Postnatal depression: recognising the signs and finding support

Newborn · Wellbeing · Reviewed 20 June 2026 · All articles

Postnatal depression (PND) is one of the most common complications of childbirth, affecting roughly 1 in 10 new mothers and a significant number of fathers and co-parents too. It is not a sign of weakness, a character flaw, or a failure to love your baby. It is a recognised medical condition, and with the right support it responds well to treatment. If you are struggling in the weeks or months after birth, you are not alone, and help is available.

Baby blues versus postnatal depression

Many new parents experience the "baby blues" in the first days after birth. Hormones shift dramatically after delivery, and it is completely normal to feel weepy, irritable, or overwhelmed from around day three to day five. These feelings typically peak by the end of the first week and resolve on their own by around two weeks postpartum.

Postnatal depression is different. Rather than fading after a few days, the low mood persists or intensifies. Symptoms can begin any time in the first year after birth, though they most commonly emerge in the first three months. If you are still feeling persistently low, anxious, or disconnected from your baby after two weeks, or if symptoms that seemed to ease have returned and worsened, it is worth speaking to your doctor or midwife without delay.

There is also a rarer but more serious condition called postpartum psychosis, which involves hallucinations, delusions, or rapid mood swings and requires immediate medical attention. If you or someone you know experiences these symptoms, call emergency services straight away.

Recognising the signs

Postnatal depression can look different in different people, which is one reason it sometimes goes unrecognised. Common signs include:

Persistent low mood that does not lift, even during moments that should feel positive
Loss of interest or pleasure in activities you previously enjoyed
Fatigue beyond normal new-parent tiredness: a deep, heavy exhaustion that rest does not seem to touch
Anxiety and excessive worry, sometimes about the baby's health or your own ability to cope
Intrusive thoughts, such as unwanted images of something bad happening to the baby. These thoughts are distressing and feel completely out of character, which is important to understand: having an intrusive thought does not mean you want to act on it
Difficulty bonding with your baby, feeling numb or disconnected, or going through the motions without feeling the warmth you expected
Changes in appetite or sleep that are not explained by the baby's schedule, such as being unable to eat or sleeping far more than the baby allows
Withdrawing from family and friends, feeling alone even when surrounded by people
Feeling unable to cope or that you are a bad parent, sometimes accompanied by excessive guilt or self-criticism

Not everyone experiences all of these, and some people function relatively well on the outside while struggling significantly on the inside. If several of these signs have been present for more than two weeks, a conversation with a healthcare professional is the right next step.

The Edinburgh Postnatal Depression Scale

The Edinburgh Postnatal Depression Scale (EPDS) is a validated ten-question self-report tool developed in 1987 and now used worldwide to screen for PND. It takes fewer than five minutes to complete and asks about mood, anxiety, and the ability to cope over the past seven days. It was validated in Italian as well as English and several other languages, making it a reliable screening instrument in many settings.

Each question is scored from 0 to 3, giving a maximum total of 30. A score of 10 or above suggests that further clinical assessment is warranted. Question 10 specifically asks about thoughts of self-harm and is evaluated separately regardless of the total score.

In most postnatal care pathways, the EPDS is offered at the six-week postnatal check and again at around three to four months. However, you do not need to wait for a scheduled appointment to raise concerns. You can ask your midwife, obstetrician, or family doctor (medico di famiglia) to go through the EPDS with you at any point, or you can use it as a guide to reflect on your own experience before a consultation.

It is important to understand that the EPDS is a screening tool, not a diagnosis. A high score means that further assessment is needed, not that you definitely have PND. Equally, some people with PND score below the threshold, particularly if they minimise their symptoms due to fear or stigma. Your clinician will consider the full picture when assessing your wellbeing.

Talking to your doctor or midwife

One of the biggest barriers to getting help is the reluctance to raise the subject. Many parents worry about being judged, about their baby being taken away, or about being seen as ungrateful when they have a healthy baby. These fears are understandable but rarely reflect reality. Healthcare professionals who work with new families are trained to respond with compassion, not judgement.

When you see your doctor or midwife, try to be as honest as you can about how you have been feeling, including on the worst days. You might say something simple: "I have not been feeling myself since the birth" or "I am struggling more than I expected." You do not need to have the right words or a tidy account of your symptoms. The clinician's job is to ask the questions that help clarify what is going on.

At the appointment, your doctor may:

Ask you to complete the EPDS or a similar questionnaire
Carry out a brief physical check to rule out conditions such as thyroid dysfunction, which can mimic depression
Ask about your sleep, your support at home, and whether you are having any thoughts of self-harm
Discuss treatment options and refer you to a specialist if needed

Partners can also be affected by postnatal depression and deserve the same level of attention. If the person who gave birth is being assessed, it is worth asking that the partner's wellbeing be considered too. Many healthcare systems, including the Italian national health service (SSN), are increasingly aware that PND affects whole families.

Treatment options

Postnatal depression is very treatable. The right approach depends on the severity of your symptoms, your personal preferences, and your circumstances.

Psychological therapies are the first-line treatment for mild to moderate PND. Cognitive behavioural therapy (CBT) helps you identify and challenge unhelpful thought patterns. Interpersonal therapy (IPT) focuses on relationships and life transitions, which is particularly relevant given the enormous identity shift that new parenthood brings. Both have strong evidence bases for PND. Sessions may be available through your local mental health service (Centro di Salute Mentale, or CSM) via the Italian national health service, often without any cost.

Antidepressants may be recommended when symptoms are moderate to severe, when psychological therapy alone is insufficient, or when you need faster relief to function safely. Several antidepressants are considered compatible with breastfeeding. Your prescribing doctor will choose the safest option for your situation and explain what to expect in terms of onset and side effects. It usually takes two to four weeks to notice the full effect, so it is important to keep in contact with your doctor during this time.

Combination treatment, using both therapy and medication, is often more effective than either alone for moderate to severe PND.

Peer support groups can be a valuable complement to professional treatment. Speaking with other parents who have been through PND can reduce isolation and provide practical strategies. Your midwife or doctor can advise on local groups, or search for support via the Societa Italiana di Psichiatria or local ASL services.

Self-care measures such as regular gentle exercise, accepting practical help with baby care, maintaining regular meals, and reducing alcohol can all support recovery, but they are not substitutes for professional treatment when PND is present.

Support resources and helplines

A range of resources is available for parents experiencing postnatal depression. Knowing where to turn can make a real difference when things feel hardest.

Telefono Amico (02 2327 2327) is a national volunteer helpline providing emotional support to people in distress. Calls are confidential. This is not a crisis line in the clinical sense, but it offers a compassionate, non-judgemental ear at any time of day or night when you simply need to talk.

GynePsy centres are specialist perinatal mental health units found in several major Italian hospitals. They bring together obstetricians, psychiatrists, and psychologists to provide integrated care for mothers with mental health needs during pregnancy and the postnatal period. If you are in a city with a GynePsy centre, ask your obstetrician for a referral.

Societa Italiana di Psichiatria (SIP) is the national psychiatric professional body and publishes clinical guidelines for the management of perinatal mental health conditions. Your doctor can refer to these guidelines when deciding on treatment. The SIP also runs public information campaigns aimed at reducing stigma around mental illness.

Local ASL (Azienda Sanitaria Locale) mental health services are available throughout Italy and provide the day-to-day pathway for most people seeking help. Your family doctor can make a referral, or you can self-refer in many areas by contacting the Centro di Salute Mentale directly. There is no charge for SSN-covered services.

Istituto Superiore di Sanita (ISS), the Italian national public health institute, provides authoritative information on postnatal depression for both professionals and the public at iss.it.

For partners and family members: your support matters enormously to recovery. Encourage professional help, take practical tasks off the person who is unwell, and look after your own wellbeing too. Many support organisations offer information specifically for partners and family carers.

Overcoming stigma

Cultural expectations around motherhood can make it harder to ask for help. There is a pervasive myth that becoming a parent, and particularly becoming a mother, should be a time of pure joy. When the reality does not match this image, many people feel shame or fear that admitting their struggles means they are failing their baby.

This myth is harmful. Postnatal depression is a medical condition rooted in a complex mix of hormonal, psychological, social, and biological factors. It has nothing to do with how much you love your child. Many people who have experienced PND go on to describe their recovery as a turning point that deepened their relationship with their baby rather than damaged it.

Speaking openly about how you are feeling, whether with a healthcare professional, a trusted friend, or a support group, is not a sign of weakness. It is the most effective thing you can do to recover. Shame has no role in treatment, and the sooner it can be set aside, the sooner recovery can begin.

If someone you know seems to be struggling after the birth of their baby, a simple, non-judgemental check-in can make a profound difference. Ask how they are really doing, listen without jumping to reassure or minimise, and gently encourage them to speak to their doctor or midwife if they have not already done so.

Frequently asked questions

How common is postnatal depression?

Postnatal depression affects roughly 1 in 10 mothers in the first year after birth, and around 1 in 25 fathers or co-parents. It is one of the most common complications of childbirth and responds well to treatment, so you are not alone and help is available.

Can fathers and non-birthing partners get postnatal depression?

Yes. Research shows that fathers and non-birthing partners develop postnatal depression at significant rates, particularly in the first few months. Symptoms overlap with those in mothers: persistent low mood, withdrawal, irritability, and difficulty bonding with the baby. Partners should be assessed and can access the same treatment options.

Is it safe to take antidepressants while breastfeeding?

Several antidepressants are considered compatible with breastfeeding. Sertraline and paroxetine, for example, transfer into breast milk at very low levels and are often recommended when medication is needed. Your doctor will weigh up your specific situation, including the severity of your symptoms and your preferences, and will choose the safest option. Never stop or start medication without medical guidance.

When should I seek urgent help for postnatal depression?

Seek same-day help if you are having thoughts of harming yourself or your baby, or if you feel you cannot keep yourself or your baby safe. In Italy you can call the emergency number 118, go to your nearest accident and emergency department, or contact a mental health crisis team via your local ASL. You can also call Telefono Amico on 02 2327 2327 for emotional support at any time of day or night.

Track your baby with Cubby, free

Log feeds, naps and nappies in one place so care tasks feel more manageable on hard days.

Start free