What we treat
Postpartum depression & perinatal mood disorders
What you’re feeling has a name. It is common. It is not your fault. And it is highly treatable — usually faster than you’d expect.
Postpartum depression isn’t just sadness
Postpartum depression (PPD) and related perinatal mood disorders show up differently for everyone. Some of the most common patterns we see:
- Persistent sadness, tearfulness, or feelings of emptiness that don’t lift
- Intense anxiety, panic, or constant worry about the baby’s safety
- Feeling disconnected from your baby, partner, or your old self
- Intrusive thoughts — sometimes scary or violent thoughts that feel completely against who you are. These are common in postpartum anxiety/OCD and are not the same as wanting to act on them.
- Rage or irritability that feels out of character
- Insomnia even when the baby is sleeping
- Guilt or feeling like a “bad” parent no matter what you do
- Thoughts that your family would be better off without you
These experiences can begin during pregnancy, in the days after birth, or up to a year (or more) postpartum. They affect roughly 1 in 7 birthing parents and meaningful numbers of partners as well.
Why it shows up — and why it’s not your fault
Pregnancy and the postpartum period involve some of the most rapid hormonal shifts the human body experiences, layered onto sleep deprivation, identity change, and (often) trauma from birth itself. PPD has biological, psychological, and social drivers. It is not weakness, ingratitude, or a parenting failure.
How we treat it
Coordinated with your OB/GYN
If you’d like, we’ll communicate directly with your OB/GYN or midwife so your care is coordinated — especially around medication choices that interact with breastfeeding or postpartum recovery.
Medication that’s safe in pregnancy and breastfeeding
Many SSRIs and SNRIs have strong safety data in pregnancy and breastfeeding. We’ll look carefully at the evidence with you, weigh untreated depression against medication exposure (untreated depression carries real risks too), and choose what fits your situation.
For severe postpartum depression, the FDA has approved zuranolone (Zurzuvae), a 14-day oral course specifically developed for PPD. We can discuss whether it’s appropriate for your case.
Therapy
Interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) both have strong evidence in perinatal depression. Therapy can be especially powerful here because so much of what’s happening is also a major life transition — not just brain chemistry.
Practical scaffolding
Sleep, support, feeding choices, and partner/family involvement are all part of treatment. We’ll help you think through how to actually get rest in the first months — not as a luxury but as a treatment requirement.
A note on bipolar postpartum
For some patients, what looks like postpartum depression is actually the depressive side of an undiagnosed bipolar disorder. The postpartum period has elevated risk for bipolar episodes. We screen for this carefully because the right medications differ.