Like many first-time moms, Lisette Lopez-Rose thought childbirth would usher in a time of pleasure. As an alternative, she had panic assaults as she imagined that one thing dangerous was going to occur to her child, and he or she felt weighed down by a disappointment that would not elevate. The San Francisco Bay Space mom knew her excessive feelings weren’t regular, however she was afraid to inform her obstetrician. What in the event that they took her child away?
At about six months postpartum, she found a web-based community of girls with related experiences and finally opened as much as her main care physician. “About two months after I began remedy, I began to really feel like I used to be popping out of a deep gap and seeing gentle once more,” she says. At this time, Lopez-Rose works at Postpartum Help Worldwide, coordinating volunteers to assist new moms kind on-line connections.
The primary-ever drug for postpartum melancholy, containing a spinoff of progesterone, acquired US Meals and Drug Administration approval in 2019. That marked a brand new method to the dysfunction. This winter, in one other main advance, a San Diego-based startup firm will launch a blood check that predicts a pregnant lady’s danger of postpartum melancholy with greater than 80 p.c accuracy.
The product, referred to as myLuma, would be the first commercially obtainable check to make use of biomarkers — molecules within the physique, on this case the blood — to foretell onset of a psychiatric dysfunction, a lot in the best way that blood exams can detect indicators of ailments like most cancers and diabetes. Pregnant ladies who study they’re in danger for postpartum melancholy might take preventive steps reminiscent of taking antidepressants after childbirth or arranging for further help.
A blood check might cut back the stigma that retains many ladies from looking for assist, says Jennifer Payne, a reproductive psychiatrist on the College of Virginia in Charlottesville and a lead investigator on the research that led to the brand new check. She is a founder and member of the scientific advisory board for the corporate that makes myLuma, Dionysus Well being.
“If now we have a blood check, it brings psychiatry right down to the extent of biology, which I believe your common particular person can perceive as one thing that wants therapy and that is not simply in any person’s head,” she says.
Unpredictable results of hormones
Payne was a fellow on the Nationwide Institute of Psychological Well being in 2001 when she turned intrigued by postpartum melancholy as a window into the onset of temper problems. That led her to a key query: Why does the sudden drop in hormones after childbirth drastically have an effect on some ladies however not others? Whereas it is not unusual for girls to expertise transient emotions of tension and disappointment inside days of giving delivery, solely in some does a deeper and extra persistent melancholy take maintain.
As Payne’s analysis developed, she teamed up with Zachary Kaminsky, then a colleague at Johns Hopkins College, who studied the results of estrogen on mouse brains. Kaminsky is an epigeneticist: He researches how small chemical substances referred to as methyl teams can connect to genes and have an effect on how energetic they’re. Environmental components from air pollution to diet can have an effect on the extent of this reversible methylation.
By evaluating feminine mice given excessive ranges of estrogen to these with out it, Kaminsky discovered that estrogen induced particular gene methylation patterns inside cells within the hippocampus, part of the mind that helps management temper. These findings steered what to search for in blood samples Payne had collected from 51 ladies with a historical past of temper problems. The ladies had been tracked all through their pregnancies and afterward, with some creating postpartum melancholy inside 4 weeks of childbirth.
Two estrogen-sensitive genes emerged from the analysis — HP1BP3 and TTC9B. Greater than 80 p.c of the ladies who had postpartum melancholy confirmed a particular sample of better methylation on one gene and fewer methylation on the opposite. What’s extra, the modifications within the genes might be detected all through every trimester of being pregnant, says Kaminsky, now on the College of Ottawa Institute of Psychological Well being Analysis on the Royal; he is also a cofounder of Dionysus. In different phrases, even early in being pregnant, Kaminsky says, “you’ll be able to predict the ladies which are going to get postpartum melancholy.”
Kaminsky, Payne and collaborators repeatedly replicated these findings. As reported in a 2016 paper in Neuropharmacology, they discovered that by the methylation patterns of these genes, they might accurately predict greater than 80 p.c of the instances of postpartum melancholy in 240 pregnant ladies who had no historical past of psychiatric problems. In one other collaboration revealed in 2020 in Psychiatry Analysis, scientists at Johns Hopkins, Emory College and the College of California, Irvine, together with Payne and Kaminsky, examined blood samples from 285 pregnant ladies and in addition confirmed the findings.
That epigenetic analysis varieties the premise of the myLuma check, which additionally incorporates extra biomarkers that enhance its accuracy, says Kaminsky. Starting in January 2026, it’s anticipated to turn into obtainable at some docs’ places of work in three states: Florida, Texas and California. Although it is not but FDA-approved, docs are permitted to make use of such lab exams to assist make medical selections.
Zeroing in on steroids
Not everybody with postpartum melancholy has these epigenetic modifications, so Payne and different researchers proceed to hunt for different biomarkers to know how hormonal modifications set off postpartum melancholy. They’re zeroing in, for instance, on neuroactive steroids, which the physique makes from molecules like progesterone within the mind and different tissues.
A kind of metabolites, referred to as allopregnanolone, has a relaxing impact — it impacts a receptor within the mind referred to as GABA-A, which is thought to be concerned in stress discount. Allopregnanolone rises throughout being pregnant and drops swiftly after supply. One other neuroactive steroid, pregnanolone, has related properties. A 3rd, isoallopregnanolone, tamps down the antidepressant impact of allopregnanolone, rising emotions of stress.
In a research of 136 pregnant ladies revealed in 2025 within the journal Neuropsychopharmacology, ladies with an imbalance in pregnanolone and isoallopregnanolone throughout being pregnant have been extra more likely to develop postpartum melancholy. Measuring the ratio of those chemical substances within the blood might be one other approach to predict postpartum melancholy, says reproductive psychiatrist Lauren M. Osborne of Weill Cornell Medication in New York Metropolis, who co-led the research with Payne.
Allopregnanolone, in the meantime, has already proved to be a beneficial device for therapy. An artificial model referred to as brexanolone was developed by Cambridge, Massachusetts-based Sage Therapeutics and FDA-approved in 2019 — the primary drug authorised particularly for postpartum melancholy. Initially offered by way of IV infusion, it has been changed by an oral model, zuranolone, which was FDA-approved in 2023.
If now we have a blood check, it brings psychiatry right down to the extent of biology, which I believe your common particular person can perceive as one thing that wants therapy and that isn’t simply in any person’s head.
Jennifer Payne, College of Virginia in Charlottesville
These are “transformative therapies” as a result of they work quickly, write the authors of a 2025 article within the Annual Overview of Medication. Girls at excessive danger of postpartum melancholy may even profit from proactively taking zuranolone, although that hasn’t but been examined, says article coauthor Samantha Meltzer-Brody, a reproductive psychiatrist on the College of North Carolina who was an instructional principal investigator in research of brexanolone and an investigator in zuranolone trials.
The provision of a blood check, she provides, “opens up that whole line of questioning on how do you get forward of it, so you do not have to attend till somebody begins struggling?”
There are different attainable targets for a postpartum melancholy check. In a 2022 article in Molecular Psychiatry, Johns Hopkins neuroscientist Sarven Sabunciyan, with Osborne, Payne and Morgan Sherer, then an immunologist at Johns Hopkins, described a small research wherein the sorts of RNA carried by blood in fatty bubbles have been completely different in ladies who developed postpartum melancholy — each in being pregnant and afterwards. Particularly, there was a lower in sorts of RNA associated to autophagy — the cleaning of particles from cells. Autophagy has been linked to different psychiatric problems.
In one other potential lead, Eynav Accortt, a medical psychologist specializing in perinatal psychological well being at Cedars-Sinai Medical Heart in Los Angeles, discovered a sample of altered proteins in plasma samples of girls who developed perinatal temper and anxiousness problems, a bunch of situations that features postpartum melancholy. This included proteins concerned in neuron operate and in irritation, which is thought to play a task in melancholy.
As researchers proceed to discover these prospects, Payne is main a big medical trial that can present extra detailed info on the predictive worth of the myLuma check. For instance, it should discover the charges of false positives (ladies who’re recognized as at-risk who don’t develop postpartum melancholy) and false negatives (ladies who develop postpartum melancholy however weren’t recognized by the check). That may be a mandatory step towards FDA approval, which might make the check obtainable on to pregnant ladies.
Lopez-Rose remembers how scared she felt within the months after her daughter was born. In these darkish occasions, she stop her job, barely slept and was overwhelmed by unfavourable ideas. She had many self-doubts, however she now is aware of that reaching out for assist was an indication that she was mom.
At this time, her daughter is 4 — and thriving, as is Lopez-Rose. However a blood check, she says, would have warned her of what to look out for, “as a substitute of it being so surprising once I was going by my melancholy.”
This text initially appeared in Knowable Journal, a nonprofit publication devoted to creating scientific data accessible to all. Join Knowable Journal’s e-newsletter.
