Postpartum Depression

The causes of sadness or depression after delivery are unclear, but the following may contribute or increase the risk:

The sudden decrease in levels of hormones (such as estrogen, progesterone, and thyroid hormones) that occurs after delivery and lack of sleep may contribute to developing postpartum depression. Also, a gene that makes a woman more susceptible to postpartum depression may be involved.

If women have had depression before they became pregnant, they should tell their doctor or midwife. Such depression often evolves into postpartum depression. Depression during pregnancy is common and is an important risk factor for postpartum depression.

Typically, symptoms of postpartum depression develop gradually over 3 months, but they may begin more suddenly. Postpartum depression interferes with women’s ability to care for themselves and the baby.

Symptoms of postpartum depression may include

Less common symptoms include

Women may not bond with their baby. As a result, the child may have emotional, social, and cognitive problems later.

Partners may also become depressed, and depression in any parent may cause stress.

Without treatment, postpartum depression can last for months or years. About one in three or four women who have had postpartum depression have it again.

In postpartum psychosis, depression may be combined with suicidal or violent thoughts, hallucinations, or bizarre behavior. Sometimes postpartum psychosis includes a desire to harm the baby.

If a parent is having thoughts of harming self or the baby, medical attention should be sought immediately.

Early diagnosis and treatment of postpartum depression are important for women and their baby. Women should see their doctor if they continue to feel sad and have difficulty doing their usual activities for more than 2 weeks after delivery or if they have thoughts about harming themselves or the baby. If family members and friends notice symptoms, they should talk with the woman and encourage her to talk to a doctor.

When women go for their postdelivery visit, doctors may ask them to fill out a questionnaire designed to identify depression. If women are depressed, doctors may also do blood tests to determine whether a disorder, such as a thyroid disorder, is causing the symptoms.

If women feel sad, support from family members and friends is usually all that is needed. But if depression is diagnosed, professional help is also needed. Typically, a combination of psychotherapy and antidepressants Drug Treatment for Depression Agomelatine, a new type of antidepressant, is a possible treatment for major depressive episodes. Several types of drugs can be used to treat depression: Selective serotonin reuptake inhibitors... read more is recommended.

Women who have postpartum psychosis may need to be hospitalized, preferably in a supervised unit that allows the baby to remain with them. They may need antipsychotic drugs Antipsychotic Drugs Psychosis refers to symptoms such as delusions, hallucinations, disorganized thinking and speech, and bizarre and inappropriate motor behavior that indicate loss of contact with reality. A number... read more as well as antidepressants.

Women who are breastfeeding should consult with their doctor before taking any of these drugs to determine whether they can continue to breastfeed (see Taking Drugs While Breastfeeding Drug Use During Breastfeeding When mothers who are breastfeeding have to take a drug, they wonder whether they should stop breastfeeding. The answer depends on the following: How much of the drug passes into the milk Whether... read more ). Many of these drugs (such as sertraline and paroxetine) allow women to continue breastfeeding.