Postpartum Depression

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Postpartum Depression

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

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

Hormonal changes in the brain may contribute to postpartum depression.

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. 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

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

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

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%5FPatients

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.org/~/media/For%20Patients/faq091.pdf?dmc=1&ts=20130312T1333495763 . Accessed March 12, 2013.

Postpartum depression. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated October 18, 2012. Accessed March 12, 2013.

Revision Information

Reviewer: Andrea Chisholm, MD
Review Date: 03/2013 -
Update Date: 00/31/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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