Postpartum depression (PPD) aka postnatal depression is major depressive disorder (MDD) that occurs in the year following the birth of a child. While rapidly fluctuating mood including tearfulness, irritability and anxiety are common during this period, these symptoms are not solely an indication of postpartum depression. For most women, these mood changes remit after two weeks. Postpartum depression extends beyond this two week period and postpartum depression symptoms are indistinguishable from any other major depressive episode. The definition of postpartum depression requires that a negative impact on functioning, possibly including caring for the baby, be present.
Postpartum Depression Statistics
Postpartum (or postnatal) mood changes are very common but a potentially serious problem. While some mistake the symptoms of depression for the "baby blues," postpartum depression often builds over the three months following birth into a full-blown mental illness. Postpartum depression statistics include:1
- 85% of women experience mood changes postpartum
- About 10% - 15% of women go onto develop postpartum depression
- 0.1% - 0.2% experience postpartum psychosis, an extreme form of postpartum depression
- 400,000 children are born to depressed mothers every year
Causes of Postpartum Depression
There is no single cause of depression after childbirth; however, biological, psychological and environmental factors are thought to contribute to postpartum depression. Some women may also be more vulnerable to postpartum depression because of genetics.
After the birth of a child, a woman's body changes dramatically from severe drops in hormone levels and changes in blood pressure, blood volume and metabolism. All of these contribute to fatigue, sluggishness and feelings of depression. Other factors contributing to the causes of postpartum depression include:2
- Lack of sleep, exhaustion
- Anxiety over caring for a newborn; difficulty breast-feeding
- Concern over physical changes of the body
- Difficulty adjusting to a new lifestyle
- Changes of the family dynamics, including those of older children
- Financial concerns
- Lack of support from others
Treatment of Postpartum Depression
Treatment of postpartum depression varies depending on an individual's needs. Some women wish to breastfeed and so concerns are raised about taking medications that will pass into their breast milk. Other women have such severe postpartum depression that medication use is required. Treatment of postpartum depression includes:
- Counseling – Therapy and connecting with other mothers can lessen the anxiety of dealing with a newborn. Lactation specialists can help with breastfeeding issues and family therapy can help ease the transition into a new lifestyle.
- Antidepressants – As in other major depressive disorders, antidepressants are a common treatment. Various antidepressants can be used, some with little risk to the baby.
- Hormone therapy – Temporarily supplementing some of the hormones that have dropped since childbirth may ease the physical transition and depression symptoms. The full risks of this treatment are unknown, however, due to the lack of research in this area.
In very severe cases of postpartum depression, such as postpartum psychosis, more aggressive medication or electroconvulsive therapy may be used. These treatments are often administered on an inpatient basis.