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

A risk factor is something that increases your chance of getting a disease or condition.

• 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
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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
• 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 causing 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
• Antipsychotic drugs (for severe cases)

Talk with your doctor about potential medication side effects, and how they might affect your child if you are breast-feeding.

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 College of Obstetricians and Gynecologists
http://www.acog.com

Womenshealth.gov
http://www.4woman.gov

CANADIAN RESOURCES:

Canadian Mental Health Center
http://www.cmha.ca

Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm

References:

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

Leopold KA, Zoschnick LB. Postpartum Depression . Women's Primary Health Grand Rounds at the University of Michigan (series). August 1997.

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