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    Postpartum Depression

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    Postpartum depression (PPD) is a complex mix of physical, emotional, and behavioral changes that happen in a woman after giving birth. According to the DSM-5, a manual used to diagnose mental disorders, PPD is a form of major depression that has its onset within four weeks after delivery. The diagnosis of postpartum depression is based not only on the length of time between delivery and onset, but also on the severity of the depression.

    What Is Postpartum Depression?

    Postpartum depression is linked to chemical, social, and psychological changes associated with having a baby. The term describes a range of physical and emotional changes that many new mothers experience. The good news is postpartum depression can be treated with medication and counseling.

    The chemical changes involve a rapid drop in hormones after delivery. The actual link between this drop and depression is still not clear. But what is known is that the levels of estrogen and progesterone, the female reproductive hormones, increase tenfold during pregnancy. Then, they drop sharply after delivery. By three days after a woman gives birth, the levels of these hormones drop back to what they were before she got pregnant.

    In addition to these chemical changes, social and psychological changes associated with having a baby create an increased risk of depression.

    What Are the Symptoms of Postpartum Depression?

    Symptoms of postpartum depression are similar to what happens normally following childbirth. They include difficulty sleeping, appetite changes, excessive fatigue, decreased libido, and frequent mood changes. However, these are also accompanied by other symptoms of major depression, which are not normal after childbirth, and may include depressed mood; loss of pleasure; feelings of worthlessness, hopelessness, and helplessness; thoughts of death or suicide or thoughts or hurting someone else.

    What Are the Risk Factors for Getting Postpartum Depression?

    A number of factors can increase the risk of postpartum depression, including:

    • a history of depression prior to becoming pregnant, or during pregnancy
    • age at time of pregnancy -- the younger you are, the higher the risk
    • ambivalence about the pregnancy
    • children -- the more you have, the more likely you are to be depressed in a subsequent pregnancy
    • having a history of depression or premenstrual dysphoric disorder (PMDD)
    • limited social support
    • living alone
    • marital conflict
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