The Screening Process for Postpartum Depression

The birth of your baby is supposed to be a happy time, but about 1 in 9 women and 1 in 10 men develop postpartum depression (PPD). There’s no blood test or body scan that shows you have this mood disorder. Instead, your doctor will ask certain questions about your state of mind.

Your doctor will test you for PPD after your baby arrives. When you take your baby for her first few check-ups, your child’s doctor may, too. If you have a history of mental health issues, you may be tested sooner or more often. The most common PPD screening tests take just a few minutes.

If you have PPD, the sooner you get help, the better for both you and your baby.

Edinburgh Postnatal Depression Scale (EPDS)

Many doctors think of this as the best way to check for PPD. It’s a list of 10 short statements, and for each one, you’ll say how often you’ve felt that way in the past 7 days. Points are assigned for each of your answers. If your total score is over 10, you may have PPD.

The questions include things like:

  • “I have been able to laugh and see the funny side of things.”
  • “I have been anxious or worried for no good reason.”
  • “The thought of harming myself has occurred to me.”

2-Question Patient Health Questionnaire (PHQ-2)

This test focuses on two symptoms depressed people often have. While it’s very short, the PHQ-2 is believed to be a good first screen of women who may have PPD.

You’ll be asked how often, over the past 2 weeks, you’ve felt:

  • Little interest or pleasure in doing things
  • Down, depressed, or helpless

You’ll have four answer choices that range from “Not at all” to “Nearly every day.” The more often you have a certain feeling, the more points that answer gets. If your score totals 3 or above, you may be depressed. Your doctor will then ask you to take a longer test called the PHQ-9.

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9-Question Patient Health Questionnaire (PHQ-9)

PPD can show up in physical symptoms, so this nine-question test looks for those as well. In addition to the same two questions as the PHQ-2, you’re also asked things like how often you have:

  • Trouble falling or staying asleep or felt you slept too much
  • Been tired or had little energy
  • Found it hard to focus
  • Lost interest in food or ate too much
  • Moved or spoken more slowly than normal
  • Felt fidgety or restless

The PHQ-9 is scored like the PHQ-2. Your score will be higher the more often you have these symptoms. If you have 5 to 9 total points, you may have mild depression, and 10 to 14 signals medium depression. If your score is 15, you could be severely depressed.

What Happens After a Positive PPD Screening

If the results of your test show you may be mildly depressed, your doctor will talk to you about how important it is to get enough sleep, exercise, and support when you need it. You’ll be asked to come in for a follow-up visit to see if self-care helps you feel better.

If your score shows you have moderate depression, your doctor may prescribe medicine or suggest counseling or both.

If you have suicidal thoughts or severe depression, you’ll get urgent care because your doctor will want to make sure you don’t hurt yourself.

If you find out you have PPD, you may feel guilty or embarrassed. But this condition is very common and doesn’t mean you’re a “bad” parent. The sooner you get help, the faster you can feel like your old self.

WebMD Medical Reference Reviewed by Nivin Todd, MD on April 02, 2019

Sources

SOURCES:

Seattle Children’s Hospital: “Postpartum Depression Screening.”

MGH Center for Women’s Mental Health: “Identifying Postpartum Depression: A Three Question Screening Tool.”

Stanford Medicine: “Edinburgh Postnatal Depression Scale (EPDS.)”

National Institute of Mental Health: “Postpartum Depression Facts.”

National Institute of Health: “Postpartum Depression Facts.”

Infectious Diseases Education and Assessment/National HIV Curriculum: “Patient Health Questionnaire-2 (PHQ-2.”)

Family Medicine: “Can we effectively use the two-item PHQ-2 to screen for postpartum depression?”

Annals of Family Medicine: “Postpartum Depression Screening at Well-Child Visits: Validity of a 2-Question Screen and the PHQ-9.”

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