Understanding Postpartum Depression -- the Basics
What Is Postpartum Depression? continued...
Women most at risk for postpartum depression are those who have a history of depression or anxiety disorders, or who have had PPD before. These factors also may increase your risk:
- A history of moderate to severe premenstrual syndrome (PMS)
- Depression or anxiety prior to or during pregnancy
- A family history of depression, anxiety disorders, or alcohol abuse
- A stressful event, such as the illness or death of a loved one, moving, or difficulties at work
- Lack of emotional support, including lack of a supportive partner or conflict with your partner
- Low self-esteem
- Trouble managing stress
- Unrealistic ideas about motherhood
- Lack of sleep
- If the pregnancy was unwanted
- A complicated pregnancy
- Having a newborn with physical or behavioral problems
New fathers can have postpartum depression, too. It's more common in stepfathers, fathers whose partner is depressed, those who have ended their relationship with the mother, and those who are unemployed, socially isolated, under severe stress, or in a physically aggressive relationship with the new mother.
If you are having hallucinations or delusions about yourself or your baby, contact your health care provider right away for help or go to the emergency room. This condition, called postpartum psychosis, is the most severe and the rarest postpartum reaction. It is an emergency requiring immediate medical help.
What Causes Postpartum Depression?
The exact cause of postpartum depression is still being debated among medical professionals. Many doctors believe that the hormonal changes that occur during pregnancy and childbirth are primarily responsible for the illness. Estrogen and progesterone, the female reproductive hormones, increase tenfold during pregnancy. Then, after a woman gives birth, her production of these hormones -- as well as endorphins, cortisol, prolactin, and corticotrophin-releasing hormones -- drops significantly. These changes may trigger postpartum depression. PPD may also be caused or aggravated by exhaustion from childbirth, stress, or lack of sleep in the early weeks of a newborn's life.