What to know about severe postpartum depression

Contact a doctor, midwife, or perinatal mental-health service as soon as possible. If there is immediate danger, thoughts of suicide or harming the baby, hallucinations, or severe confusion, seek emergency help now and stay with a trusted adult.

Postpartum depression can present with persistent sadness, emptiness, irritability, guilt, hopelessness, loss of interest, difficulty bonding with the baby, or feeling unable to cope. Sleep and appetite may change beyond what the baby's routine explains, and concentration or everyday decisions may become difficult.

Some parents feel anxious, emotionally numb, detached, or frightened by unwanted intrusive thoughts. Having an unwanted thought does not mean you want to act on it, but a clinician should assess its content, distress, and any risk. Symptoms can begin during pregnancy or after birth and can affect any parent.

Tell one trusted person clearly that you are struggling and ask them to help with the baby, meals, rest, and arranging care. A clinician can assess mood, anxiety, sleep, physical recovery, thyroid or anaemia symptoms, medication use, and the safety of both parent and baby.

Treatment may include talking therapy, practical and family support, medication, or specialist perinatal care. If you are breastfeeding, the prescriber can discuss options in that context; do not stop a prescribed mental-health medicine suddenly without clinical advice. Small practical actions can support recovery, but they are not substitutes for treatment when symptoms are severe.

Call local emergency services or go to the nearest emergency department if you may act on thoughts of suicide or harming the baby, cannot keep yourself or the baby safe, hear or see things others do not, hold unusual fixed beliefs, become severely confused, or feel extremely energised and unable to sleep. These symptoms can occur with a postpartum psychiatric emergency.

Do not remain alone while urgent help is being arranged. A trusted adult should take over the baby's immediate care, remove access to anything that could be used for harm, and tell the emergency team about recent childbirth, sleep, medicines, and any frightening thoughts or unusual experiences.

Ask how your symptoms will be assessed, what treatment can begin promptly, how feeding preferences affect medicine choices, and who to contact if you worsen outside clinic hours. It is also useful to agree on a written safety plan and identify the person who can help with appointments, rest, and infant care.