Perinatal Depression

Written and Fact-Checked by: Jenna Carberg

What Perinatal Depression Means

Perinatal depression is depression that occurs during pregnancy or in the year after giving birth. “Perinatal” means around birth — so the term deliberately covers both sides of the delivery, rather than treating them as separate conditions.

That is the whole point of the word, and it exists because the old framing was wrong. Splitting “depression in pregnancy” from “depression after birth” implied two different problems. In practice it is usually one episode that crosses the birth. The DSM-5-TR notes that about half of postpartum depressive episodes actually begin during pregnancy.

The American Psychiatric Association now uses perinatal depression in place of postpartum depression for exactly this reason. Postpartum depression has not stopped existing or stopped being called that — it is the part of perinatal depression that begins after the birth.

The Terminology, Untangled

There are eight or nine words in circulation for overlapping slices of the same thing, which is the actual reason most people land on this page. Here is the map.

Term What it covers
Perinatal depression The umbrella: pregnancy plus the first year after birth
Prenatal / antenatal / antepartum depression During pregnancy only. Three words, one meaning — see depression during pregnancy
Postpartum / postnatal depression After the birth. “Postnatal” is the usual term in the UK
Peripartum onset The DSM-5-TR specifier. Narrower than clinical usage: onset in pregnancy or within 4 weeks of delivery
Maternal depression Loose, non-clinical; usually means the same as perinatal depression
PMADs Perinatal mood and anxiety disorders — the whole family, not just depression
Baby blues Not depression. Common, peaks around day 5, gone within 2 weeks

Two things fall out of that table worth knowing.

The DSM window is narrower than real life. Its peripartum onset specifier stops four weeks after delivery. Clinicians, researchers and every major screening guideline work with the first year. If a diagnosis says “peripartum onset” and your symptoms started at five months, the label is a filing convention, not a judgment about whether what you have is real.

Perinatal depression is not the whole picture. Depression is one member of a family.

Perinatal Mood and Anxiety Disorders (PMADs)

PMAD is the umbrella clinicians use for everything that can happen to mental health around a birth. Depression is the best known and not the most common presentation in every case.

  • Postpartum depression — persistent low mood, loss of pleasure, guilt. Roughly 1 in 8 mothers.
  • Postpartum anxiety — constant worry and physical tension. At least as common as depression and far less discussed.
  • Postpartum OCD — intrusive thoughts of harm coming to the baby, paired with checking or avoidance. The thoughts horrify the person having them, and research finds they are not linked to a higher risk of harming the baby.
  • Postpartum panic disorder — sudden surges of fear with chest pain, a racing heart and breathlessness.
  • Postpartum PTSD — after a birth experienced as traumatic. Flashbacks, avoidance, hypervigilance.
  • Postpartum rage — not a diagnosis of its own, but a recognized and very common presentation of the above.
  • Tokophobia — severe fear of childbirth, before a first birth or after a traumatic one.
  • D-MER — a sudden wave of dread or sadness at milk letdown that passes within minutes.
  • Postpartum psychosis — rare, roughly 1 to 2 per 1,000 births, and a same-day medical emergency.

Knowing which one fits changes the treatment offered, which is the practical reason the distinctions are worth making.

When Perinatal Depression Starts

There is no single onset point, which is precisely why the perinatal framing is more useful than the postpartum one.

During pregnancy About half of episodes labeled “postpartum” begin here
First 2 weeks after birth Usually the baby blues, which resolve on their own
Weeks 2 to 12 The most common window for postpartum depression to become apparent
3 to 12 months Later onset is well documented and frequently dismissed

For the detail on duration and recovery, see the postpartum depression timeline.

Symptoms

Perinatal depression presents like major depression elsewhere, with some particular colorations: guilt attached to motherhood, difficulty bonding, intrusive fears about the baby, and anger or numbness in place of sadness.

Clinically it is a major depressive episode — five or more symptoms over two weeks, at least one of which is low mood or loss of interest. The full list and the harder-to-recognize presentations are on signs and symptoms of postpartum depression, which applies equally during pregnancy.

Screening

Routine perinatal screening is recommended by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the American Academy of Family Physicians. In practice you are most likely to be offered it at a prenatal visit, your postpartum checkup, or one of your baby’s early well-child visits — pediatric practices screen parents too.

Three tools do most of the work:

  • EPDS — 10 questions, the standard perinatal instrument. Validated in pregnancy as well as after birth, despite the name.
  • PHQ-9 — 9 questions, general depression. Free to take here, scored instantly.
  • GAD-7 — 7 questions, anxiety. Take this one if fear fits you better than sadness, because a depression screen is not built to measure anxiety.

Separately, the US Preventive Services Task Force recommends in a 2019 B-grade statement that clinicians refer pregnant and postpartum people at increased risk of perinatal depression to counseling — prevention offered on the basis of risk factors, before any symptoms appear. A history of depression qualifies you. It is worth asking for by name.

Treatment

Perinatal depression responds well to treatment, and the options are the same across pregnancy and after birth, with different considerations at each stage.

  • Therapy — CBT and interpersonal therapy both have good evidence. IPT focuses on relationships and the life changes around them, which is much of what this period consists of.
  • Medication — SSRIs and SNRIs are commonly prescribed, several are used while breastfeeding, and zuranolone (Zurzuvae) is approved specifically for postpartum depression. During pregnancy the decision is a comparison of two sets of risks rather than a choice between risk and safety — see depression during pregnancy.
  • Support groups — often available within days, free online options included.

What to Do Next

  • Get a score to bring to an appointment. The PHQ-9 and GAD-7 are free, take three minutes and save nothing.
  • Tell your ob-gyn, midwife, or your baby’s pediatrician. All three are legitimate doors.
  • Find a therapist who treats perinatal conditions — look for the PMH-C credential.
  • Postpartum Support International runs a free HelpLine at 1-800-944-4773, or text “Help” to 800-944-4773 in English, 971-203-7773 in Spanish.
  • In a crisis, call or text 988.

Frequently Asked Questions

What is the difference between perinatal and postpartum depression?

Perinatal depression is the umbrella term covering pregnancy and the first year after birth. Postpartum depression is the part of it that begins after delivery. They are not competing labels — one contains the other.

Why did the name change from postpartum to perinatal depression?

Because about half of episodes begin during pregnancy rather than after it. Calling the whole thing “postpartum” hid that, and delayed treatment for people who were already unwell before the birth. The American Psychiatric Association now uses perinatal depression as the broader term.

What does perinatal depression look like?

Persistent low mood or loss of pleasure lasting two weeks or more, often with guilt about motherhood, difficulty bonding, intrusive fears about the baby, and frequently anger or numbness rather than visible sadness.

What are PMADs?

Perinatal mood and anxiety disorders — the family of conditions that can occur around a birth, including depression, anxiety, OCD, panic disorder, PTSD and postpartum psychosis.

How long does perinatal depression last?

With treatment, most people improve substantially within weeks to a few months. Untreated, it can last many months, and about 1 in 4 people still have symptoms years later. See the timeline.

Is perinatal depression the same as the baby blues?

No. The baby blues affect many new mothers, often more than a third,, peak around day five and resolve on their own within two weeks. Anything still present after two weeks is worth assessing.

Can fathers and partners have perinatal depression?

Yes. It affects roughly 1 in 10 fathers across the first year, rising to about 1 in 4 between three and six months after the birth. Screening guidelines focus on mothers, so it is easy to miss. See postpartum depression in men.

PostpartumDepression.org Team
Written by:

Jenna Carberg was diagnosed with postpartum depression following the birth of her daughter in 2016. It was a healthy birth but in the following days, Jenna's mood changed quickly. Doctors suggested that it might be the "baby blues", but her husband Chris suggested she seek a second opinion. Jenna was diagnosed with postpartum depression and began a journey that lasted 9 long months with significant ups and downs. Jenna's mental health care and her experiences became a passion for her to share with the world. She and her husband Chris founded PostpartumDepression.org as a support website designed to help women suffering in silence and their loved ones.

  1. National Institute of Mental Health. “Perinatal Depression.” NIH Publication No. 23-MH-8116. https://www.nimh.nih.gov/health/publications/perinatal-depression. Accessed September 15, 2026.
  2. American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).” Washington, DC: American Psychiatric Association Publishing; 2022. https://doi.org/10.1176/appi.books.9780890425787.
  3. Carlson K, Mughal S, Azhar Y, Siddiqui W. “Perinatal Depression.” In: StatPearls. Treasure Island, FL: StatPearls Publishing; updated January 22, 2025. https://www.ncbi.nlm.nih.gov/books/NBK519070/. Accessed September 15, 2026.
  4. American Psychiatric Association. “What Is Perinatal Depression (Formerly Postpartum)?.” https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression. Accessed September 15, 2026.
  5. Tosto V, Ceccobelli M, Lucarini E, et al. “Maternity Blues: A Narrative Review.” J Pers Med. 2023;13(1):154. https://doi.org/10.3390/jpm13010154.
  6. Rezaie-Keikhaie K, Arbabshastan ME, Rafiemanesh H, et al. “Systematic Review and Meta-Analysis of the Prevalence of the Maternity Blues in the Postpartum Period.” J Obstet Gynecol Neonatal Nurs. 2020;49(2):127-136. https://doi.org/10.1016/j.jogn.2020.01.001.
  7. Bauman BL, Ko JY, Cox S, et al. “Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression – United States, 2018.” MMWR Morb Mortal Wkly Rep. 2020;69(19):575-581. https://doi.org/10.15585/mmwr.mm6919a2.
  8. Dennis CL, Falah-Hassani K, Shiri R. “Prevalence of Antenatal and Postnatal Anxiety: Systematic Review and Meta-Analysis.” Br J Psychiatry. 2017;210(5):315-323. https://doi.org/10.1192/bjp.bp.116.187179.
  9. Fairbrother N, Collardeau F, Woody SR, Wolfe DA, Fawcett JM. “Postpartum Thoughts of Infant-Related Harm and Obsessive-Compulsive Disorder: Relation to Maternal Physical Aggression Toward the Infant.” J Clin Psychiatry. 2022;83(2):21m14006. https://doi.org/10.4088/JCP.21m14006.
  10. Raza SK, Raza S. “Postpartum Psychosis.” In: StatPearls. Treasure Island, FL: StatPearls Publishing; updated June 26, 2023. https://www.ncbi.nlm.nih.gov/books/NBK544304/. Accessed September 15, 2026.
  11. Paladine HL, Blenning CE, Strangas Y. “Postpartum Care: An Approach to the Fourth Trimester.” Am Fam Physician. 2019;100(8):485-491. https://www.aafp.org/pubs/afp/issues/2019/1015/p485.html. Accessed September 15, 2026.
  12. Rafferty J, Mattson G, Earls MF, Yogman MW. “Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice.” Pediatrics. 2019;143(1):e20183260. https://doi.org/10.1542/peds.2018-3260.
  13. American Academy of Family Physicians. “Pregnancy Care: Clinical Guidance and Practice Resources.” https://www.aafp.org/clinical-insights/womens-health/pregnancy-care. Accessed September 15, 2026.
  14. Cox JL, Holden JM, Sagovsky R. “Detection of Postnatal Depression. Development of the 10-Item Edinburgh Postnatal Depression Scale.” Br J Psychiatry. 1987;150:782-786. https://doi.org/10.1192/bjp.150.6.782.
  15. Bergink V, Kooistra L, Lambregtse-van den Berg MP, et al. “Validation of the Edinburgh Depression Scale During Pregnancy.” J Psychosom Res. 2011;70(4):385-389. https://doi.org/10.1016/j.jpsychores.2010.07.008.
  16. Kroenke K, Spitzer RL, Williams JB. “The PHQ-9: Validity of a Brief Depression Severity Measure.” J Gen Intern Med. 2001;16(9):606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x.
  17. Spitzer RL, Kroenke K, Williams JBW, Löwe B. “A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7.” Arch Intern Med. 2006;166(10):1092-1097. https://doi.org/10.1001/archinte.166.10.1092.
  18. US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et al. “Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement.” JAMA. 2019;321(6):580-587. https://doi.org/10.1001/jama.2019.0007.
  19. US Food and Drug Administration. “FDA Approves First Oral Treatment for Postpartum Depression.” August 4, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-treatment-postpartum-depression. Accessed September 15, 2026.
  20. Postpartum Support International. “Help for Perinatal Individuals.” https://postpartum.net/get-help/help-for-moms/. Accessed September 15, 2026.
  21. Goodman JH. “Postpartum Depression Beyond the Early Postpartum Period.” J Obstet Gynecol Neonatal Nurs. 2004;33(4):410-420. https://doi.org/10.1177/0884217504266915.
  22. Paulson JF, Bazemore SD. “Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression: A Meta-analysis.” JAMA. 2010;303(19):1961-1969. https://doi.org/10.1001/jama.2010.605.

Get Answers to Your Postpartum Depression Questions

Find a Therapist