Hormones, Thyroid, and Vitamins:A Closer Look at Postpartum Depression
Sep 24, 2026
Nobody Has an SSRI Deficiency: Rethinking Postpartum Depression A new mother comes in for one visit, gets a diagnosis, leaves with a prescription, and comes back in a month. In a lot of practices that is first-line care for postpartum depression. The problem is that nothing on the list of things that actually crashed after delivery is an antidepressant. Dr. Terri welcomes back Dr. Johnny J. Peet, MD, a gynecologist with nearly three decades in private practice, for a conversation about what is really happening in a woman's body after a baby, and why he treats postpartum depression almost nothing like he did twenty years ago. Progesterone and estrogen fall off a cliff. Thyroid drops at the same time. Vitamin levels that were fine before pregnancy quietly slip. Add a physical recovery, real anxiety, and no sleep, and his take is that the surprising thing is how many women come through it fine. They open with the trend Dr. Terri is seeing in her own practice, young premenopausal women asking for estrogen because it is trending online, at the same time patches are getting hard to fill. If you have been handed a prescription and told that is the answer, this is the conversation nobody had with you. What you'll discover: What the removal of the estrogen and testosterone black box warnings actually changed, and where the fear came from [03:23] Why an empty hormone receptor in the brain produces symptoms [05:45] The decade-long decline in testosterone and thyroid that happens long before menopause gets the credit [07:25] The full list of what crashes after delivery, and why no single item explains it [09:30] The reason your brain lowers testosterone after the second baby on purpose [13:54] The questions a clinician has to ask before treating anyone's postpartum mood [15:55] What a partner, a grandmother, and four consecutive hours of sleep are actually worth [17:01] The treatment order most practices skip entirely [20:09] Thyroid, TSH, and why a normal-looking panel misses it [22:23] The symptom triad that points to low testosterone in women [26:57] Postpartum depression is common, it is treatable, and it is almost never one problem.