Table of Contents

What is the Perinatal Period?

Broadly, the perinatal period refers to pregnancy through the first year postpartum (after birth).

What Is Perinatal Depression?

Perinatal depression may leave expectant and new mothers with a range of depressive and anxious feelings, including irritability, self-doubt, guilt, hopelessness, and suicidal thoughts. It can occur during pregnancy or within the first year after delivery. Research has shown that perinatal depression may negatively impact maternal quality of life, intimate relationships, birth outcomes, breastfeeding likelihood, and children’s long-term cognitive and emotional development.

The terms perinatal depression and postpartum depression are often used interchangeably. However, perinatal depression is increasingly preferred because it encompasses symptoms that may arise both during pregnancy and after childbirth.

What Are Potential Causes of Perinatal Depression?

Risk factors may include:

  • Stressful life events
  • History of depression
  • Limited social support
  • Unplanned or unwanted pregnancies
  • Poor relationship quality
  • Current or past abuse
  • Low socioeconomic status

What Are Symptoms of Perinatal Depression?

Symptoms vary in frequency, duration, and intensity. Some individuals may experience only a few symptoms, while others may experience many.

Common symptoms include:

  • Persistent sad, anxious, or “empty” moods
  • Feelings of guilt, worthlessness, hopelessness, or helplessness
  • Fatigue or low energy
  • Restlessness or difficulty sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Sleep disturbances (insomnia or hypersomnia)
  • Trouble bonding with the baby
  • Persistent doubts about parenting ability
  • Thoughts of death or suicide

If you or someone you know is having suicidal thoughts, please call The 988 Suicide & Crisis Lifeline or seek medical help immediately.

How Is Perinatal Depression Diagnosed?

Perinatal depression can affect any pregnant or postpartum individual, regardless of age, income, race, ethnicity, or education. Diagnosis can be challenging because symptoms such as fatigue or sleep changes may overlap with typical pregnancy experiences. A licensed health care provider can conduct a comprehensive assessment to distinguish between perinatal depression, milder conditions like “baby blues,” and other potential disorders.

Lifestance Health specializes in Perinatal Depression treatment with multiple locations in 33 states. Services and available treatments vary by location.

Find a provider near you:

How Is Perinatal Depression Prevented?

Counseling and therapy may help reduce the risk of perinatal depression. Speaking with a licensed therapist or counselor can support emotional wellbeing and help individuals manage challenges during pregnancy and postpartum.

When to Get Help

If symptoms of depression or anxiety arise during pregnancy or after childbirth, it is important to consult a health care provider. Screenings during prenatal and postpartum visits can help detect early signs. Early identification and appropriate management are critical to the health of both parent and child.

What Are Treatment Options for Perinatal Depression?

If symptoms persist for more than two weeks or interfere with daily life, treatment may be appropriate. Many individuals with perinatal depression may benefit from medication, psychotherapy, or a combination of both, as determined by a licensed clinician. Group therapy may also be helpful.

Treatment options may vary by location and provider. Please confirm availability in your area, see what insurances LifeStance accepts, and check with your insurance provider regarding coverage.

Talk Therapy and Alternative Treatments

Psychotherapy and counseling are considered first line treatments for perinatal depression and may support recovery. Approaches include:

  • Cognitive Behavioral Therapy (CBT): Helps individuals identify and change unhelpful thought patterns and behaviors.
  • Interpersonal Therapy (IPT): Focuses on improving communication, building support networks, and managing relationship challenges.
  • Other modalities may include trauma-informed prenatal EMDR, psychodynamic therapy, and psychoeducation.

Medication Options

When talk therapy isn’t enough or depression is severe, medications are often prescribed. Commonly prescribed antidepressants are well studied and considered safe for use during pregnancy and breastfeeding. It is always important to consider the risk of untreated mental illness during the perinatal period vs the risks of any treatment. A licensed LifeStance mental health psychiatric clinician will discuss risks and benefits with you as part of your treatment planning.

Common classes of antidepressants include:

  • Selective Serotonin Reuptake Inhibitors (SSRIs): May help regulate serotonin levels.
    Examples: Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil)
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): May affect both serotonin and norepinephrine.
    Examples: Venlafaxine (Effexor), Duloxetine (Cymbalta)
  • Tricyclic Antidepressants (TCAs): An older class with broader mechanisms.
    Examples: Amitriptyline, Nortriptyline (Pamelor), Clomipramine
  • Neuroactive Steroids: A newer category of medication that is only taken for postpartum depression, that targets the GABAergic system.
    Example: Zuranolone (Zurzuvae)

References

American Psychological Association. (n.d.). Postpartum depression. In Topics: Women & Girls. Retrieved December 9, 2025, from https://www.apa.org/topics/women-girls/postpartum-depression

Cortizo, R. (2020). Hidden trauma, dissociation and prenatal assessment within the Calming Womb Model. Journal of Prenatal and Perinatal Psychology and Health, 34(6), 469–481. https://birthpsychology.com/wp-content/uploads/journal/published_paper/volume-34/issue-6/NNRsuErB.pdf

Dagher RK, Bruckheim HE, Colpe LJ, Edwards E, White DB. (2021). Perinatal Depression: Challenges and Opportunities. J Womens Health (Larchmt), 30(2):154-159. doi: 10.1089/jwh.2020.8862.

Policy Center for Maternal Mental Health. (2025, May). *Maternal Mental Health https://policycentermmh.org/maternal-mental-health-fact-sheet/

Substance Abuse and Mental Health Services Administration. (n.d.). 988 Suicide & Crisis Lifeline. https://988lifeline.org/

Treatment options discussed in this article are not guaranteed to be effective for all individuals. Medications should only be taken as prescribed by a licensed provider. Availability of services may vary by location and insurance coverage. Please consult a qualified health care professional for personalized advice.

photo of LifeStance provider Dr Melanie Barrett, MD

Clinically Reviewed By:

Melanie Barrett, MD
View Profile
Dr. Melanie Barrett received her medical degree from the University of Oklahoma College of Medicine following undergraduate studies in Psychology at Texas A&M University in College Station, Texas. She completed her psychiatry residency at the University of North Carolina Hospitals, Chapel Hill, where she served as Chief Resident. She maintains board certification through the American Board of Psychiatry & Neurology. Dr. Barrett specializes in interventional treatments including Zulresso (brexanolone) for postpartum depression as well as Spravato (esketamine) and ketamine IV therapy for treatment resistant depression. She regularly provides teaching and consultations to medical professionals interested in learning about postpartum depression and Zulresso.
photo of LifeStance provider Rosa Cortizo

Clinically Reviewed By:

Rosa Cortizo, PsyD
View Profile
Dr. Rosita Cortizo, born and raised in Panama City, Panama, Central America, is a high risk, multicultural, bilingual prenatal and perinatal Clinical Psychologist working with female adults and children. She earned a Master of Arts in Psychology with specialty in Chemical Dependency in San Diego, California. Dr. Cortizo has licenses as a Marriage and Family therapist and as a Clinical Psychologist in the state of California, she is EMDRIA Certified, an Approved EMDR Consultant, trained in Sensory Motor Psychotherapy, Equine Assisted Therapy Certified, and was the 2021 ISSTD President. Dr. Cortizo provides trauma-informed prenatal care and psychotherapy tailored to the unique needs of the client. She has worked in Public Health in Southern California with pregnant and diverse women at high risk with multiple diagnosis, traumatic stress, and relational crisis for more than 30 years. Dr. Cortizo is an advocate of womb-babies and infants, our future, and works to empower pregnant women, women, and families with devotion. Outside of work, Dr. Cortizo enjoys traveling, meditating, pottery, and eco-adventures.
photo of LifeStance provider

Clinically Reviewed By:

, MD