Postpartum depression is a depressive episode beginning in pregnancy or within a year of birth, affecting about one in eight mothers. It is treated with psychotherapy, antidepressants compatible with breastfeeding such as sertraline, and, for moderate to severe cases, zuranolone, the first oral medication FDA-approved specifically for postpartum depression. Most mothers improve within weeks of starting treatment. Stedfast Psychiatry treats postpartum depression and perinatal mood disorders at 11641 Kew Gardens Ave in Palm Beach Gardens and by video across Florida; new patients call (561) 437-2199.
Postpartum Depression and Perinatal Mood Disorders at our Palm Beach Gardens office
The Palm Beach Gardens office at 11641 Kew Gardens Ave, Suite 209 serves Frenchman's Reserve, Evergrene, Eastpointe, Steeplechase and Garden Oaks and the surrounding communities of North Palm Beach, Juno Beach, Jupiter, Lake Park and Riviera Beach. Downtown at the Gardens is a useful landmark for first-time visitors.
Call (561) 437-2199 to book, or request an appointment online and we will call you back. The office is open weekdays 8:00 AM to 5:00 PM. The office is just south of PGA Boulevard near Military Trail, a short drive from The Gardens Mall. From I-95, take exit 79 for PGA Boulevard and head east to Military Trail, then turn south and watch for Kew Gardens Avenue on your left.
Both Deep TMS and Spravato are delivered on site at this office, so a patient who does not respond to medication can move to an interventional option without changing clinics.
Who you will see in Palm Beach Gardens
The Palm Beach Gardens team includes psychiatrists Dr. Louis Velazquez and Dr. Tanya Peguero Estevez, psychiatric nurse practitioner Sophia Schulman and physician assistant Ellington Curtis. Visits in Spanish are available with Tanya Peguero Estevez. Children and teens are seen by Louis Velazquez, Sophia Schulman, Ellington Curtis and Stephanie Mills.
Dr. Louis Velazquez, MD
Psychiatrist · Ages 4 to 80
Sophia Schulman, PMHNP-BC
Psychiatric Nurse Practitioner · Children 7+, adolescents and adults
Ellington Curtis, PA-C
Physician Assistant · Adults and teens 14+
Dr. Tanya Peguero Estevez, MD
Psychiatrist · Adults 18+ · English, Spanish
Stephanie Mills
Clinician · Adults and teens 13+
Signs of postpartum depression and perinatal mood disorders
- Persistent sadness, emptiness or crying lasting beyond two weeks after birth
- Feeling unable to bond with or enjoy your baby
- Intense anxiety, panic or constant worry about the baby's health
- Intrusive thoughts of harm coming to the baby that feel horrifying
- Inability to sleep even when the baby sleeps
- Loss of appetite or eating much more than usual
- Feeling like a failure as a mother or that your family would be better off without you
- Irritability, anger or withdrawal from your partner and friends
How we diagnose it
We evaluate perinatal mood disorders with a clinical interview and the Edinburgh Postnatal Depression Scale (EPDS), the standard screening tool, along with the GAD-7 and a review of obsessive thoughts, panic, trauma symptoms and sleep. We ask carefully about any history of bipolar disorder or hypomania, because the postpartum period is a high-risk time for a first manic episode and antidepressants alone can trigger one. We screen for postpartum psychosis (confusion, hallucinations, paranoia, rapid mood shifts), which requires emergency care. We check thyroid function (TSH), a complete blood count for anemia, and vitamin D and B12 when indicated. We ask about breastfeeding, your baby's health and your support at home, and with your permission we coordinate with your OB-GYN and your baby's pediatrician.
About one in eight women who give birth in the US report symptoms of postpartum depression.
Source: CDC, Pregnancy Risk Assessment Monitoring System
Perinatal depression affects up to 1 in 7 women during pregnancy or the first year after birth, and fewer than half are diagnosed.
Source: American College of Obstetricians and Gynecologists
Zuranolone was FDA-approved in August 2023 as the first oral treatment specifically for postpartum depression, taken once daily for 14 days.
Source: US Food and Drug Administration
Mental health conditions, including suicide and overdose, are the leading underlying cause of pregnancy-related deaths in the US.
Source: CDC Maternal Mortality Review Committees, 2017 to 2019 data
Treatment for postpartum depression and perinatal mood disorders in Palm Beach Gardens
Medication management
SSRIs are first-line and most are compatible with breastfeeding. Sertraline has the most safety data and passes into breast milk in very low amounts; escitalopram, citalopram and paroxetine are also used, and if you took a medication successfully before pregnancy we usually prefer to resume it. Improvement begins in two to four weeks with full benefit at six to eight weeks, and treatment continues for at least six to twelve months. Zuranolone (Zurzuvae), FDA-approved in 2023, is the first oral medication specifically for postpartum depression: a 14-day course that produces improvement within days in clinical trials, with the trade-off that it causes drowsiness and you cannot drive for 12 hours after each dose. Brexanolone (Zulresso), a 60-hour IV infusion, is also FDA-approved for postpartum depression and given in a hospital setting. For postpartum anxiety and OCD, SSRIs at adequate doses work well. We monitor for sedation, feeding changes in the baby, and emerging hypomania.
Psychotherapy
Cognitive behavioral therapy and interpersonal therapy are both effective for postpartum depression and are a complete treatment for mild to moderate episodes. Interpersonal therapy addresses the role transition, relationship changes and isolation of new parenthood directly. For postpartum OCD, exposure and response prevention helps mothers stop avoiding their baby out of fear of intrusive thoughts. For birth trauma, trauma-focused therapy is used. Partners are welcome in sessions, and we connect families with postpartum support groups through Postpartum Support International.
Interventional options
For postpartum depression that has not responded to two or more antidepressants, Deep TMS is an option. Deep TMS is FDA-cleared for major depressive disorder and anxious depression, involves no medication, and is compatible with breastfeeding; a course is 36 sessions over six to nine weeks at our Palm Beach Gardens office. Spravato (esketamine) is FDA-approved for treatment-resistant depression and for MDD with suicidal ideation in adults 18 and older; it has not been studied in breastfeeding and is generally avoided in women who are nursing, but it may be considered for severe, treatment-resistant postpartum depression when breastfeeding has ended or the risks are weighed carefully. Severe postpartum depression with psychosis or inability to care for oneself may require hospital treatment, and we coordinate that when needed.
What to expect
Your first visit is a 60-minute evaluation that can be done by video from home, with your baby present if that is easiest. We take a full history, complete the EPDS, discuss medication safety for pregnancy or breastfeeding in detail, and agree on a plan that day. Follow-ups are at one to two weeks early on because the postpartum period moves quickly, then every two to four weeks. We offer in-person and telehealth care throughout Florida and South Carolina and coordinate with your OB-GYN and pediatrician with your consent.
The complete guide, including causes, subtypes and research, is on our Postpartum Depression and Perinatal Mood Disorders page.
Emergency and crisis resources near Palm Beach Gardens
In an emergency, call 911 or go to Palm Beach Gardens Medical Center Emergency Room (3360 Burns Rd, Palm Beach Gardens). The 988 Suicide and Crisis Lifeline is available by call or text 24 hours a day. Jupiter Medical Center Emergency Department and 988 Suicide and Crisis Lifeline are also listed on the Palm Beach Gardens office page.
Frequently asked questions
Who provides postpartum depression and perinatal mood disorders treatment at the Palm Beach Gardens office?
The Palm Beach Gardens team includes psychiatrists Dr. Louis Velazquez and Dr. Tanya Peguero Estevez, psychiatric nurse practitioner Sophia Schulman and physician assistant Ellington Curtis. Visits in Spanish are available with Tanya Peguero Estevez. Every provider works under psychiatrist oversight and the same evaluation standard: about an hour for a first visit, validated screening scales, and a written plan.
Can I be seen by video instead of coming to Palm Beach Gardens?
Yes. Stedfast Psychiatry providers are licensed in Florida and offer video visits for evaluations and follow-ups. Some situations, including certain controlled-substance prescriptions and first visits for young children, require an in-person appointment at 11641 Kew Gardens Ave.
Does the Palm Beach Gardens office take my insurance?
We accept most major commercial plans and Medicare. Call (561) 437-2199 with your member ID and we will verify benefits before the visit. Self-pay new-patient evaluations are $185.
How soon can a new patient be seen in Palm Beach Gardens?
Most new patients are scheduled within one to two weeks. If you need to be seen sooner, ask about a video visit; those often open up within days. If you are in crisis, call or text 988 or go to the nearest emergency room rather than waiting.
Can I get Deep TMS or Spravato as a Palm Beach Gardens patient?
Yes. Deep TMS is delivered on site in Palm Beach Gardens. Spravato is available at Palm Beach Gardens, Palm Beach Gardens and Royal Palm Beach.
How do I know if it is baby blues or postpartum depression?
Baby blues affect up to 80 percent of new mothers, start within days of birth, involve crying spells and mood swings, and resolve by two weeks without treatment. Postpartum depression lasts beyond two weeks, deepens rather than lifts, and includes hopelessness, inability to sleep when the baby sleeps, loss of interest in the baby or in anything, and sometimes thoughts of self-harm. If you are past two weeks and not improving, or if you feel worse, it is time for an evaluation.
Can I take antidepressants while breastfeeding?
Yes, in most cases. Sertraline is the best-studied and passes into breast milk in very small amounts with no established harm to infants. Escitalopram, citalopram and paroxetine are also considered compatible. We choose based on your history and the data, discuss it openly, and can coordinate with your pediatrician. Untreated postpartum depression carries its own risks for the baby's development, which is part of the balance.
Nearby Stedfast offices
If you are in crisis, call or text 988 or go to the nearest emergency room. Educational content; individual results vary. Reviewed by Dr. David Husted, board-certified psychiatrist.