Like many first-time mothers, Lisette Lopez-Rose thought giving birth would mark a joyful time. Instead, she had panic attacks when she imagined something bad would happen to her child, and she was weighed down by overwhelming sadness. The San Francisco mother knew her extreme emotions weren't normal, but she was afraid to tell her obstetrician. What if they take her baby away?
About six months after giving birth, she discovered a network of women with similar experiences online and eventually opened up to her doctor. “About two months after I started taking the medication, I felt like I was coming out of a deep hole and seeing the light again,” she says. Today Lopez-Rose works at International postpartum supportcoordinating volunteers to help young mothers form online connections.
The world's first drug for postpartum depression containing a progesterone derivative received approval from the US Food and Drug Administration in 2019. This marked a new approach to this disorder. This winter, in another major advance, a San Diego startup company will launch a blood test that predicts a pregnant woman's risk of postpartum depression with more than 80 percent accuracy.
The product, called myLuma, will be the first commercially available test to use biomarkers – molecules in the body, in this case in the blood – to predict the onset of a mental disorder, much in the same way blood tests can detect signs of diseases such as cancer and diabetes. Pregnant women who learn they are at risk of postpartum depression can take preventive measures, such as taking antidepressants after giving birth or arranging for additional support.
The blood test could reduce the stigma that keeps many women from seeking help, says Jennifer Payne, a reproductive psychiatrist at the University of Virginia in Charlottesville and lead investigator of the research that led to the new test. She is the founder and member of the scientific advisory board of Dionysus Health, the company that makes myLuma.
“If we have a blood test, it takes psychiatry down to a level of biology that I think the average person can understand as something that needs treatment and it's not just in someone's head,” she says.
Unpredictable effects of hormones
Payne was a fellow at the National Institute of Mental Health in 2001 when she became intrigued by postpartum depression as a window into mood disorders. This led her to a key question: Why does the sudden drop in hormone levels after childbirth affect some women but not others? Although it is not uncommon for women to experience transient feelings of anxiety and sadness for a few days after giving birth, this only occurs in some cases. deeper and more persistent depression sets in.
As her research progressed, Payne teamed up with Zachary Kaminsky, then a colleague at Johns Hopkins University who was studying the effects of estrogen on the brains of mice. Kaminsky is an epigeneticist: he studies how small chemicals called methyl groups can attach to genes and influence their activity. Environmental factors, from pollution to nutrition, can influence the extent of reversible methylation.
By comparing female mice fed high levels of estrogen with animals without it, Kaminski found that estrogen caused specific patterns of gene methylation within cells. hippocampuspart of the brain that helps control mood. These results suggested what to look for in the blood samples Payne collected from 51 women with a history of mood disorders. The women were followed throughout pregnancy and beyond, with some developing postpartum depression within four weeks of giving birth.
The study identified two estrogen-responsive genes. HP1BP3And TTS9B. More than 80 percent women who had postpartum depression, a characteristic pattern was observed: more methylation of one gene and less methylation of another. What's more, changes in genes can be detected throughout each trimester of pregnancy, says Kaminski, now at the Institute for Mental Health Research at Queen's University of Ottawa; he is also the co-founder of Dionysus. In other words, even early in pregnancy, Kaminski says, “you can predict which women will have postpartum depression.”
Kaminsky, Payne and their colleagues repeated these findings repeatedly. As reported in a 2016 article. V NeuropharmacologyThey found that, thanks to the methylation patterns of these genes, they could correctly predict more than 80 percent of cases of postpartum depression in 240 pregnant women with no history of mental disorders. In another collaboration published in 2020 in Psychiatric researchScientists from Johns Hopkins University, Emory University and the University of California at Irvine, including Payne and Kaminsky, tested blood samples from 285 pregnant women and also confirmed their results.
These epigenetic studies formed the basis of the myLuma test, which also includes additional biomarkers to improve its accuracy, Kaminski said. It is expected to be available in select physicians' offices in three states: Florida, Texas and California, beginning in January 2026. Although it has not yet been approved by the FDA, doctors are allowed to use such laboratory tests to make clinical decisions.
Targeting steroids
Not everyone with postpartum depression experiences these epigenetic changes, so Payne and other researchers continue to look for other biomarkers to understand how hormonal changes cause postpartum depression. They focus, for example, on neuroactive steroids, which the body produces from molecules such as progesterone in the brain and other tissues.
One of these metabolites, called allopregnanolone, has a calming effect – affects the receptor in the brain called GABA-A, which is known to be involved in stress reduction. Allopregnanolone levels increase during pregnancy and decrease rapidly after childbirth. Another neuroactive steroid, pregnanolone, has similar properties. The third, isoallopregnanolone, weakens the antidepressant effect of allopregnanolone, increasing feelings of stress.
In a study of 136 pregnant women published in 2025 in the journal Neuropsychopharmacologywomen with pregnanolone and isoallopregnanolone imbalance during pregnancy were more likely to develop postpartum depression. Measuring the ratio of these chemicals in the blood may be another way to predict postpartum depression, says reproductive psychiatrist Lauren M. Osborne of Weill Cornell Medicine in New York, who co-led the study with Payne.
Meanwhile, allopregnanolone has already proven to be a valuable treatment option. A synthetic version called brexanolone was developed by Cambridge, Massachusetts-based Sage Therapeutics and approved by the FDA in 2019—the first drug approved specifically for the treatment of postpartum depression. It was originally administered intravenously but was replaced by an oral version, zuranolone, approved by the FDA in 2023.
If we have a blood test, it brings psychiatry down to a level of biology that I think the average person can understand as something that needs treatment, and it's not just in someone's head.
Jennifer Payne, University of Virginia at Charlottesville
It is a “transformative therapy” because it works quickly, the article's authors write. 2025 article in Annual Review of Medicine. Women at high risk for postpartum depression may even benefit from active use of zuranolone, although this has not yet been tested, says paper co-author Samantha Meltzer-Brody, a reproductive psychiatrist at the University of North Carolina who was the scientific director of the brexanolone study and an investigator in the zuranolone trial.
The availability of blood testing, she adds, “opens up a whole host of questions about how do you get ahead of it so you don't have to wait for someone to start suffering?”
There are other possible purposes for testing for postpartum depression. IN Article 2022 in Molecular psychiatryJohns Hopkins neuroscientist Sarven Sabuntsian, along with Osborne, Payne and Morgan Scherer, then an immunologist at Johns Hopkins University, described a small study in which the types of RNA carried in the blood in fat bladders were different in women who developed postpartum depression—both during and after pregnancy. her. In particular, there was a decrease in RNA species associated with autophagy—the cleansing of debris from cells. Autophagy has been linked to other psychiatric disorders.
Another potential leader may be Einav Akkort, a clinical psychologist specializing in perinatal mental health at Cedars-Sinai Medical Center in Los Angeles. altered proteins in plasma samples women who develop perinatal mood and anxiety disorders, a group of conditions that includes postpartum depression. These included proteins involved in neuronal function and inflammation, which known to play a role in depression.
While researchers continue to explore these possibilities, Payne is leading a large clinical trial that will provide more detailed information about the predictive value of the myLuma test. For example, the rate of false positives (women at risk who do not develop postpartum depression) and false negatives (women who develop postpartum depression but were not detected by the test) will be studied. This is a necessary step toward FDA approval, which could make the test available directly to pregnant women.
Lopez-Rose remembers how scared she was in the months after her daughter was born. During those dark times, she quit her job, barely slept, and was plagued by negative thoughts. She had a lot of self-doubt, but now she knows that asking for help was a sign that she was a good mother.
Today, her daughter is four years old and thriving, as is Lopez-Rose. But the blood test, she said, would have alerted her to what to look out for, “instead of it being so shocking when I was going through depression.”
This article originally appeared in Famous magazinea non-profit publication dedicated to making scientific knowledge accessible to everyone. Subscribe to Knowable Magazine's newsletter..
