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.
Women commonly have mood changes during pregnancy, especially after delivery. These mood changes may be caused by changes in hormone levels. Many non-hormonal factors may also affect mood during this period:
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.
You may have a higher chance of postpartum depression if you:
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:
There is no single test to diagnose postpartum depression. Your doctor may have you complete a questionnaire (such as the Edinburgh Postnatal Depression Scale) at your office visit to look for signs of depression or risks for depression.
Sometimes depression following pregnancy can be related to other medical conditions. Hypothyroidism, for example, causes symptoms such as fatigue, irritability, and depression. 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 take steps right away to get help.
Here are some other helpful tips:
The treatment for depression after birth often includes medication, therapy, or both.
If you are thinking of harming yourself or your infant, seek immediate medical help.
If you are diagnosed with postpartum depression, support groups may be helpful, but they should not replace medication or individual psychotherapy (talk therapy).
Medication and professional psychotherapy can often successfully reduce or eliminate symptoms.
If left untreated, postpartum depression can last for months or years, and you may be at risk of harming yourself or your baby.
The potential long-term complications are the same as in major depression.
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.
Screening questionnaires may help detect depression or risks for depression early.
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.
Depression - postpartum; Postnatal depression
Massachusetts General Hospital Center for Women's Mental Health: Postpartum Psychiatric Disorders. Accessed August 10, 2010.
Pearlstein T, Howard M, Salisbury A, Zlotnick C. Postpartum depression. Am J Obstet Gynecol. 2009;200:357-364.
ACOG Committee on Practice Bulletins--Obstetrics. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists number 92. Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol. 2008;111:1001-1020.
Depression during and after pregnancy. Updated March 6, 2009. Accessed August 10, 2010.
Updated by: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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