Does Postpartum Depression Only Occur in the Weeks After Baby is Born?

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I received the following email from a reader of Postpartum Progress, and her story was so interesting to me that I wanted to share it with you. I don’t doubtsome of you have had an experience similar to hers. What so many people don’t understand is how little training physicians receive on perinatal mood and anxiety disorders, and how wrong they often are about the information they give their patients. Here’s the email:

“I just LOVE that you have on your website:

[Postpartum depression] can show up any time in the first 12 months after having a baby (or after having a miscarriage, a stillbirth, or an abortion, in fact). Most often, it rears its ugly head sometime between three and four months after the baby is born, but it wouldn’t be unusual if it showed up earlier or later.

Everything I read from the literature given at the hospital, my doctor’s office and on major websites all stated that PPD occurs up to 4-6 weeks after delivery … so when I was four months postpartum and the baby was sleeping and I wasn’t and was having major anxieties about driving and sleeping and still having crying outbursts I kept thinking ‘Well, it couldn’t be PPD because that only occurs right after the baby is born … something else must be majorly wrong with me’

With the love and support of friends and family, I was able to get the help I needed. I am now 16 months postpartum and got my life back. I’m having the time of my life with my son and am luckily able to balance a great career.

I hope that your education will extend somehow to the other literature that is out there. It’s 4-5 months or later that it can really hit some women and not necessarily right after the baby is born …”

So many women don’t think they have postpartum depression or related illnesses because they believe if it hasn’t shown up in the first few weeks it can’t be PPD. While it may in fact actually start in the first few months after chidlbirth, some women may not notice it until much later in the first year. And others have told me they really were doing okay until months later.

Here’s an example of this I found this week in the Sarasota Herald-Tribune, in a sidebar piece to an article on depression:

Postpartum depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

One month! The paper notes that the source for this information is the National Institute for Mental Health. UGH!!

I’d love to hear from those of you whose postpartum depression showed up later — or at least you didn’t recognize it until later. Did you also feel that it couldn’t be PPD?

 

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  1. Hi Katherine,
    Great topic. My PPD/Anxiety may have been brewing the whole time, but it hit me like a brick around the time my son was 3 months old. I knew something was terribly wrong and I was praying that it was PPD and not something permanent…but I was confused because of these two reasons: 1. It happened 3 months after my son was born and not immediately and 2. It seemed to come on so quickly. One day I was able to function and the next day I was incapacitated.
    The funny thing is, my friends all saw me go through it and now all my friends are having their 2nds. Some of them are telling me after couple of weeks with their 2nd newborn, that they avoided PPD. I don't know what to say…Do I say, "not so fast…it could still happen in a few months." Or do I say, "good for you!"?

  2. Someday I hope to really write about my experience, but in a nutshell, I realized at 3 mo. postpartum I was functioning at a lesser level than at 6 weeks pp. I had a baby who slept and ate well, a super-supportive husband, and experience with PPD after my 2nd baby (This was baby #4). But the anxiety I felt and the difficulty I experienced when making decisions or trying to finish formerly routine tasks convinced me that something was out of wack–like my thyroid. When the thyroid test came back in normal range, I bawled hopelessly. A few days later I saw an internist who spent 1 1/2 hours with me and ultimately declared I had Postpartum depression. "But I'm not depressed!" At least that wasn't the overriding symptom and I knew what PPD should feel like. In sum, my PPD/A has been anything but stereotypical or textbook. Now at 20 mo. postpartum, I am still dealing with some of the fallout of the disorder, but I am so much better. I say if you feel like something is not right at anytime during the Perinatal experience, get info (love this website!) and get help.

  3. This is a GREAT post, and I think it really says a lot that the 2 previous comments also mention their PPD was diagnosed 3 months postpartum. I was diagnosed with PPD when my daughter was 3 months old. I was definitely experiencing symptoms before then, but didn't get help or get diagnosed until 3 months postpartum. With me, I didn't think it was postpartum depression because I wasn't "depressed." I wasn't crying, didn't have trouble getting out of bed in the morning. None of that. For me, it was terrible, terrible irritability, and I just become a totally different person. Thankfully, my PPD was treated very well with anti-depressants. But, again – I wasn't diagnosed until 3 months postpartum.

  4. FINALLY someone is addressing this fact! I couldn't have PPD because WebMD says it occurs within six weeks of delivery… Well, I do have it! I've been on Zoloft for approximately 12 days now and feel like a zombie (but I'm only 35% depressed still). My OB wanted me to see a therapist who is "not in my network" and so I sit here, waiting for my appointment to arrive with a "generic therapist" to take control and monitor my meds (thanks to my HMO). I drop the pill in my mouth each night at 9:30pm (because it makes me completely useless after taking it) and then I wait for my eyelids to fight me for control of the night. Whether I want to or not, I'm bed bound within an hour of taking 50mg of Zoloft each night. My mind is erased. I can't remember what happens post med taking! My PPD began when I went back to work, severe emotions and anxiety attacks (About 11 weeks PP, but I waited an additional 7 weeks to address the situation). I lashed out at my husband and two other sons, my baby, however, was king! I'd like to get off the rollercoaster now, please!

  5. Hi Pamela, I just wanted you to know that I'm also taking Zoloft, and like you I felt tired and "out of it" fo the first few weeks when I took it. However, 3 months later, I am much more tolerant of those side effects and having a much more successful experience. You may find that the same thing happens with you, and if not you should be able to ask your doctor to help you find something else. I'm sorry you're frustrated, I have many of the same PPD/A issues as you. I hope you feel better soon. We're all in this together.

  6. Of course there is also another side of it. Sometimes, it might exist and just not be fully understood or admited.
    With my wife, I saw it early on, but she kept saying that it was just "baby blues". Since this was our first time, we really didn't understand what was happening. 3 years later, she admits that it got really bad, but back then, she was too sick to accept it. Then of course, once we decided that she needed help, it took even longer to get someone to help us.

  7. I went through post partum depression after I had my daughter. I can't say exactly when it started – things were somewhat rough from the start on a number of fronts, but it was definitely some time before I fully recognized and admitted that I was dealing with depression. In fact, to some extent, it was only as I made a few changes and began to come out of it that I fully realized how much it had been affecting me, and I remember another mom sharing a similar experience of coming out of the haze.
    When I had my son, I was watching closely for the signs of the depression that had hit me with my first. For about two and a half months, I thought I was doing okay. I'd had a few blue patches, but not the continual cycle of crying and self-deprecation and guilt I knew from the last journey. I was watching so closely for those familiar landmarks that I missed the anxiety that was building up to explosive levels behind me. I didn't recognize it until I began to crack. It was very frightening and I'm grateful that I didn't need to fight or push my doctor to get help.
    My son is now nearing 14 months, and I continue to struggle with cycles of anxiety and depression. I now run into the other arbitrary timeline that's associated with postpartum depression and anxiety – the assumption that postpartum issues will be resolved within a year. It's thankfully not be a barrier to continuing to get support, but the idea is out there, along with the question of when does it cease to be postpartum, vs. a more general issue, or PMDD?
    Great discussion.

  8. My daughter appears to be showing symptoms of PPD and so she called her OB/GYN to make an appointment. The nurse called her back today to say that after 3 months they don't consider it PPD and to call her primary doctor. Now she is confused and doesn't know what is wrong with her. I googled and found your site and told my daughter that she may still be suffering from PPD. She will be calling her primary doctor to set up an appointment. It's a shame some doctors don't want to acknowledge PPD after the first few weeks of delivering a baby.

  9. Joan,
    You can have PPD anytime in the first year after birth. The nurse who told your daughter that was completely uninformed. I'm truly sorry she had that experience. I hope the primary doctor has been more helpful.
    – Katherine

  10. At 6 months postpartum I watched my sister labor and push for 2 hrs with her son, and after a grueling labor she ended up with c section. I was fine but the next day is when I woke up feeling empty. Why was I here? What point was my life? I wasnt special. People have babies all the time. I have no purpose. I was suicidal. I thought I was gay and I thought I was going to hurt my daughter because I was so afraid of something bad happening to her that I dwelled on it and then internalized. I went into the hospital but was sane enough to realize I was not getting help. I signed out against medical advice after 3 days. I was just re-telling my story to the next worker who came on shift. There was no progress. My family babysat me for several months. I got outpatient care and tried many meds. After 1.5 yrs i was better. It was the scariest time of my life. Fake it till you make it and stay busy! Change your thought patterns, read self help books. Im not gay, but my friend just came out and I think, looking back on it, that I was looking for a reason why I might be sad.
    Mental illness runs in my family but within 2 yrs my mother died, we got married, got preg, gave birth, bought a house, found out a woman committed suicide in my house, and I witnessed an awful labor. I dont know if it was just too many changes at once, ppd, ppocd or ppp, or just my time for mental illness to hit.
    Paxil saved my life. Love your blog! Thanks for letting me vent…..dont get to talk about this often.

    • Thanks so much for this post. My grandfather came out left his family after being married for several years. When i went through post partum i experiene the same thing and am only 5 month out since having my son. It even started before i had him. I am on an anti-depressent Paxil and an anxiety medication but still have bad days. I just want to be better right away but have a feeling this is going to take time.

  11. I experienced PPD/A with both of my children. My oldest is 7 and my youngest is 13 mo. I suffered severely after the second one, and had to have inpatient treatment. Things got much better and I was coasting along swimmingly! Then when he turned 13 mo, I had the panic again. Feeling so tired and unhappy and anxious. This has been going on for about 2 weeks and I am back on meds, but I just feel like it is so unfair to be hit with this again. I don't understand how it could happen. I live in a small town in AK and there isn't a lot of help around here. I wish there was a therapist that was well versed in PPD/A, if that is what I even have, a year later. I'm just wondering if anyone else out there has gotten better, just to have a relapse a year later.

  12. I am so glad to find this. I am almost 4 months postpartum and am feeling the same way. Tired but unable to sleep, weepy, forgetful and struggling at work and home. I didn't start out this way… it's really been the last month. I just can't keep up. I will see my doctor about ppd. I wish someone told me in the hospital that symptoms could occur in the first year, not just the first month!

  13. I got my first bout of ppd ocd after my daughter was 10 months old . all i remember is waking up one day and i wasnt me the intrusive thoughts were herendous.I remember calling my mother straight away that morning and she came over and told me that i was just having bad dreams but i knew that was not it how can u be having bad dreams AWAKE!! For the next 4 months i laid in my bed crying not wanting to wash myself or clean i felt like since she was 10 months old I was just going mad!!! No one seemed to understand and telling me to snap out of it I had an abusive partner back then so instead of getting help i was getting kicked .I finally left this man and moved to europe with 2 small children still dealing with this dark cloud in my head. I remember thinking all i want to do is go to bed and wake up like i used to. It is so hard to ask for help you feel like people are going to look at you like a terrible mother. I now have 4 kids and still deal with ppd every now and then but my husband now is very supportive and supports my need for counselling and medication. I really think i could have avoided the hell in my head if there was more support and information. Sometimes you feel like the hospital tells you all about contraception and ow to take care of your wounds before you leave but never about the darkness that ISNT baby blues.

  14. my sister is experiencing fierce rage at the moment.her son is now 2 and a half.she hasnt been without rage since he was born.other than that she is a very loving mother,and has no rage at all towards her son.all her rage is vented at my parents,and me and my sisters.she is particularly obsessive towards me in particular.her partner can be very abusive and it is like he has brainwashed her against her family and he seems to be full of rage herself.she once mentioned she was afraid of her partner and felt so much anger towards being stuck with him for life.she wont admit this now and has gone to crazy measures to destroy our family,like going to the gaurds over text messages etc and has sais she wont stop till m mother is in her grave.we are all very confused,is this postpartum depression and is rage a big part of this illness.would be so thankful for any replys at all.she is s full of anger for 2 and a half years now and our family is destroyed withthreats and we are living in fear of her.she cant see it and sees us as being in the wrong and that we are making her angry eventhough we might nt see her for months and she would be very angry over past events.she has talked about suicide too.im afraid she is going to kill my parents with the way she is acting

  15. wow that letter was very interesting my baby is almost 4months she is my sixth and ive never had any ppd before but this last week ive felt a little more anxiety about everyday things cried over stupid things and just felt moody and stressed and not quit sure why because i love my life i had thought you only got it right after the baby was born but after reading that letter i wonder if maybe …….

  16. I don’t know if I’m having PPD. We have never heard of that before, only after my co-worker told us that she was having therapy due to PPD:

    My son is already 1 yr and 8 months

    This is what I’m feeling:
    1. I tend to be irritated most of the time, I feel that the world is so unjust to me because of lack of career upgrading. we are also having a hard time financially, thus i blame our financial status to my irritability.

    2. I just want to cry and cry.

    3. Sometimes I wake up in the middle of the night and even though how much I try to go back to sleep, i just can’t. Sleep would only come to me much later – 3-4 hours after.

    4. When i get irritated, i get this very painful headache.

    5. Sometimes, I feel like i don’t want this kind of life, that this was not the kind of life i had expected. I had even asked myself whether it was indeed a good decision to marry ( I love my husband and my family). Sometimes i am having regrets with the way my life turned out.

    6. I hate my life and i hate the world.

    My husband said that I have changed. That this is not what I used to be. But i cant help it.

    I hope that you could help me, Whether this is PPD or it’s just me grumbling over my fate. Thanks

    • Meridith, it is definitely possible that you are struggling with depression or anxiety, and those are illnesses that you can be treated for. Therapy is one form of treatment that is very effective. It would be worth seeing your doctor to discuss your symptoms and how you are feeling and see if he or she can work with you to identify what is going on and help you.

  17. My experience. My son was a year old and i was taking very low dose birth control for pcos. I started not feeling like myself. I started a long process of antidepressants and anti anxiety medications that ended in 6 antidepressants, 3 anti anxiety medications, and a brief stay in a mental institution. Finally after over a year of dealing with overwhelming depression and daily panic attacks I’m perfectly fine now. No doctor has ever said it but I’m 100% sure it was postpartum depression. I still have nearly untreatable pcos that is a constant issue but mentally its like a weight has been lifted. Please dont think you’re crazy just because symptoms appear late and insist on proper treatment. Good luck everyone.

  18. My son is 8 months and the PPD is just now hitting me pretty hard. Unfortunately, I’m high risk: prior hormonally-related depression, no support beyond my partner, etc. Luckily, I have a good partner, an excellent therapist with whom I have a history, and a great “easy” baby.

    Part of me wants to explain to friends exactly why we cancel get-togethers at the last minute. I’m really tired of putting on the happy mother face and saying (because it’s what they want to hear), “Everything’s GREAT! I’ve TOTALLY got this whole parenting thing DOWN!” Some days are worse than others and playing that role, essentially for their benefit, just costs me too damn much. But part of me knows the silent judging that will go on if I tell them the truth: “Isn’t she a little late to be going through PPD?” And is it their business anyway?

  19. I started showing symptoms of PPD 7 months in and had full blow PPD & Anxiety with panic attacks by the time my son was a year old. He is 4 years old now and I am stilll suffering from it since I did not get the proper treatment. I started paxil which worked wonderfully for a full year and then crapped out, unfortunately I was on a very low budget and could not afford counseling or therapy and I also did not know what my options were as my doctor informed me that I COULD ONLY HAVE PPD for a certain amount of time after the baby was born. I still have depression anxiety and panic attacks and I even had to give my son to his father because I didn’t find the help I needed.
    I am so glad this website is here, I just wish I would have found it sooner. :(

  20. Hello, I loved this article as I think I may have ppd after reading all the causes and symptoms broke down by mommy english and it’s been 13mos since I gave birth to my son..I think now looking back on the last yr I noticed something was off with me and went to a therapist for general stress in April. I thought you could only have ppd in the 1st couple weeks to the early months of new motherhood. I’m so glad when I googled if I could get ppd after a yr one of your links came up and I am for sure going to be calling my Dr in the morning as I want to get started with treatment I’m just not the same person I used to be and dont want my son growing up knowing that side of me the side I dont like. But thank you again for having such a great supportive website.

    • You’re welcome Ashley! And I’m so glad you are reaching out for help. Good for you – that is often the hardest step of all. If the symptoms of postpartum depression or anxiety sound familiar, it’s definitely worth talking to your doctor about it.

      • It hit me at 9 months ….
        I would like to share my story. I want to start off by saying I have never had any anxiety , depression , or ocd. My son was born April 2012 everything went great. I even left the hospital 2 days early from a c/s. When my son was about 9 months old I woke up one morning with a headace , dizziness , and I could not concertante . I went to my doctor were she said I had a mild case of vertigo . After about week and a half of visiting my doctors office all hell broke lose in my head. The nightmare began. I had thoughts that I have never in my life ever thought off. They were a horror show in my head. Everything in my house was negative . I would look at my fireplace and i thought I would throw my kids in. I can go on and on . I had every thought the stabbing, drowning, putting them in the dryer. I hope I’m not scarring anyone. I knew these thoughts were wrong and not me. I really thought I was going crazy. I headed back to my doctors office the next day. We’re she told me it was sleep deprivation . I asked her are you sure she said yes. I went home I finally told my husband and my cousin. They all said the samething you have postpartum . I started todo some research on the web and came cross postpartum ocd. I wasn’t depressed I was function perfectly . I was just so sad and unhappy of all these crazy thoughts i was having. After going 3 more times to my doctors office she was still telling me I had sleep deprivation . After 6 months of hell I finally went to see an other doctor. I Told him the whole story. He looked at me and said postpartum ocd. Finally!!!!
        I went I meds a very low does. I tired a therapist it’s not for me. I’m a year and 3 months I’m a lot better then what I was. I don’t have the fear like I did or the crazy thoughts or the triggers of watching the tv. I do get them right around I’m pmsing . I think this just takes lots of time and support. I know the worst is behind and now there habit thoughts. I know it’s a long story.
        What I want to say is you know yourself better then anyone . Trust your gut and get the help you need. It is temporary. It just takes a long time to recovery from all the crazy thoughts that go on. I hope this helps someone out there.
        Love Maria

        • I LOVE THIS ARTICLE! !! I have been extremely exhausted, constant worry, feel useless, and feel like im not good enough for my husband. I lash out at him, once the deed is done, i regret it so much. I love him so much, my baby is now 5 months old. I am having my 2nd session with my counselor today. I don’t know if i need medication, or what. I just want to be my old self again. Not this irritable, nasty person. I use to love hanging out, and forgave easily now, thats not the case. I only feel safe around my husband, and mom. Idl whats wrong with me?!