Definition

Postpartum depression (PPD) refers to mood problems that happen up to one year after giving birth. Short term mood problems are common after giving birth. PDD is when severe problems last for more than two weeks.

Causes

The exact cause is not known. It may be due to sudden hormonal changes during and after delivery.

Risk Factors

The risk of this problem is higher in those with:

  • A prior history of depression or PPD
  • A prior history of anxiety disorders
  • A family history of mood disorders
  • Stress or conflict at home or with a partner
  • Problems breastfeeding

Central Nervous System
Female_brain_nerves_torso

Hormonal changes in the brain may contribute to postpartum depression.

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Symptoms

Problems may be:

  • Feelings of irritability, worry, or panic
  • Loss of interest or pleasure in life
  • Rapid mood swings
  • Feelings of hopelessness or guilt
  • Change in weight or hunger
  • Obsessive, unreasonable thoughts
  • Repetitive fears about your child’s health and welfare
  • Poor focus, memory loss, and problems making decisions
  • Sleeping too much or too little
  • Restlessness
  • Lack of energy or motivation

More severe problems may be:

  • Lack of interest in your infant
  • Fear of hurting or killing yourself or your child
  • Thoughts of death or suicide
  • Sensing or believing things that are not real
  • Loss of contact with reality

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. The diagnosis may be made in a person who has had certain symptoms every day for at least two weeks.

More tests may be done to rule out other causes of depression, such as thyroid problems.

Treatment

The goal of treatment is to manage symptoms until they pass. Choices are:

  • Medicines to ease symptoms, such as antidepressants or hormonal therapy
  • Counseling alone or with a support group

Prevention

People at risk for PDD should talk to their doctors about counseling methods that may help.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
https://www.acog.org

Office on Women's Health
https://www.womenshealth.gov

CANADIAN RESOURCES:

Canadian Psychological Association
https://www.cpa.ca

Women's Health Matters—Women's College Hospital
http://www.womenshealthmatters.ca

REFERENCES:

ACOG Committee Opinion No. 650: physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol. 2015;126(6):e135-e142. Reaffirmed 2017.

Do I have a form of postpartum depression? American Pregnancy Association website. Available at: http://americanpregnancy.org/first-year-of-life/forms-of-postpartum-depression. Accessed November 17, 2020.

Postpartum depression. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/postpartum-depression. Accessed November 17, 2020.

Postpartum depression. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/postpartum-care-and-associated-disorders/postpartum-depression. Accessed November 17, 2020.

Postpartum depression. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/Patients/FAQs/Postpartum-Depression. Accessed November 17, 2020.

Stewart DE, Vigod S. Postpartum Depression. N Engl J Med. 2016 Dec 1;375(22):2177-2186.

Last reviewed September 2020 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 11/17/2020