Postpartum Depression

by Michelle Badash, MS

Definition

Postpartum depression is a type of depression that affects some women shortly after childbirth. It is not uncommon for women to experience temporary mood disorders after giving birth. If it goes on for more than a week, it is called postpartum depression.

Causes

The cause of postpartum depression is unclear. The cause may be related to sudden hormonal changes during and after delivery. Untreated thyroid conditions may also be associated with postpartum depression.

Risk Factors    TOP

Factors that can increase your chance of developing postpartum depression include:

  • Previous episode of depression or postpartum depression
  • Family member with depression
  • History of severe premenstrual syndrome (PMS)
  • Lack of support system and/or strained relationship with partner
  • History of anxiety disorder

Central Nervous System

Female_brain_nerves_torso
Hormonal changes in the brain may contribute to postpartum depression.
Copyright © Nucleus Medical Media, Inc.

Symptoms    TOP

Symptoms usually occur within 6 months after childbirth, though they may begin during the pregnancy and may last from a few weeks to a few months. Symptoms may range from mild depression to severe psychosis. Postpartum depression is different than baby blues, which is a mild form of depression that occurs within a few days after childbirth and lasts up to a week.

Symptoms may include:

  • Loss of interest or pleasure in life
  • Not wanting to engage in social situations
  • Loss of appetite
  • Rapid mood swings
  • Episodes of crying or tearfulness
  • Poor concentration, memory loss, difficulty making decisions
  • Difficulty falling or staying asleep
  • Feelings of irritability, anxiety, or panic
  • Restlessness
  • Fear of hurting or killing oneself or one's child
  • Feelings of hopelessness or guilt
  • Obsessive thoughts, especially unreasonable, repetitive fears about your child’s health and welfare
  • Lack of energy or motivation
  • Unexplained weight loss or gain

More serious symptoms associated with postpartum depression that may require immediate medical attention include:

  • Lack of interest in your infant
  • Suicidal or homicidal thoughts
  • Hallucinations or delusions
  • Loss of contact with reality

Diagnosis    TOP

The doctor will ask about your symptoms and medical history. A physical exam may be done. Your doctor may ask you to have blood tests to see if an undiagnosed physical problem, like a thyroid condition, could be contributing to your symptoms. You may be referred to a mental health professional.

Treatment    TOP

Treatment for postpartum depression may include counseling, medication, or both.

Medications

Medication may include:

  • Antidepressants
  • Anti-anxiety drugs
  • Anti-psychotic drugs—for severe cases

Talk with your doctor about potential medication side effects and how they might affect your child if you are breastfeeding.

Counseling

Support groups for mothers with postpartum depression can help you see that others are struggling with and managing postpartum depression.

Prevention    TOP

Since postpartum depression is aggravated by stress, life stressors should be kept to a minimum after delivery. The following may help prevent postpartum depression:

Before Delivery:

  • Childbirth education classes
  • Realistic expectations about the postpartum experience

After Delivery:

  • Help with childcare and household chores
  • Rest
  • Some women feel better when the number of visitors is limited; others feel better when they have other people around
  • Support to allow yourself some enjoyable personal time, such as going for a walk

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org/For_Patients
Womenshealth.gov
http://www.womenshealth.gov/

CANADIAN RESOURCES:

Canadian Psychological Association
http://www.cpa.ca/cpasite
Women's Health Matters
http://www.womenshealthmatters.ca/

References:

Exercise during pregnancy and the postpartum period. The American Congress of Obstetricians and Gynecologists, Committee Opinion, No. 267 . January 2002 (Reaffirmed 2009).
Leopold KA, Zoschnick LB. Postpartum Depression . Women's Primary Health Grand Rounds at the University of Michigan (series). August 1997.
Postpartum depression. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.or... . Accessed March 12, 2013.
Postpartum depression. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated October 18, 2012. Accessed March 12, 2013.
Last reviewed March 2013 by Andrea Chisholm, MD
Last Updated: 03/15/2013
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