Having a baby is supposed to be one of life’s most joyous times. And it usually is, even though up to 70 percent of new moms experience a short-term bout of the “baby blues.” Thought to be caused by dramatic changes in hormone levels right after giving birth, the baby blues may leave newly minted mothers crying for no reason, irritable, restless and anxious, according to the American Psychiatric Association. But these symptoms last only a week or two and generally go away on their own without treatment.

For an estimated 1 in 7 women, however, these blues become a more serious form of depression known as peripartum depression. Mental health experts prefer the term peripartum to postpartum because this depression often begins during pregnancy, not just after delivery.

Unlike the baby blues, peripartum depression is emotionally and physically debilitating and may continue for months or even years, the APA says. Like other forms of depression, however, it is treatable. Getting treatment is important for the health of both the mother and the baby. Depression has been linked to premature birth and low birth weight. It can interfere with mother-child bonding and lead to sleeping and feeding problems for the baby. The APA reports that children of mothers with peripartum depression are at greater risk for cognitive, emotional, developmental and verbal deficits and impaired social skills as they get older.

The condition is so serious that in 2016, the U.S. Preventive Services Task Force, an independent panel of experts, updated its recommendation for depression screening in adults to include screening pregnant and postpartum women. “Many OB-GYNS, family doctors and pediatricians screen for this, using various scales, because of the prevalence of depression and the impact it has on the mom, the baby and the family,” says Dr. Michelle B. Riba, associate director of the University of Michigan Comprehensive Depression Center. “There is more of an understanding that it exists because celebrities, like Brooke Shields, have talked about it. There is more and more acknowledgement of it, which is all good.”

Risks, Causes and Symptoms

All women are at risk, but those who have a personal or family history of depression or other mood disorders, or are in the midst of an especially stressful time (on top of the stress of having a baby) or who don’t have good social support from family and friends are at increased risk.

Along with the rapid changes in sex, thyroid and stress hormones that arise during pregnancy and after delivery, other factors may also play a role in depressive symptoms, such as the physical changes that come with pregnancy, stress on personal or work relationships, worries about parenting skills or money – and the one inevitable and ubiquitous stressor: lack of sleep.

The symptoms of peripartum depression include many of the same symptoms of other forms of depression, including sluggishness, fatigue, feeling hopeless or worthless, loss of interest or pleasure in life and difficulty concentrating. But on top of that, pregnant women and new mothers may:

Cry for “no reason.”

Feel disinterested in or not feel bonded to the baby.

Feel they are a “bad mother.”

Fear they may harm the baby or herself.

Feel isolated, guilty or ashamed of their condition.

Many women also experience symptoms of anxiety, the APA states, noting a study finding that almost two-thirds of women with peripartum depression also had an anxiety disorder. “In fact, anxiety can be the leading symptom, but it is still referred to as peripartum depression,” says William Pollack, associate professor of psychology in the department of psychiatry at Harvard Medical School.

Treatment Is Effective

As with other types of depression, peripartum depression is typically treated with psychotherapy, lifestyle changes and social support. Antidepressant medication is also an option, but the APA says that women who are pregnant or nursing should discuss the risks and benefits of medication with their physicians because certain types of antidepressant may pass on to the baby through the placenta or breast milk. For that reason, APA guidelines recommend psychotherapy without medication as a first-line treatment when the depression or anxiety is mild. “The good news is, when you work with mothers and get them on the right treatment path, and monitor treatment so they don’t withdraw from medications too quickly, then psychotherapy and pharmacotherapy are very helpful,” Riba says.

It must be noted that new fathers can also experience peripartum depression. The APA estimates that 4 percent of fathers experience depression in the first year after their child’s birth. Younger fathers, fathers with a history of depression and fathers with financial problems are at increased risk. “If the father starts to feel down, or if he is getting irritable or angry, getting help is as important for him as it is for his wife,” Pollack says.

The most important thing for both mothers and fathers to remember, he says, is that peripartum depression is a real possibility. “You don’t have to worry about it, but if you see it, talk it over with your primary care doctor or your OB-GYN, and watch it. If it becomes more than the baby blues, you want to get treatment sooner rather than later,” he says.