Postpartum Depression
En Español (Spanish Version)

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 or "blues" after giving birth. If it goes on for more than a few days, however, 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
These factors increase your chance of developing postpartum depression. Tell your doctor if you have any of these risk factors:
  • 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

Hormonal changes in the brain may contribute to postpartum depression.
© 2011 Nucleus Medical Media, Inc.

Symptoms
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 (in very rare cases). 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 want 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
The doctor will ask about your symptoms and medical history, and may perform a physical exam. Your doctor may ask you to undergo blood tests, to see if some undiagnosed physical problem (such as a thyroid condition) could be contributing to your symptoms. You may be referred to a mental health professional.

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

Medications
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 triumphing over postpartum depression.

Prevention
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
  • Sufficient rest
  • Some women feel better when the number of visitors is limited; others feel isolated without company, and notice that they feel better when they have other people around
  • Support to allow yourself some enjoyable personal time (for example, going for a walk)



RESOURCES:
American Congress of Obstetricians and Gynecologists


CANADIAN RESOURCES:
Canadian Psychological Association


References:
American College of Obstetricians and Gynecologists website. Available at: http://www.acog.com . Accessed October 13, 2005.

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.

Last Reviewed January 2012