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What Is Postpartum Depression?

Postpartum depression (PPD) is temporary depression related to pregnancy and childbirth. It comes in two forms: early onset, commonly referred to as the "baby blues," and late onset. The early-onset type is mild and may affect as many as 80% of women after they deliver. It starts after delivery and usually resolves within a couple of weeks without medical treatment. The later-onset form is what most people think of as postpartum depression. This more severe form is usually recognized several weeks after delivery. Overall it affects about 10%-16% of women.

Symptoms of the "baby blues" include sadness, anxiety, tearfulness, and trouble sleeping. These symptoms usually appear within several days of delivery and go away by 10 to 12 days after the birth. Usually the only treatment needed is reassurance and some help with household chores and care of the baby. About 20% of women who have postpartum blues will develop more lasting depression. So it is very important to let your doctor know if you experience "blues" that last longer than two weeks.

The symptoms of postpartum depression — which may last from weeks to up to a year — may be quite intense, even frightening, for women who develop the condition. If you have postpartum depression, you may feel unable to take care of your baby or yourself. Daily tasks, such as dressing, cooking, and working around your home or on the job, may seem impossible. You may have alternating "good" and "bad" days. Like some women with PPD, you may feel too ashamed of your feelings to tell others, including your partner. You may be afraid that if you talk about your symptoms — which may include thoughts about harming your baby — your infant may be taken away from you. But this is not likely. You may at times experience very intense anxiety. With professional help, almost all women who experience PPD are able to overcome their feelings and take good care of themselves and their children. If you think you have postpartum depression, it's important to seek help as soon as possible.

Women most at risk for postpartum depression are those who have a history of depression or anxiety disorder 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 during pregnancy.
• A family history of depression, anxiety disorder, 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 or trouble managing stress.
• Unrealistic ideas about motherhood.
• Lack of sleep.
• If the pregnancy was unwanted.
• A long, 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.

IMPORTANT!
If you are having hallucinations or delusions about yourself or your baby, contact your doctor right away for help. This condition, called postpartum psychosis, is the most severe and the rarest postpartum reaction. It is an emergency requiring immediate medical help.

What Causes It?

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 apparently 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.