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Perinatal depression (PND) is associated with poor obstetric and neonatal outcomes, and severe PND warrants psychiatric hospitalization. A mother–baby unit is ideal for joint admission of the mother–baby dyad for treating mothers with severe PND. Medical and psychosocial factors might precipitate, perpetuate, and maintain PND and hence requires holistic interventions by a multidisciplinary team. The current case illustrates various symptom domains, risks, protective factors, and ways to differentiate postpartum blues and bipolar depression from PND. Measures to prevent a relapse form an essential component of managing PND.