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Postpartum depression

URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/007215.htm

Postpartum depression is moderate to severe depression in a woman after she has given birth. It

may occur soon after delivery or up to a year later. Most of the time, it occurs within the first 3

months after delivery.

Causes

Women commonly have mood changes during pregnancy, especially after delivery. These moodchanges may be caused by changes in hormone levels. Many non-hormonal factors may also

affect mood during this period:

  Changes in your body from pregnancy and delivery

  Changes in work and social relationships

  Having less time and freedom for yourself 

  Lack of sleep

  Worries about your ability as a mother

Feelings of anxiety, irritation, tearfulness, and restlessness are common in the week or two after

pregnancy. These feelings are often called the postpartum or "baby blues." These symptoms

almost always go away soon, without the need for treatment.

Postpartum depression may occur when the baby blues do not fade away or when signs of depression start 1 or more months after childbirth.

You may have a higher chance of postpartum depression if you:

  Are under age 20

  Currently abuse alcohol, take illegal substances, or smoke (these also cause serious

medical health risks for the baby)

  Did not plan the pregnancy, or had mixed feelings about the pregnancy

  Had depression, bipolar disorder (for example, manic depression), or an anxiety disorder

before your pregnancy, or with a previous pregnancy

  Had a stressful event during the pregnancy or delivery, including personal illness, deathor illness of a loved one, a difficult or emergency delivery, premature delivery, or illness

or birth defect in the baby

  Have a close family member who has had depression or anxiety

  Have a poor relationship with your significant other or are single

  Have financial problems (low income, inadequate housing)

  Have little support from family, friends, or your significant other

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Symptoms

The symptoms of postpartum depression are the same as the symptoms of depression that occursat other times in life. Along with a sad or depressed mood, you may have some of the following

symptoms:

  Agitation or irritability

  Changes in appetite

  Feelings of worthlessness or guilt

  Feeling withdrawn or unconnected

  Lack of pleasure or interest in most or all activities

  Loss of concentration

  Loss of energy

  Problems doing tasks at home or work 

  Negative feelings toward the baby

  Significant anxiety

  Thoughts of death or suicide  Trouble sleeping

A mother with postpartum depression may also:

  Be unable to care for herself or her baby

  Be afraid to be alone with her baby

  Have negative feelings toward the baby or even think about harming the baby (Although

these feelings are scary, they are almost never acted on. Still you should tell your doctorabout them right away.)

  Worry intensely about the baby, or have little interest in the baby

Exams and Tests

There is no single test to diagnose postpartum depression. Your doctor may have you complete aquestionnaire (such as the Edinburgh Postnatal Depression Scale) at your office visit to look for

signs of depression or risks for depression.

Sometimes depression following pregnancy can be related to other medical conditions.

Hypothyroidism, for example, causes symptoms such as fatigue, irritability, and depression.

Women with postpartum depression should have blood tests to screen for medical causes of 

depression.

Treatment

A new mother who has any symptoms of postpartum depression should take steps right away to

get help.

Here are some other helpful tips:

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  Ask your partner, family, and friends for help with the baby's needs and in the home.

  Don't hide your feelings. Talk about them with your partner, family, and friends.

  Don't make any major life changes during pregnancy or right after giving birth.

  Don't try to do too much, or to be perfect.

  Make time to go out, visit friends, or spend time alone with your partner.

 Rest as much as you can. Sleep when the baby is sleeping.

  Talk with other mothers or join a support group.

The treatment for depression after birth often includes medication, therapy, or both.

  If you are diagnosed with depression, you may need to be followed closely for at least 6months.

  There are several types of antidepressant medications that may be given to breastfeeding

mothers, including paroxetine, sertraline, and nortriptyline.

  Ask your doctor or nurse for a referral to a mental health therapist. Cognitive behavioraltherapy (CBT) and interpersonal therapy (IPT) are types of talk therapy that have been

found effective for postpartum depression.

If you are thinking of harming yourself or your infant, seek immediate medical help.

Support Groups

If you are diagnosed with postpartum depression, support groups may be helpful, but they should

not replace medication or individual psychotherapy (talk therapy).

Outlook (Prognosis)

Medication and professional psychotherapy can often successfully reduce or eliminatesymptoms.

Possible Complications

If left untreated, postpartum depression can last for months or years, and you may be at risk of 

harming yourself or your baby.

The potential long-term complications are the same as in major depression. 

When to Contact a Medical Professional

Call your doctor if you experience any of the following:

  Your baby blues don't go away after 2 weeks

  Symptoms of depression get more intense

  Symptoms of depression begin at any time after delivery, even many months later

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  It is hard for you to perform tasks at work or at home

  You cannot care for yourself or your baby

  You have thoughts of harming yourself or your baby

  You develop thoughts that are not based in reality, or you start hearing or seeing things

that other people cannot

Do not be afraid to seek help immediately if you feel overwhelmed and are afraid that you may

hurt your baby.

Prevention

Having good social support from family, friends, and coworkers may help reduce the seriousness

of postpartum depression, but may not prevent it.

Screening questionnaires may help detect depression or risks for depression early.

Women who had postpartum depression after past pregnancies may be less likely to developpostpartum depression again if they start taking antidepressant medications after they deliver.

Alternative Names

Depression - postpartum; Postnatal depression

References

Massachusetts General Hospital Center for Women's Mental Health: Postpartum Psychiatric

Disorders. Accessed August 10, 2010.

Pearlstein T, Howard M, Salisbury A, Zlotnick C. Postpartum depression.  Am J Obstet Gynecol.

2009;200:357-364.

ACOG Committee on Practice Bulletins--Obstetrics. ACOG Practice Bulletin: Clinical

management guidelines for obstetrician-gynecologists number 92. Use of psychiatricmedications during pregnancy and lactation. Obstet Gynecol. 2008;111:1001-1020.

Depression during and after pregnancy. Updated March 6, 2009. Accessed August 10, 2010.

Update Date: 9/4/2010

Updated by: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of 

Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David

Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Browse the Encyclopedia 

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MedlinePlus Topics

  Postpartum Depression 

Read More

  Major depression