's no singular cause for PPD, experts believe a steep drop in the hormones estrogen and progesterone following childbirth may be to blame, kickstarting depression in the same way smaller hormonal changes prompt premenstrual mood changes.
On average, PPD usually begins in the first 3 weeks after having a baby, according to ACOG, the American College of Obstetricians and Gynecologists.
How Long Can Postpartum Depression Last?
"I started to regain myself when my daughter was 2-and-half years old," says Dr. Bennett. "My hair started to curl again, and I started to taste food and see color again.
Postpartum depression can improve quickly with professional treatment, but it usually doesn't resolve on its own. If left untreated, PPD has the potential to become a long-term condition.
Research suggests that the longer a woman suffers from PPD after giving birth, the more likely she is to experience chronic depression. A 2018 study published in JAMA Psychiatry found that the majority of women who suffered from severe depression at 2 and 8 months postpartum continued to experience symptoms of depression more than 10 years later.
"As with any disorder, the sooner PPD gets treated the better the prognosis is for mom and the entire family," says Dr. Bennett.
Postpartum Depression Timeline in Dads
Around 5 to 10 percent of fathers experience postpartum depression, according to a 2014 study published in the journal Pediatrics. It can be caused by sleep deprivation and many other factors—"but obviously not by reproductive hormones, as it often does in women," says Bennett—and may result in anger, withdrawal, and feelings of overwhelm or neglect.
"PPD is very relational in how it impacts couples," says Brandon Eddy, Ph.D., marriage and family therapist and assistant professor at the University of Nevada, Las Vegas. Research from the National Institutes of Health shows that men whose partners have PPD are more likely to suffer from PPD themselves, experiencing it at an increased rate of between 24 to 50 percent.
The postpartum timeline for dads can be very similar to that of moms. "The first few weeks are a difficult adjustment for both parents, but if people find themselves still really struggling and depressed after that then they should seek treatment immediately," says Dr. Eddy. "PPD is only going to get worse without treatment."
Finding the Right PPD Treatment for You
The most effective treatment for PPD is a combination of psychotherapy and medication, says Dr. Eddy, but Dr. Bennett says parents who are opposed to taking antidepressants shouldn't let that keep them away. "Not all patients need medication," she says.
Bennett also emphasizes the importance of working with a practitioner who specializes in maternal mental health.
"They should have at least a two-day training in specific perinatal mood disorders and be able to rattle off a list of resources like the documentary The Dark Side of the Full Moon," says Dr. Bennett. "There's no better gift to your child than a happy, healthy, grounded parent," she adds.
For help, call the Postpartum Support International helpline at 1-800-944-4773 or send a text to 503-894-9453.