What to do after your EPDS score: a step-by-step action plan
You took the test. Maybe at a health visitor appointment. Maybe on your phone at 2am because something did not feel right. Either way, you have a number now. And the number has raised more questions than it answered.
What does this score actually mean? Is it bad enough to do something about? Who do I call? What if I scored low but still feel terrible?
Our EPDS explained guide covers what the test measures and where it falls short. This article picks up where that one ends: what to actually do next, based on your score, with a clear plan for each range.
A quick reminder of what the EPDS is
The Edinburgh Postnatal Depression Scale is a 10-item screening questionnaire, not a diagnosis. It flags risk. It does not confirm a condition. A high score means "further assessment is needed." A low score means "this particular tool did not detect symptoms today." Neither is the final word.
A 2020 individual participant data meta-analysis published in the British Medical Journal examined the diagnostic accuracy of the EPDS across thousands of women and found that while it is a useful screening tool, its sensitivity varies depending on the cutoff used and the population screened. No single score should determine your care.
Your score-by-score action plan
Score 0 to 8: low risk
What it means: On this particular day, your answers did not flag clinically significant symptoms.
What to do:
- Breathe. This is reassuring.
- But do not treat it as permanent clearance. Postpartum depression can develop at any point in the first year.
- Monitor yourself. If something shifts in the coming weeks or months, take the test again or speak to someone.
- Continue investing in your wellbeing: sleep, nutrition, social connection, alone time and small routines that protect your energy.
Important: If you scored low but something still feels wrong, trust that feeling. The EPDS does not capture anxiety disorders, PTSD, OCD or bonding difficulties. Read about perinatal OCD and postpartum PTSD to see whether those descriptions fit your experience more closely.
Score 9 to 11: possible depression
What it means: You are in a grey zone. Your score suggests you may be experiencing early or mild depressive symptoms.
What to do:
A 2025 systematic review published in World Journal of Psychiatry outlined a stepped care approach to postpartum depression. For women with low to moderate EPDS scores, the recommended first steps are:
- Psychoeducation. Understanding what postpartum depression is and that it is treatable can itself reduce distress. Our guide to how long postpartum really lasts and the article on matrescence both serve this purpose.
- Lifestyle support. Sleep hygiene, nutrition, physical activity and social connection are evidence-based interventions at this stage.
- Informal social support. Peer groups, postnatal classes, online communities. Connecting with other mothers who understand reduces isolation.
- Rescreen in 2 to 4 weeks. If your score stays the same or increases, move to the next level of care.
Action | Why it matters |
|---|---|
Tell someone how you are feeling | Breaking the silence reduces shame and opens the door to support |
Book a GP appointment | Even if you are not sure it is "bad enough," your GP can assess and monitor |
Start a journal | Expressive writing reduces PPD symptoms across multiple RCTs; our 60 journaling prompts can help you start |
Rescreen in 2 to 4 weeks | Symptoms fluctuate; one score is a snapshot, not a verdict |
Score 12 to 13: probable depression
What it means: Your score is above the standard clinical cutoff. Depression is likely and a professional assessment is the appropriate next step.
What to do:
- See your GP or midwife within the next week. Do not wait for the next routine appointment. Tell reception it is about your mental health. Most practices will prioritise this.
- Ask for a clinical assessment. The EPDS is a screen. Diagnosis requires a conversation with a clinician who can evaluate your symptoms in context.
- Discuss treatment options. At this level, structured therapy (CBT or IPT) is a first-line recommendation. Medication may also be appropriate. Our CBT vs meds guide gives a side-by-side comparison of both approaches.
- Ask about local perinatal mental health services. Many areas have specialist teams for postpartum mood disorders. Your GP can refer you.
"Individuals with moderate scores are directed toward more structured treatments including cognitive behavioral therapy, interpersonal therapy, or peer-led support groups, while those with high scores warrant pharmacological interventions." — World Journal of Psychiatry (2025)
Score 14 and above: high probability of depression
What it means: Your score is significantly elevated. Clinical depression is highly likely and prompt intervention is important.
What to do:
- Contact your GP, midwife or health visitor today. Not next week. Today. If it is out of hours, call NHS 111 (UK) or your local crisis line.
- Be honest about all your symptoms. Not just the sadness. Mention sleep changes, anxiety, intrusive thoughts, numbness, irritability and anything you have been holding back.
- Expect a treatment plan. At this level, the stepped care model recommends a combination of therapy and medication. SSRIs are the most commonly prescribed option and are compatible with most breastfeeding situations. Our medication guide for PPD covers the specifics.
- Ask about urgent referral. Perinatal psychiatry teams exist for exactly this. If your GP does not mention referral, ask directly.
- Tell someone you trust. Your partner, a friend, your mother. You need someone in your corner while you navigate this.
Any score where question 10 is not zero
Question 10 asks about thoughts of self-harm. If you answered anything other than "never," this overrides whatever your total score says.
- Speak to a professional immediately. This does not mean you are in danger. It means someone needs to check in with you properly.
- You are not being dramatic. Disclosing thoughts of self-harm is one of the bravest things you can do.
- In the UK: call your GP, NHS 111, or the Samaritans (116 123). In the US: call 988 (Suicide and Crisis Lifeline) or text HOME to 741741 (Crisis Text Line).
What your clinician should do next
A quality improvement study at Cedars-Sinai (Woofter et al., 2025) found that when screening moved from verbal nurse-administered PHQ-9 to self-administered EPDS via iPad, positive depression screenings increased from 4% to 11.4% and social work referrals rose from 64% to 84%. Better screening leads to better follow-up, but only when the system responds.
After a positive screen, your clinician should:
- Conduct a clinical interview to confirm or rule out a diagnosis
- Discuss treatment options including therapy, medication or both
- Provide a follow-up appointment within 2 to 4 weeks
- Refer to specialist perinatal services if symptoms are severe
- Screen for co-occurring conditions including anxiety, PTSD and OCD
If none of that happens, advocate for yourself. Our guide to choosing the right mental health provider can help you find the right person when the system does not offer one.
The score is a starting point, not a sentence
A number on a questionnaire does not define you. It does not measure how much you love your child, how hard you are trying or how good a mother you are. It measures symptoms. And symptoms are treatable.
Whatever your score, you have already done the hardest part: you looked at the truth. Now the only question is what you do with it.
If you need help figuring out the next step, this article on why every mom should consider therapy is a good place to start. And if asking for help still feels hard, this one is written for exactly that feeling.
You are not your score. But your score is trying to tell you something. Listen to it.
Sources and further reading
- Levis, B. et al. (2020). Accuracy of the EPDS for screening to detect major depression among pregnant and postpartum women: individual participant data meta-analysis. British Medical Journal, 371, m4022. bmj.com
- PMC. (2025). Epidemiology, pathophysiology, and interventions for postpartum depression: systematic review. World Journal of Psychiatry. pmc.ncbi.nlm.nih.gov
- Woofter, R. et al. (2025). Improving inpatient postpartum depression screening: results from a quality improvement initiative. Archives of Women's Mental Health. pmc.ncbi.nlm.nih.gov
- American Academy of Pediatrics. (2022). Integrating postpartum depression screening in your practice in 4 steps. aap.org
- Cox, J.L., Holden, J.M. & Sagovsky, R. (1987). Detection of postnatal depression: development of the 10-item EPDS. British Journal of Psychiatry, 150, 782-786.
- Postpartum Support International: postpartum.net
Frequently Asked Questions
- What does my EPDS score actually mean?
- The EPDS is a screening tool, not a diagnosis. It helps flag whether you may need a closer assessment, but it cannot confirm postpartum depression on its own.
- What should I do if my EPDS score is 0 to 8?
- A score of 0 to 8 is generally reassuring, but it is not a permanent all-clear. Keep an eye on how you feel, and if your mood changes later, take the test again or speak to a healthcare professional.
- Is a high EPDS score something I should worry about?
- A higher score suggests that further assessment is needed, but it does not mean you definitely have depression. The next step is to contact your GP, health visitor, midwife, or another maternity mental health service for support.
- What if I scored low on the EPDS but still feel bad?
- Trust your instincts if something feels wrong, even with a low score. The EPDS does not always pick up anxiety, OCD, PTSD, or bonding difficulties, so it is still worth asking for help.
- Who should I contact after getting my EPDS score?
- Start with the person or service that gave you the test, such as your health visitor, midwife, or GP. If you have any thoughts of harming yourself or your baby, seek urgent help right away.
a freelance writer and certified maternal wellness coach with a background in psychology and over two years of experience writing about motherhood, mental health, and relationships.
