Sheila Duffy often stops to encourage mothers she meets during her neighbourhood walks, especially if they seem to be having a hard day.
Many new mothers struggle under the weight of high expectations, she says, whether that is pressure to get in shape quickly or to make their life seem as polished as an Instagram reel. These pressures only increase if mothers experience postpartum depression, as Duffy did more than 30 years ago after her second child was born.
At that time, her husband was working long hours and the couple lived far from their parents.
“I had two under two and the isolation, the lack of support, was a big deal for me,” she said. Thankfully, a nurse recognized Duffy was showing signs of postpartum depression and suggested she visit the Pacific Post Partum Support Society. The Burnaby, B.C.-based charity runs support groups for mothers of young children.
Duffy’s support group changed her life. She learned how to care for herself and found others who understood her situation. Now, Duffy is the society’s director and has worked at the organization for nearly 30 years.
New mothers today are more likely to seek help sooner, Duffy says. And more help is available. In December, Health Canada approved the first medication designed to treat postpartum depression. The drug, zuranolone, works by addressing hormonal imbalances that may contribute to postpartum depression.
But treating postpartum depression involves more than addressing hormonal imbalances, sources say.
“[Postpartum depression] is a multi-dimensional issue, with lots of contributing factors, and then also lots of things that are going to make a difference,” said Duffy.
Fast-acting relief
Researchers say about one in five women worldwide experience postpartum depression. Common symptoms include persistent feelings of guilt, difficulty bonding with the baby, lack of interest in enjoyable activities and thoughts of death or suicide.
“It is a very treatable condition,” said Dr. Crystal Clark, a professor at the University of Toronto’s Temerty Faculty of Medicine and Canada Research Chair in reproductive mental health.
However, many mothers struggle to ask for help because they fear people will think they are bad parents, she says. They may also worry about how medication could impact their children, especially if they are breastfeeding.
Zuranolone promises to speed up treatment.
Zuranolone, sold under the name Zurzuvae, was approved for use in Canada on Dec. 9. The drug is specifically designed to treat postpartum depression faster than general antidepressants.
Biogen, the company that produces Zurzuvae, says women have seen their depressive symptoms lessen after only three days of taking the drug. This differs from other antidepressants, where results are often not seen for four to six weeks, and which patients may take for up to a year.
In contrast, women only take zuranolone for 14 days. The company says women have seen benefits up to 45 days after starting the medication.
Taking zuranolone could be compared to “taking a cycle of antibiotics” when sick, says Clark. It is a short-term medication that can effectively address symptoms.
“This is a wonderful announcement,” said Dr. Ryan van Lieshout, a psychiatry professor at McMaster University in Hamilton, Ont. who focuses on mental health during pregnancy and the postpartum period. “It shows us that pharmaceutical companies are interested in developing compounds for women and women’s health conditions.”
However, it is not clear whether insurance companies or public health plans will cover the expensive medication. Reports peg the cost of the drug, which the U.S. approved in 2023, at nearly US$16,000.
Social connection
Often, women with postpartum depression end up taking antidepressants because they cannot find psychotherapy, says van Lieshout.
“The first-line treatment, the ones we recommend first, are usually psychotherapy like cognitive behavioural therapy or interpersonal psychotherapy,” said van Lieshout.
“It can be difficult to access those, particularly in the publicly funded system, and so a lot of people will end up taking antidepressants.”
Daisy Singla, a senior scientist at the Centre for Addiction and Mental Health (CAMH), says more women could access therapy if more health-care professionals were trained to deliver it.
Singla was a principal investigator in a 2024 study showing midwives, doulas and nurses who were not mental health-care providers could deliver behavioural activation treatment for women with postpartum depression as effectively as psychotherapists. In behavioural activation treatment, individuals are encouraged to find activities that can help relieve their depression.
“In order to feel differently, one needs to do differently,” said Singla.
For women with postpartum depression, this often means asking others for help, she says.
“Interpersonal support can really serve as a protective factor [against postpartum depression], and not having interpersonal support often serves as a risk factor,” she said.
Many new mothers today struggle to find that support, says Jennifer Wright-Maley, a registered midwife and registered provisional psychologist in Calgary.
Diminished social connections can make navigating the changes associated with having a baby more difficult. Many adult children today live far from their parents or lack close friends. So they lack ready access to people who will bring them meals or help with housework during their child’s first days.
As a therapist, Wright-Maley often helps clients determine who they can ask to help them.
“I wish that as a culture we were better about acknowledging how difficult this era of life is and offering things that are actually useful.”
Duffy, at the Pacific Post Partum Support Society, agrees.
“We’re cut off from our communities in this day and age,” she said. “We’re supposed to have the village of support, and the village doesn’t really exist.”
But she knows from her own personal experience, and the experiences of women she has met, that talking about the struggles of parenthood can really help.
“Just sharing their experiences is really therapeutic,” she said. “It breaks that isolation.”
