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Postpartum depression is an illness that you can get after having a baby. It's just like depression, which you can get at other times. But it comes at a time when you are expected to feel happy. If you get postpartum depression, you may find it hard to enjoy being with your baby and difficult to care for him or her.

Postpartum depression nearly always gets better on its own. But if the depression goes on for a long time, you may not bond properly with your baby. And your baby may not develop as well as he or she should. There are treatments that may help you feel better faster. So, it's important to see your doctor and get treatment early.

• It's normal to feel low, irritable or anxious for a few days after your baby is born. But if these feelings don't go away or they get worse, you may have postpartum depression.
• Postpartum depression is common. About 10 in every 100 to 15 in every 100 new mothers get it.
• Postpartum depression is an illness. It is not a sign that you don't love your baby or can't look after him or her properly.
• There are lots of treatments that may help.
• It's important to see your doctor early on. The sooner you get help, the sooner you are likely to feel better and start enjoying being a mother.
• If you have strange thoughts and feelings about your baby, or hear or see things that aren't real, you may have a more serious illness called postpartum psychosis. You will need to be looked after in the hospital.

To understand what goes wrong in postpartum depression, it helps to know a little about what feelings are normal after you have a baby.

Having a baby involves huge changes in your life and your body. And they happen very quickly.

• You suddenly have responsibility 24 hours a day for the care of a human being who completely depends on you.
• Your hormones rise to very high levels during pregnancy. But they fall suddenly in the few days after your baby is born.¹ To read more, see Hormone changes after childbirth.
• Being a mother will affect almost every aspect of your life, including your work and your relationships.
• You have to cope with having less sleep.
• If you are in a relationship, you and your partner have to switch instantly from being a couple to being parents.
• If you are a single parent, you might feel even greater pressure to cope and do things well with less support.

These are a lot of changes to deal with. So, it's hardly surprising that many new mothers get a condition called the baby blues for a few days after giving birth.² This is a when you have mild problems with your mood. To learn more, see The baby blues.

But the baby blues usually go away within 10 days after you have given birth. If your sadness goes on for more than two weeks, you may have postpartum depression instead. This is when how you feel becomes a more serious problem.

One of two things may happen if you have postpartum depression:³

• You may keep feeling depressed after the baby blues should have stopped
• Or you may start feeling depressed later in your baby's first year, usually in the first three months.

Some women even start feeling depressed during pregnancy. We don't know as much about depression before the birth of a baby as we do about the postpartum kind.⁴ And for some women, postpartum depression is probably depression continuing from before they got pregnant.⁵

The symptoms of postpartum depression are just like the symptoms of the depression you can get at other times. To learn more, see What are the symptoms of postpartum depression?

Some symptoms, such as sleep problems, weight changes and loss of energy, are also a normal part of being a new mother. This explains why doctors and other health professionals often don't spot postpartum depression.

We don't know what causes postpartum depression. Some researchers think it may be because of:^{6 7}

• Changes in your hormone levels
• Problems with your thyroid gland
• Changes in your immune system from stress.

There is not much evidence to prove these ideas though. For most women, postpartum depression is more likely to be caused by things in their personal and family life.

But changes in your body might well play a part in causing a much rarer and severe illness called postpartum psychosis. This is most likely to come on suddenly in the first two weeks after your baby is born. It's so serious that most women have to be looked after in the hospital.

Women with postpartum psychosis often have big mood swings and think and behave abnormally. They may also have hallucinations and fantasies that show they can't tell what is real and what isn't.³ For more information, see Postpartum psychosis.

We don't know why some women get postpartum depression and others don't. But there are things that increase your chance of getting it. These are called risk factors.

Having a risk factor doesn't mean that you will definitely get postpartum depression. It just means you are more likely to get it than a woman who doesn't have that risk factor.⁸

The main risk factors for postpartum depression are:^{8 9 10 11}

• You've had depression or other mental health problems before
• You don't have much help or support from your family and friends
• Your relationship with your husband or partner is poor
• You have difficult things going on in your life.

To read more, see Risk factors for postpartum depression.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.