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Postpartum Depression

Mental Health, Women's Health / By

Postpartum Depression

Postpartum depression is moderate to severe depression in a woman after she has given birth. It may occur soon after delivery or up to a year later. Most of the time, it occurs within the first 3 months after delivery.

Causes

The exact causes of postpartum depression are unknown. Changes in hormone levels during and after pregnancy may affect a woman’s mood. Many non-hormonal factors may also affect mood during this period:

  • Changes in your body from pregnancy and delivery
  • Changes in work and social relationships
  • Having less time and freedom for yourself
  • Lack of sleep
  • Worries about your ability to be a good mother

You may have a higher chance of postpartum depression if you:

  • Are under age 20
  • Currently use alcohol, take illegal substances, or smoke (these also cause serious health risks for the baby)
  • Did not plan the pregnancy, or had mixed feelings about the pregnancy
  • Had depression, bipolar disorder, or an anxiety disorder before your pregnancy, or with a past pregnancy
  • Had a stressful event during the pregnancy or delivery, including personal illness, death or illness of a loved one, a difficult or emergency delivery, premature delivery, or illness or birth defect in the baby
  • Have a close family member who has had depression or anxiety
  • Have a poor relationship with your significant other or are single
  • Have money or housing problems
  • Have little support from family, friends, or your spouse or partner

Signs and Symptoms

Some of the more common symptoms a woman may experience include:

  • Feeling sad, hopeless, empty, or overwhelmed
  • Crying more often than usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Feeling moody, irritable, or restless
  • Oversleeping, or being unable to sleep even when her baby is asleep
  • Having trouble concentrating, remembering details, and making decisions
  • Experiencing anger or rage
  • Losing interest in activities that are usually enjoyable
  • Suffering from physical aches and pains, including frequent headaches, stomach problems, and muscle pain
  • Eating too little or too much
  • Withdrawing from or avoiding friends and family
  • Having trouble bonding or forming an emotional attachment with her baby
  • Persistently doubting her ability to care for her baby
  • Thinking about harming herself or her baby.

Diagnosis

Your doctor will usually talk with you about your feelings, thoughts and mental health to distinguish between a short-term case of postpartum baby blues and a more severe form of depression.

As part of your evaluation, your doctor may:

  • Ask you to complete a depression-screening questionnaire
  • Order blood tests to determine whether an underactive thyroid is contributing to your signs and symptoms
  • Order other tests, if warranted, to rule out other causes for your symptoms

Treatment

Treatment and recovery time vary, depending on the severity of your depression and your individual needs. If you have an underactive thyroid or an underlying illness, your doctor may treat those conditions or refer you to the appropriate specialist. Your doctor also may refer you to a mental health provider.

Postpartum depression

Postpartum depression is often treated with psychotherapy (also called talk therapy or mental health counseling), medication or both.

  • Psychotherapy. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health provider. Through therapy, you can find better ways to cope with your feelings, solve problems, set realistic goals and respond to situations in a positive way. Sometimes family or relationship therapy also helps.
  • Antidepressants. Your doctor may recommend an antidepressant. If you’re breast-feeding, any medication you take will enter your breast milk. However, some antidepressants can be used during breast-feeding with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants.
  • Medication. When your safety is assured, a combination of medications — such as antidepressants, antipsychotic medications and mood stabilizers — may be used to control your signs and symptoms.
  • Electroconvulsive therapy (ECT). If your postpartum depression is severe and does not respond to medication, ECT may be recommended. During ECT, a small amount of electrical current is applied to your brain to produce brain waves similar to those that occur during a seizure.