Depression After the Birth of a Child (Postpartum Depression)

Postpartum depression is a complex mix of physical, emotional, and behavioral changes that occur after giving birth that are attributed to the chemical, social, and psychological changes associated with having a baby.

Who Is Affected by Postpartum Depression?

About 50%-75% of new mothers experience the "baby blues" after delivery. About 10% of these women will develop a more severe and longer-lasting depression after delivery. One in 1,000 women develop the more serious condition called postpartum psychosis.

What Factors Increase the Risk Of Developing Postpartum Depression?

• Having a history of depression or premenstrual dysphoric disorder (PMDD)
• Age at time of pregnancy -- the younger you are, the higher the risk
• Living alone.
• Limited social support.
• Children -- the more you have, the more likely you are to be depressed in a subsequent pregnancy.
• Marital conflict.
• Ambivalence about the pregnancy.
• A history of depression during pregnancy.

Types of Postpartum Depression

Postpartum blues -- Better known as the "baby blues," this condition affects between 50%-75% of women after delivery. If you are experiencing the baby blues, you will have frequent, prolonged bouts of crying for no apparent reason, sadness and anxiety. The condition usually begins in the first week (one to four days) after delivery. Although the experience is unpleasant, the condition usually subsides within two weeks without treatment. All you'll need is reassurance and help with the baby and household chores.

Postpartum depression -- This is a far more serious condition than postpartum blues, affecting about one in 10 new mothers. If you've had postpartum depression before, your risk increases 50 to 80%. You may experience alternating "highs" and "lows," frequent crying, irritability and fatigue, as well as feelings of guilt, anxiety and inability to care for your baby or yourself. Symptoms range from mild to severe and may appear within days of the delivery or gradually, even up to a year later. Although symptoms can last from several weeks up to a year, treatment with psychotherapy or antidepressants is very effective.

Postpartum psychosis -- This is an extremely severe form of postpartum depression and requires emergency medical attention. This condition is relatively rare, affecting only one in 1,000 women after delivery. The symptoms generally occur quickly after delivery and are severe, lasting for a few weeks to several months. Symptoms include severe agitation, confusion, feelings of hopelessness and shame, insomnia, paranoia, delusions or hallucinations, hyperactivity, rapid speech, or mania. Postpartum psychosis requires immediate medical attention since there is an increased risk of suicide and risk of harm to the baby. Treatment will usually include admission to hospital for the mother, and medicine.

What Causes Postpartum Depression?

More research is needed to determine the link between the rapid drop in hormones after delivery and depression. The levels of estrogen and progesterone, the female reproductive hormones, increase tenfold during pregnancy but drop sharply after delivery. By three days postpartum, levels of these hormones drop back to pre-pregnant levels. In addition to these chemical changes, the social and psychological changes associated with having a baby create an increased risk of postpartum depression.