Postpartum depression

In this article we will follow on and discuss the causes and symptoms of Postpartum depression and major depression.

Postpartum depression occurs in 7% of women during the first year after delivery.

Although every woman is at risk, women with the following conditions are at higher risk:

• Postpartum blues (e.g., rapid mood swings, irritability, anxiety, decreased concentration, insomnia, crying spells)
• Prior episode of postpartum depression
• Prior diagnosis of depression
• Family history of depression
• Significant life stressors (e.g., relationship conflict, stressful events in the last year, financial difficulties, parenting with no partner, partner with depression)
• Lack of support from partner or family members (e.g., financial or child care support)
• History of mood changes temporally associated with menstrual cycles or oral contraceptive use
• Prior or current poor obstetric outcomes (e.g., previous miscarriage, preterm delivery, neonate admitted to the neonatal intensive care unit, an infant with a congenital malformation)
• Prior or continuing ambivalence about the current pregnancy (e.g., because it was unplanned or termination was considered)
• Problems with breastfeeding

Causes and Symptoms

The exact causes of postpartum depression is unknown; however, prior depression is the major risk, and hormonal changes during the puerperium (first 6 weeks post childbirth), sleep deprivation, and genetic susceptibility may contribute.

Symptoms and Signs of Postpartum Depression: Symptoms of postpartum depression are similar to those of major depression and may include:

• Extreme sadness
• Mood swings
• Uncontrollable crying
• Insomnia or increased sleep
• Loss of appetite or overeating
• Irritability and anger
• Headaches and body aches and pains
• Extreme fatigue
• Unrealistic worries about or disinterest in the baby
• A feeling of being incapable of caring for the baby or of being inadequate as a mother
• Fear of harming the baby
• Guilt about her feelings
• Suicidal ideation
• Anxiety or panic attacks

Typically, symptoms develop insidiously over 3 months, but onset can be more sudden. Postpartum depression interferes with women’s ability to care for themselves and their baby. Women may not bond with their infant, resulting in emotional, social, and cognitive problems in the child later. Partners may also be at increased risk of depression, and depression in either parent may result in relationship stress.

Without treatment, postpartum depression can resolve spontaneously or become chronic depression. Risk of recurrence is about 1 in 3 to 4. Other potential psychiatric disorders in the postpartum period include anxiety and, rarely, postpartum psychosis.