Depression - postpartum; Postnatal 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, incidence, and risk factors
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:
You may have a higher chance of postpartum depression if you:
Feelings of anxiety, irritation, tearfulness, and restlessness are common in the week or two after pregnancy. These feelings are often called the postpartum or "baby blues." These symptoms almost always go away soon, without the need for treatment.
Postpartum depression may occur when the baby blues do not fade away or when signs of depression start 1 or more months after childbirth.
The symptoms of postpartum depression are the same as the symptoms of depression that occurs at other times in life. Along with a sad or depressed mood, you may have some of the following symptoms:
A mother with postpartum depression may also:
Signs and tests
There is no single test to diagnose postpartum depression. Diagnosis is based on the symptoms you describe to your doctor or nurse.
Women with postpartum depression should have blood tests to screen for medical causes of depression.
A new mother who has any symptoms of postpartum depression should contact their doctor or nurse right away to get help.
Here are some other helpful tips:
The treatment for depression after birth often includes medication, therapy, or both. Whether or not you are breast-feeding will play a role in what medicine your doctor recommends. You may be recommended to a mental health specialist. Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are types of talk therapy that often help postpartum depression.
Support groups may be helpful, but they should not replace medication or talk therapy if you have postpartum depression.
Having good social support from family, friends, and coworkers may help reduce the seriousness of postpartum depression.
Medication and professional talk therapy can often successfully reduce or eliminate symptoms.
If left untreated, postpartum depression can last for months or years.
The potential long-term complications are the same as in major depression. Untreated, postpartum depression may put you at risk of harming yourself or your baby.
Calling your health care provider
Call your doctor if you experience any of the following:
Do not be afraid to seek help immediately if you feel overwhelmed and are afraid that you may hurt your baby.
Having good social support from family, friends, and coworkers may help reduce the seriousness of postpartum depression, but may not prevent it.
Women who had postpartum depression after past pregnancies may be less likely to develop postpartum depression again if they start taking antidepressant medications after they deliver. Talk therapy may also be helpful in preventing it.
Cohen LS, Wang B, Nonacs R, et al. Treatment of mood disorders during pregnancy and postpartum. Psychiatr Clin North Am. 2010 Jun;33(2):273-93.
Review Date: 9/19/2012
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY.
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