Depression is a mental health illness when someone feels sad (including crying often), empty, or hopeless most of the time (or loses interest in or takes no pleasure in daily activities) for at least 2 weeks. Depression affects a person’s ability to work, go to school, or have relationships with friends and family. Depression is one of the most common mental health conditions in the United States. It is an illness that involves the body, mood, and thoughts. It can affect the way you eat and sleep, the way you feel about yourself, and the way you think about things.

It is different from feeling “blue” or “down” or just sad for a few hours or a couple of days. Depression is also different from grief over losing a loved one or experiencing sadness after a trauma or difficult event. It is not a condition that can be willed or wished away. People who have depression cannot just “pull themselves” out of it.

Everyone feels sad at times. People with depression feel sad most days. Depression can make it hard to care for yourself and your family. It can also affect you at work or school.

Signs of Depression

Talk to your healthcare provider if you have some of these signs for more than two weeks:

• Feel Sad
• Sleep too little or all the time
• Feel tired all the time
• Feel nervous or cranky
• Cry a lot
• Eat too much or all the time
• Have no interest in eating
• Feel guilty
• Feel hopeless
• Have trouble paying attention
• Notice that things that used to make you happy, don’t make you happy anymore
• Think about death or try to kill yourself

Treatment

There is hope. Depression can be treated with medicine or counseling. Sometimes both are used. Talk with your healthcare provider about your treatment options.

There are many different kinds of medicine used to treat depression. These medicines are called antidepressants. Like any drug, depression medicines can sometimes cause side effects. Ask your doctor, nurse or pharmacist about all of the risks and side effects.

Clinical trials can help doctors learn more about treatments for depression. Visit the Women in Clinical Trials webpage to learn how you can get involved in clinical trials and make a difference for yourself or other women like you.

Depression and Pregnancy

Lots of women feel sad or cry a lot after they have a baby. This is called “the baby blues”. This feeling usually goes away after about two weeks.

Some women become depressed after they give birth. This kind of depression is called postpartum depression. Other women who had depression before they got pregnant notice that their depression gets worse during pregnancy.

• Talk to your doctor about your feelings when you are pregnant and after you have your baby.
• Talk to your doctor about the risks and benefits of taking depression medicines during pregnancy and breastfeeding. Some medicines can affect your baby’s health.
• Talk to your healthcare provider before you stop taking your depression medicines during pregnancy.
• If you need to continue taking your medicine during pregnancy, learn how you can sign-up for a pregnancy registry to share your experience.

Depression and postpartum depression are common and treatable. If you think you have depression or postpartum depression, seek treatment from your health care provider as soon as possible.

Depression

Everyone feels sad sometimes, but these feelings usually pass within a few days. Depression interferes with daily life and may last for weeks or months at a time. Most people, even those with the most severe forms of depression, can get better with treatment.

Postpartum Depression

Postpartum depression is depression that occurs after having a baby. Feelings of postpartum depression are more intense and last longer than those of “baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby. “Baby blues” symptoms typically resolve on their own within a few days.

How Many Women Experience Depression and Postpartum Depression?

Depression is a common and serious illness. A CDC study shows that about 1 in 10 women in the United States reported symptoms that suggest they experienced an episode of major depression in the last year. Using the Pregnancy Risk Assessment Monitoring System (PRAMS), CDC research shows about 1 in 8 women with a recent live birth experience symptoms of postpartum depression. Estimates of the number of women affected by postpartum depression differ by age, race/ethnicity, and state. View your state’s prevalence of postpartum depressive symptoms using PRAMS.

The COVID-19 pandemic has affected mental health. Many people are experiencing grief and facing challenges that can be stressful and overwhelming.

Symptoms of Depression

Depression doesn’t feel the same for everyone. How often symptoms occur, how long they last, and how intense they may feel can be different for each person.

Symptoms of depression can include:

• Lasting sad, anxious, or “empty” mood.
• Feelings of hopelessness or pessimism.
• Feelings of guilt, worthlessness, or helplessness.
• Feelings of irritability or restlessness.
• Loss of interest in hobbies and activities.
• Loss of energy.
• Problems concentrating, recalling details, and making decisions.
• Difficulty falling asleep or sleeping too much.
• Overeating or loss of appetite.
• Thoughts of suicide or suicide attempts.
• Aches or pains that do not get better with treatment.

Symptoms of Postpartum Depression

How often postpartum depression symptoms occur, how long they last, and how intense they feel can be different for each person. The symptoms of postpartum depression are similar to symptoms for depression, but may also include:

• Crying more often than usual.
• Feelings of anger.
• Withdrawing from loved ones.
• Feeling numb or disconnected from your baby.
• Worrying that you will hurt the baby.
• Feeling guilty about not being a good mom or doubting your ability to care for the baby.

Risk Factors for Depression or Postpartum Depression

Experiences that may put some women at a higher risk for depression can include

• Stressful live events.
• Low social support.
• Previous history of depression.
• Family history of depression.
• Difficulty getting pregnant.
• Being a mom to multiples, like twins or triplets.
• Being a teen mom.
• Preterm (before 37 weeks) labor and delivery.
• Pregnancy and birth complications.

Postpartum depression can also occur among women with a healthy pregnancy and birth.

How Depression Affects Fathers

Some fathers also report symptoms of depression. To better understand the experiences of fathers, PRAMS implemented a PRAMS for Dads pilot project. The pilot project in Georgia found 1 in 10 fathers reported depressive symptoms since the birth of their new baby. Studies such as PRAMS for Dads can help quantify men’s health behaviors and service needs.

Treatment

Depression is treatable, and most people get better with treatment. If you think you may be depressed, the first step to seeking treatment is to talk to your health care provider. You can ask your health care provider for a referral to a mental health professional.

Yes. Different kinds of depression include:

• Major depressive disorder. Also called major depression, this is a combination of symptoms that affects a person’s ability to sleep, work, study, eat, and enjoy hobbies and everyday activities.
• Dysthymic disorder. Also called dysthymia, this kind of depression lasts for 2 years or more. The symptoms are less severe than those of major depression but can prevent you from living normally or feeling well.

Other types of depression have slightly different symptoms and may start after a certain event. These types of depression include:

• Psychotic depression, when a severe depressive illness happens with some form of psychosis, such as a break with reality, hallucinations, and delusions
• Postpartum depression, which is diagnosed if a new mother has a major depressive episode after delivery. Depression can also begin during pregnancy, called prenatal depression.
• Seasonal affective disorder (SAD), which is a depression during the winter months, when there is less natural sunlight
• Bipolar depression, which is the depressive phase of bipolar illness and requires different treatment than major depression

There is no single cause of depression. Also, different types of depression may have different causes. There are many reasons why a woman may have depression:

• Family history. Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression.
• Brain changes. The brains of people with depression look and function differently from those of people who don’t have depression.
• Chemistry. In someone who has depression, parts of the brain that manage mood, thoughts, sleep, appetite, and behavior may not have the right balance of chemicals.
• Hormone levels. Changes in the female hormones estrogen and progesterone during the menstrual cycle, pregnancy, postpartum period, perimenopause, or menopause may all raise a woman’s risk for depression. Having a miscarriage can also put a woman at higher risk for depression.
• Stress. Serious and stressful life events, or the combination of several stressful events, such as trauma, loss of a loved one, a bad relationship, work responsibilities, caring for children and aging parents, abuse, and poverty, may trigger depression in some people.
• Medical problems. Dealing with a serious health problem, such as stroke, heart attack, or cancer, can lead to depression. Research shows that people who have a serious illness and depression are more likely to have more serious types of both conditions. Some medical illnesses, like Parkinson’s disease, hypothyroidism, and stroke, can cause changes in the brain that can trigger depression.
• Pain. Women who feel emotional or physical pain for long periods are much more likely to develop depression. The pain can come from a chronic (long-term) health problem, accident, or trauma such as sexual assault or abuse.

Not all people with depression have the same symptoms. Some people might have only a few symptoms, while others may have many. How often symptoms happen, how long they last, and how severe they are may be different for each person.

If you have any of the following symptoms for at least 2 weeks, talk to a doctor or nurse or mental health professional:

• Feeling sad, “down,” or empty, including crying often
• Feeling hopeless, helpless, worthless, or useless
• Loss of interest in hobbies and activities that you once enjoyed
• Decreased energy
• Difficulty staying focused, remembering, or making decisions
• Sleeplessness, early morning awakening, or oversleeping and not wanting to get up
• Lack of appetite, leading to weight loss, or eating to feel better, leading to weight gain
• Thoughts of hurting yourself
• Thoughts of death or suicide
• Feeling easily annoyed, bothered, or angered
• Constant physical symptoms that do not get better with treatment, such as headaches, upset stomach, and pain that doesn’t go away

Depression is linked to many health problems in women, including:

• Heart disease. People with heart disease are about twice as likely to have depression as people who don’t have heart disease.
• Obesity. Studies show that 43% of adults with depression have obesity. Women, especially white women, with depression are more likely to have obesity than women without depression are. Women with depression are also more likely than men with depression to have obesity.
• Cancer. Up to 1 in 4 people with cancer may also experience depression. More women with cancer than men with cancer experience depression.

Talk to someone like a doctor, nurse, psychiatrist, mental health professional, or social worker about your symptoms.

Talk to your doctor or nurse if you have symptoms of depression. Certain medicines and some health problems (such as viruses or a thyroid disorder) can cause the same symptoms as depression. Sometimes depression can be part of another mental health condition.

Diagnosis of depression includes a mental health professional asking questions about your life, emotions, struggles, and symptoms. The doctor, nurse, or mental health professional may order lab tests on a sample of your blood or urine and do a regular checkup to rule out other problems that could be causing your symptoms.

Overview:

Pregnancy can be an exciting time in a woman’s life, but it can also bring challenges. Many women experience the baby blues after giving birth, and some women develop symptoms of depression that are more intense, long lasting, and can interfere with daily activities. Mothers with depression feel sad, hopeless, and have little interest in doing things they once enjoyed.

• Postpartum depression, which can last months or years after giving birth, can affect a mother’s ability to bond with and care for her baby.
• If left untreated, it can impact the mother’s health and may cause sleeping, eating, and behavioral problems for the baby.
• When maternal depression is effectively treated and managed, it benefits both mother and child.

1 in 8

1 in 8 women report symptoms of depression after giving birth.

20%

About 1 in 5 women were not asked about depression during a prenatal visit.

50%

Over half of pregnant women with depression were not treated.

Problem:

Healthcare providers are missing opportunities to ask women about depression.

• About 1 in 5 women were not asked about symptoms of depression during a prenatal visit, and 1 in 8 were not asked during a postpartum visit.
• Whether healthcare providers ask pregnant and postpartum women about depression varies state to state.
  • States range from 51% to 91% of women asked during a prenatal visit and 51% to 96% of women asked during a postpartum visit.

Postpartum depression is more serious than baby blues.

BABY BLUES

• Very common
• Usually starts 2-3 days after birth
• May experience feelings of worry, unhappiness and fatigue
• Usually gets better on its own within 2 weeks

POSTPARTUM DEPRESSION

• Usually starts 1-3 weeks after birth
• Interferes with ability to do daily life activities
• Intense symptoms of sadness, anxiety, and hopelessness
• May include loss of interest in activities, withdrawing from friends and family, or thoughts of hurting self or baby
• Can occur up to a year after birth
• Usually requires treatment

Percentage of women with symptoms of depression after birth varies by state

THE WAY FORWARD ⟩⟩⟩

States can:

• Support programs that help providers screen and treat women.
• Use existing programs like Healthy Start, home visiting, and Title V Maternal and Child Health Services Block Grant to address maternal depression.
• Monitor measures related to maternal depression.

Healthcare providers can:

• Ask every pregnant and postpartum woman about symptoms of depression.
• Know local resources for referral to treatment and follow up.

Women can:

• Know that you are not alone.
• Tell your doctor about your symptoms.
• Ask about options for help.

Friends and families can:

• Know the symptoms of depression.
• Encourage women to talk with a healthcare provider about symptoms of depression.
• Offer emotional and practical support.

Talk with every mom, every pregnancy.

Your doctor or mental health professional may treat depression with therapy, medicine, or a combination of the two. Your doctor or nurse may refer you to a mental health specialist for therapy.

Some people with milder forms of depression get better after a few months of therapy. People with moderate to severe depression might need therapy and a type of medicine called an antidepressant. Antidepressants change the levels of certain chemicals in your brain. It may take several weeks for antidepressants to work. There are different types of antidepressant medicines, and some work better than others for certain people. Some people get better only with both treatments — therapy and antidepressants. Learn what you can do if these treatments don't help.

Having depression can make some people more likely to turn to drugs or alcohol to cope. But drugs or alcohol can make your mental health condition worse and can affect how antidepressants work. Talk to your therapist or doctor or nurse about any alcohol or drug use.

Taking St. John’s wort for depression has not been approved by the Food and Drug Administration (FDA). Studies show mixed results about the plant’s ability to treat depression.

It may be dangerous to take St. John’s wort if you also take other medicines. St. John’s wort can make many medicines not work at all or may cause dangerous or life-threatening side effects. The medicines used to treat heart disease, HIV, depression, seizures, certain cancers, and organ transplant rejection may not work or may have dangerous side effects if taken with St. John’s wort. St. John’s wort may also make birth control pills not work, which increases the chance you will get pregnant when you don’t want to.It is crucial that you tell your doctor or nurse if you take St. John’s wort.

Depression is a serious mental illness that can be successfully treated with therapy and FDA-approved medicines. FDA-approved medicines and natural treatments can have side effects. It’s best to talk to a doctor or nurse about treatment for depression.

For some people, yes. Researchers think that exercise may work better than no treatment at all to treat depression. They also think that regular exercise can lower your risk of getting depression and help many depression symptoms get better. Researchers do not know whether exercise works as well as therapy or medicine to treat depression. People with depression often find it very difficult to exercise, even though they know it will help make them feel better. Walking is a good way to begin exercising if you haven’t exercised recently.

Researchers are studying natural and complementary treatments (add-on treatments to medicine or therapy) for depression. Currently, none of the natural or complementary treatments are proven to work as well as medicine and therapy for depression. However, natural or complementary treatments that have little or no risk, like exercise, meditation, or relaxation training, may help improve your depression symptoms and usually will not make them worse.

Maybe. Some medicines, such as some types of antidepressants, may make it more difficult for you to get pregnant, but more research is needed. Talk to your doctor about other treatments for depression that don’t involve medicine if you are trying to get pregnant. For example, a type of talk therapy called cognitive behavioral therapy (CBT) helps women with depression. This type of therapy has little to no risk for women trying to get pregnant. During CBT, you work with a mental health professional to explore why you are depressed and train yourself to replace negative thoughts with positive ones. Certain mental health care professionals specialize in depression related to infertility.

Women who are already taking an antidepressant and who are trying to get pregnant should talk to their doctor or nurse about the risks and benefits of stopping the medicine. Learn more about taking medicines during pregnancy in our Pregnancy section.

Getting treatment earlier rather than later can relieve symptoms quicker and reduce the length of time treatment is needed.

Other things that may help include:

• Spending time with other people and talking with a friend or relative about your feelings
• Increasing your level of physical activity. Regular exercise can help people with mild to moderate depression and may be one part of a treatment plan for those with severe depression. Talk with your health care professional about what kind of exercise is right for you.
• Breaking up large tasks into small ones, and tackling what you can as you can. Don't try to do too many things at once
• Delaying important decisions until you feel better. Discuss decisions with others who know you well.
• Keeping stable daily routines. For example, eating and going to bed at the same time every day.
• Avoiding alcohol

As you continue treatment, gradually you will start to feel better. Remember that if you are taking an antidepressant, it may take several weeks for it to start working. Try to do things that you used to enjoy before you had depression. Go easy on yourself.

Depression is a real medical condition.

Depression is a common but serious mood disorder. Depression symptoms can interfere with your ability to work, sleep, study, eat, and enjoy your life. Although the causes of depression are still being studied, current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Most people with depression need treatment to feel better.

You can’t just ‘snap out’ of depression.

Well-meaning friends or family members may try to tell someone with depression to “snap out of it,” “just be positive,” or “you can be happier if you just try harder.” But depression is not a sign of a person’s weakness or a character flaw. The truth is that most people who experience depression need treatment to get better.

If you are a friend or family member of a woman with depression, you can offer emotional support, understanding, patience, and encouragement. But never dismiss her feelings. Encourage her to talk to her doctor and remind her that with time and treatment, she can feel better.

Most people with depression need treatment to feel better.

If you think you may have depression, start by making an appointment to see your health care provider. This could be your primary doctor or a health provider who specializes in diagnosing and treating mental health conditions (for example, a psychologist or psychiatrist). Certain medications, and some medical conditions, such as viruses or a thyroid disorder, can cause the same symptoms as depression. A health care provider can rule out these possibilities by doing a physical exam, interview, and lab tests. Your health care provider will examine you and talk to you about treatment options and next steps.

Depression can hurt—literally.

Sadness is only a small part of depression. In fact, some people with depression do not feel sadness at all. A person with depression may also experience many physical symptoms, such as aches or pains, headaches, cramps, or digestive problems. Someone with depression may also have trouble with sleeping, waking up in the morning, and feeling tired.

If you have been experiencing any of the following signs and symptoms for at least two weeks, you may be suffering from depression:

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Decreased energy or fatigue
• Difficulty sleeping, early-morning awakening, or oversleeping
• Loss of interest or pleasure in hobbies and activities
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Talk to your doctor about these symptoms. Be honest, clear, and concise—the doctor needs to know how you feel. Your doctor may ask when your symptoms started, what time of day they happen, how long they last, how often they occur, if they seem to be getting worse or better, and if they keep you from going out or doing your usual activities. It may help to take the time to make some notes about your symptoms before your doctor’s visit.

Certain types of depression are unique to women.

Pregnancy, the postpartum period, perimenopause, and the menstrual cycle are all associated with dramatic physical and hormonal changes. Certain types of depression that occur at different stages of a woman’s life include:

Premenstrual Dysphoric Disorder (PMDD)

Most people are familiar with the term “PMS” or premenstrual syndrome. Moodiness and irritability in the weeks before menstruation are quite common and the symptoms are usually mild. But there is a less common, more severe form of PMS called premenstrual dysphoric disorder (PMDD). PMDD is a serious condition with disabling symptoms such as irritability, anger, depressed mood, sadness, suicidal thoughts, appetite changes, bloating, breast tenderness, and joint or muscle pain.

Perinatal Depression

Being pregnant isn’t easy. Pregnant women commonly deal with morning sickness, weight gain, and mood swings. Caring for a newborn is challenging, too. Many new moms experience the “baby blues”—a term used to describe mild mood changes and feelings of worry, unhappiness, and exhaustion that many women sometimes experience in the first two weeks after having a baby. These feelings usually last a week or two and then go away as a new mom adjusts to having a newborn.

Perinatal depression is a mood disorder that can affect women during pregnancy and after childbirth, and is much more serious than the “baby blues.” The word “perinatal” refers to the time before and after the birth of a child. Perinatal depression includes depression that begins during pregnancy (called prenatal depression) and depression that begins after the baby is born (called postpartum depression). Mothers with perinatal depression experience feelings of extreme sadness, anxiety, and fatigue that may make it difficult for them to carry out daily tasks, including caring for themselves, their new child, or others.

If you think you have perinatal depression, you should talk to your health care provider or trained mental health care professional. If you see any signs of depression in a loved one during her pregnancy or after the child is born, encourage her to see a health care provider or visit a clinic.

Perimenopausal Depression

Perimenopause (the transition into menopause) is a normal phase in a woman’s life that can sometimes be challenging. If you are going through perimenopause, you might be experiencing abnormal periods, problems sleeping, mood swings, and hot flashes. But it is a myth that it is “normal” to feel depressed. If you are struggling with irritability, anxiety, sadness, or loss of enjoyment at the time of the menopause transition, you may be experiencing perimenopausal depression.

Depression affects each woman differently.

Not every woman who is depressed experiences every symptom. Some women experience only a few symptoms. Others have many. The severity and frequency of symptoms, and how long they last, will vary depending on the individual and her particular illness. Symptoms may also vary depending on the stage of the illness.

Depression can be treated.

Even the most severe cases of depression can be treated. Depression is commonly treated with medication, psychotherapy (also called “talk therapy”), or a combination of the two.

Antidepressants are medications commonly used to treat depression. People respond differently to antidepressants, and you may need to try different medicines to find the one that works best. Researchers also are studying and developing other medications for depression, such as brexanolone for postpartum depression, and esketamine.

There are many different types of psychotherapy, such as cognitive behavioral therapy or interpersonal therapy. The particular approach a therapist uses depends on the condition being treated and the training and experience of the therapist. Therapists also may combine and adapt elements of different approaches.

Depression affects each individual differently. There is no “one-size-fits-all” for treatment. It may take some trial and error to find the treatment that works best.