Why rates of postpartum depression have doubled in the last decade

When a young woman with a history of severe depression during pregnancy arrived at the reproductive psychiatry clinic at Montefiore Einstein Hospital in New York City, she had to bravely push aside years of fear and family resistance to face her feelings of depression during pregnancy.

"We had to override a lot of negative ideas that her family had given her about what it meant to be engaged in mental health care, especially when you're pregnant, but we got her in treatment," Rubiahna Vaughn, director of the division of women's mental health at Montefiore Medical Center and associate professor of psychiatry and obstetrics & gynecology at Albert Einstein College of Medicine, told ABC News.

This is not an isolated incident.

Rates of postpartum depression -- a serious mood disorder affecting new moms within the first 12 months after childbirth -- have doubled over the last decade, according to a new study of more than 440,000 people from Kaiser Permanente Southern California. The rate of diagnosis jumped from about 9% in 2010 to 19% in 2021.

This is part of a larger trend. Mental health conditions are now the leading cause of pregnancy-related deaths in the U.S., according to the Centers for Disease Control and Prevention.

Postpartum depression symptoms can include persistent feelings of sadness, lack of interest in activities, eating and sleep disturbances and excessive irritability or crying. It's more serious than the temporary and mild sadness of the "baby blues," according to the American Psychiatric Association.

"I think it's actually crystal clear to me that more of our moms are struggling with mood and anxiety disorders," Vaughn said.

Challenges finding the right medical care, a lack of support and even the effects of the COVID-19 pandemic have made it more difficult for people who are pregnant to get the mental health treatment they need, Vaughn said.

While all racial and ethnic groups saw a rise in postpartum depression, non-Hispanic Black and non-Hispanic white people had the highest rates of depression, the new study found. However, the largest increases were seen in Asian and Pacific Islanders and non-Hispanic Black individuals at 280% and 140%, respectively.

Older women, people who reported substance use during pregnancy, and those who were overweight or had obesity were also at higher risk of postpartum depression, the study found.

Some people may not seek help because they are worried health care providers may judge them for expressing negative feelings about their pregnancy, and perhaps even report them to Child Protective Services, Vaughn said. Patients "may silence themselves," Vaughn noted, adding that sometimes medical professionals are reluctant to prescribe antidepressants, despite the benefits outweighing the risks.

Regular screening that starts early can help catch postpartum depression symptoms sooner so that people can get the appropriate care. Anyone at high risk should be identified even before they become pregnant and be followed closely after they give birth, Vaughn advised.

When left untreated, postpartum depression can lead to worse overall health for the new parent and make it difficult for them to bond with their baby. It also places the baby at higher risk for preterm birth, low birth weight, mood and anxiety disorders, and long-term developmental challenges, said Vaughn.

Severe postpartum depression can lead to thoughts of self-harm and harm to the baby.

Despite the alarming statistics, Vaughn is hopeful that postpartum depression is solvable.

"If we identify perinatal depression in a timely fashion, we can get patients feeling better so they can get back to their lives -- as mothers, as parents, as pillars of their society," Vaughn said.

As for Vaughn's patient, there's a happy ending. With early intervention including antidepressants and therapy, the young woman delivered a healthy baby and her depression is under control.

If you or someone you know is living with thoughts of suicide -- free confidential help is available 24 hours a day, 7 days a week. Call or text the National Lifeline at 988.

Esther Zusstone, MD is a radiology resident at NYU Langone and a member of the ABC News Medical Unit.