{
  "release_id": "fc5a600ec7387e71",
  "id": "maternal:guide-mood-after-birth",
  "owner": "maternal",
  "kind": "patient_guide",
  "slug": "mood-after-birth",
  "name": "Mood after birth",
  "aliases": [],
  "atlases": [
    "maternal"
  ],
  "summary_plain": "What the sources say about the baby blues, postpartum depression, postpartum psychosis, screening and help.",
  "summary_technical": "Static guide from a NIMH page, a MedlinePlus page and an openFDA record. It scores no questionnaire.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-15",
  "next_review_due": "2027-04-15",
  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "postpartum"
      ],
      "care-area": [
        "maternal-mental-health"
      ]
    }
  },
  "payload": {
    "purpose": "explainer",
    "audience": "People who have given birth, and the people with them",
    "about": [
      "maternal:perinatal-depression",
      "maternal:postpartum-depression",
      "maternal:postpartum-psychosis",
      "maternal:perinatal-depression-screening",
      "maternal:zuranolone",
      "maternal:brexanolone"
    ],
    "reading_grade_target": 10,
    "scope_note": "Written from a NIMH page and a MedlinePlus page, both US government pages, plus one task force summary and one drug record.",
    "warning_blocks": [
      {
        "heading": "Signs of postpartum psychosis",
        "signs": [
          {
            "id": "ps-1",
            "text": "NIMH lists delusions, meaning thoughts or beliefs that are not true.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is postpartum psychosis?, paragraph 1"
              }
            ]
          },
          {
            "id": "ps-2",
            "text": "NIMH lists hallucinations, meaning seeing, hearing or smelling things that are not there.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is postpartum psychosis?, paragraph 1"
              }
            ]
          },
          {
            "id": "ps-3",
            "text": "NIMH lists mania, a high, elated mood that often seems out of touch with reality.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is postpartum psychosis?, paragraph 1"
              }
            ]
          },
          {
            "id": "ps-4",
            "text": "NIMH also lists paranoia and confusion.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is postpartum psychosis?, paragraph 1"
              }
            ]
          }
        ],
        "act_now": [
          {
            "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
            "locator": "What is postpartum psychosis?, paragraph 2",
            "words": "Women experiencing symptoms of postpartum psychosis should seek immediate help by calling 911 or going to the nearest emergency room."
          }
        ]
      },
      {
        "heading": "Thoughts of suicide or of harming oneself or the baby",
        "signs": [
          {
            "id": "sg-1",
            "text": "MedlinePlus lists thinking of harming oneself or the baby as a symptom of postpartum depression.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What are the symptoms of postpartum depression?, list"
              }
            ]
          },
          {
            "id": "sg-2",
            "text": "MedlinePlus also names thoughts about suicide in its section on symptoms.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What are the symptoms of postpartum depression?, get help right away"
              }
            ]
          }
        ],
        "act_now": [
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "If you have thoughts about suicide, or hurting yourself or your baby get help right away:"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Call 911 or go to your local emergency room"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Contact a crisis hotline. In the United States, you can reach the National Suicide and Crisis Lifeline at any time:"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Call or text 988"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Chat online with Lifeline Chat"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "TTY users: Use your preferred relay service or dial 711 then 988"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Veterans can contact the Veterans Crisis Line:"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Call 988, then press 1"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Text 838255"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Chat online"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Call your mental health provider or other health care provider"
          },
          {
            "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
            "locator": "What are the symptoms of postpartum depression?, get help right away",
            "words": "Reach out to a loved one or close friend"
          }
        ]
      }
    ],
    "sections": [
      {
        "heading": "The baby blues",
        "statements": [
          {
            "id": "blues-1",
            "text": "The baby blues are mild, short-lasting mood changes that many women have in the first 2 weeks after birth.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is postpartum depression different from baby blues?, paragraph 1"
              }
            ]
          },
          {
            "id": "blues-2",
            "text": "The baby blues usually go away within a few days to a week.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What is postpartum depression?, paragraph 1"
              }
            ]
          }
        ]
      },
      {
        "heading": "Postpartum depression and perinatal depression",
        "statements": [
          {
            "id": "ppd-1",
            "text": "Mood changes that are severe, or last longer than 2 weeks after birth, may be signs of postpartum depression.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is postpartum depression different from baby blues?, paragraph 2"
              }
            ]
          },
          {
            "id": "ppd-2",
            "text": "Postpartum depression is a common but serious mood disorder that can begin in the first year after birth.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What is postpartum depression?, paragraph 3"
              }
            ]
          },
          {
            "id": "ppd-3",
            "text": "Most episodes of perinatal depression begin within 4 to 8 weeks after the baby is born.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is perinatal depression?, paragraph 1"
              }
            ]
          },
          {
            "id": "ppd-4",
            "text": "Women with postpartum depression generally do not feel better without treatment.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is postpartum depression different from baby blues?, paragraph 2"
              }
            ]
          },
          {
            "id": "ppd-5",
            "text": "The US Preventive Services Task Force says perinatal depression affects as many as 1 in 7 women.",
            "cites": [
              {
                "claim": "maternal:claim-perinatal-depression-affects-1-in-7"
              }
            ]
          },
          {
            "id": "ppd-7",
            "text": "A woman is not to blame for having perinatal depression.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What are the risk factors for perinatal depression?, paragraph 1"
              }
            ]
          },
          {
            "id": "ppd-8",
            "text": "A history of depression or bipolar disorder, in the woman or her family, may raise the risk.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "Who is at risk for postpartum depression?, list"
              }
            ]
          }
        ]
      },
      {
        "heading": "Signs of postpartum depression",
        "statements": [
          {
            "id": "sym-1",
            "text": "Symptoms may include feeling sad or empty most of the time, crying more than usual, and pulling away from family and friends.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What are the symptoms of postpartum depression?, list"
              }
            ]
          },
          {
            "id": "sym-2",
            "text": "Other symptoms may include little or no interest in the baby, and constant doubts about caring for the baby.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What are the symptoms of postpartum depression?, list"
              }
            ]
          },
          {
            "id": "sym-3",
            "text": "Postpartum depression symptoms are more intense and last longer than the baby blues.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What are the symptoms of postpartum depression?, paragraph 1"
              }
            ]
          },
          {
            "id": "sym-5",
            "text": "NIMH lists thoughts of death, of harming oneself or the baby, and suicide attempts among the more common symptoms of perinatal depression.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What are the signs and symptoms of perinatal depression?, list"
              }
            ]
          },
          {
            "id": "sym-6",
            "text": "A provider can tell whether symptoms come from perinatal depression or something else.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What are the signs and symptoms of perinatal depression?, closing paragraph"
              }
            ]
          }
        ]
      },
      {
        "heading": "Postpartum psychosis",
        "statements": [
          {
            "id": "psy-1",
            "text": "Postpartum psychosis is a serious mental illness that can occur after childbirth.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is postpartum psychosis?, paragraph 1"
              }
            ]
          },
          {
            "id": "psy-2",
            "text": "MedlinePlus describes postpartum psychosis as a very rare medical emergency.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What are the symptoms of postpartum depression?, postpartum psychosis"
              }
            ]
          },
          {
            "id": "psy-3",
            "text": "NIMH describes postpartum psychosis as a psychiatric emergency that requires hospitalization.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is postpartum psychosis?, paragraph 2"
              }
            ]
          },
          {
            "id": "psy-4",
            "text": "Recovery from postpartum psychosis is possible with professional help.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "What is postpartum psychosis?, paragraph 2"
              }
            ]
          },
          {
            "id": "psy-5",
            "text": "Confusion, hallucinations and dangerous behaviors are possible symptoms of postpartum psychosis.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What are the symptoms of postpartum depression?, postpartum psychosis"
              }
            ]
          }
        ]
      },
      {
        "heading": "How screening and diagnosis work",
        "statements": [
          {
            "id": "scr-1",
            "text": "A provider may use screening questions or questionnaires about mood, sleep and thoughts.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "How is postpartum depression diagnosed?, list"
              }
            ]
          },
          {
            "id": "scr-2",
            "text": "Diagnosis can also use a clinical evaluation based on symptoms.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "How is postpartum depression diagnosed?, list"
              }
            ]
          },
          {
            "id": "scr-3",
            "text": "Blood tests may check for physical conditions, such as thyroid disorders, that can cause or worsen depression.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "How is postpartum depression diagnosed?, list"
              }
            ]
          },
          {
            "id": "scr-4",
            "text": "Completing recommended screening questionnaires in pregnancy and after birth may lower the risk of postpartum depression.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "Can postpartum depression be prevented?, list"
              }
            ]
          },
          {
            "id": "scr-5",
            "text": "Early postpartum checkups may also lower the risk, because symptoms can be found and treated sooner.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "Can postpartum depression be prevented?, list"
              }
            ]
          }
        ]
      },
      {
        "heading": "Treatment and the two approved medicines",
        "statements": [
          {
            "id": "tx-1",
            "text": "Treatment usually includes therapy, medication, or both.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, paragraph 1"
              }
            ]
          },
          {
            "id": "tx-2",
            "text": "Most women feel better with proper treatment.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, paragraph 1"
              }
            ]
          },
          {
            "id": "tx-3",
            "text": "Evidence-based therapies include cognitive behavioral therapy and interpersonal therapy.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Psychotherapy"
              }
            ]
          },
          {
            "id": "tx-4",
            "text": "Antidepressants can effectively treat perinatal depression, alone or with talk therapy.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          },
          {
            "id": "tx-4a",
            "text": "NIMH notes that, in some cases, people under 25 may have more suicidal thoughts or behavior on antidepressants, especially early on or when the dose changes.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          },
          {
            "id": "tx-5",
            "text": "NIMH says brexanolone has been approved in the US for severe postpartum depression.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          },
          {
            "id": "tx-5a",
            "text": "The 2022 brexanolone label lists postpartum depression in patients 15 years and older.",
            "cites": [
              {
                "snapshot_id": "maternal:fda-zulresso-label-2022-2026-10-14",
                "locator": "Section 1, Indications and usage"
              }
            ]
          },
          {
            "id": "tx-6",
            "text": "NIMH says brexanolone is given through an IV during a brief hospital stay.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          },
          {
            "id": "tx-6a",
            "text": "openFDA lists the brexanolone product as discontinued.",
            "cites": [
              {
                "snapshot_id": "maternal:openfda-drugsfda-nda211371-2026-10-15",
                "locator": "results[0].products[0].marketing_status"
              }
            ]
          },
          {
            "id": "tx-7",
            "text": "NIMH says zuranolone, a pill, was approved in the US more recently as the first oral medication for postpartum depression in adults.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          },
          {
            "id": "tx-8",
            "text": "All medications can have side effects.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          },
          {
            "id": "tx-9",
            "text": "NIMH links weighing the risks and benefits of treatment to the provider knowing about pregnancy or nursing.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          },
          {
            "id": "tx-10",
            "text": "A provider can choose the safest treatment options when told about breastfeeding.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What is the treatment for postpartum depression?, paragraph 2"
              }
            ]
          }
        ]
      },
      {
        "heading": "Where the sources describe help",
        "statements": [
          {
            "id": "help-1",
            "text": "NIMH names a primary care doctor or a mental health professional as a place to start.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How can I find help for perinatal depression?, Visit a mental health professional"
              }
            ]
          },
          {
            "id": "help-2",
            "text": "NIMH lists an online treatment locator for mental health services, run by the Substance Abuse and Mental Health Services Administration.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How can I find help for perinatal depression?, Visit a mental health professional"
              }
            ]
          },
          {
            "id": "help-3",
            "text": "NIMH says support or advocacy groups can be an important source of help and information.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How can I find help for perinatal depression?, Join a support or advocacy group"
              }
            ]
          },
          {
            "id": "help-4",
            "text": "NIMH describes a National Maternal Mental Health Hotline with free, confidential support before, during and after pregnancy.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How can I find help for perinatal depression?, National Maternal Mental Health Hotline"
              }
            ]
          },
          {
            "id": "help-5",
            "text": "NIMH says family and friends may be the first to notice signs of depression in a new mother.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How can family and friends provide help for perinatal depression?, paragraph 2"
              }
            ]
          }
        ]
      }
    ],
    "checklists": [
      {
        "heading": "Topics the sources link to a visit",
        "items": [
          {
            "id": "ck-1",
            "text": "How long mood changes have lasted, which NIMH uses to tell postpartum depression from the baby blues.",
            "cites": [
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is postpartum depression different from baby blues?, paragraph 2"
              }
            ]
          },
          {
            "id": "ck-2",
            "text": "Any past depression or bipolar disorder, or a family history of either, which MedlinePlus lists as a risk factor.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "Who is at risk for postpartum depression?, list"
              }
            ]
          },
          {
            "id": "ck-3",
            "text": "Whether the patient is pregnant or breastfeeding, which the sources link to treatment choices.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-postpartum-depression-2026-10-15",
                "locator": "What is the treatment for postpartum depression?, paragraph 2"
              },
              {
                "snapshot_id": "maternal:nimh-perinatal-depression-2026-10-14",
                "locator": "How is perinatal depression treated?, Medication"
              }
            ]
          }
        ]
      }
    ],
    "questions": [
      {
        "text": "How can the baby blues be told apart from postpartum depression?",
        "grounded_in": [
          "blues-1",
          "blues-2",
          "ppd-1",
          "sym-3"
        ]
      },
      {
        "text": "Do these symptoms fit the baby blues, postpartum depression, or something else?",
        "grounded_in": [
          "sym-1",
          "sym-2",
          "sym-6"
        ]
      },
      {
        "text": "What do the screening questions cover, and when are they asked during pregnancy and after birth?",
        "grounded_in": [
          "scr-1",
          "scr-4"
        ]
      },
      {
        "text": "Which treatments are options: talk therapy, medication, or both?",
        "grounded_in": [
          "tx-1",
          "tx-3",
          "tx-4",
          "tx-4a"
        ]
      },
      {
        "text": "How do pregnancy or breastfeeding change which treatments are options?",
        "grounded_in": [
          "tx-9",
          "tx-10"
        ]
      },
      {
        "text": "Are brexanolone or zuranolone options, and what does each involve?",
        "grounded_in": [
          "tx-5",
          "tx-5a",
          "tx-6",
          "tx-6a",
          "tx-7"
        ]
      },
      {
        "text": "Which support groups or services are available nearby?",
        "grounded_in": [
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