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Postpartum Depression

Postpartum depression (PPD) is a depressive disorder that can affect parents after a new baby is born.
It’s commonly associated with women, although men can also experience postpartum depression.

About one in seven mothers may develop this depressive disorder, and about 5% to 10% of new fathers will develop it. In men who have partners who suffer from it, the risk increases by about 24% to 50%.

Postpartum Depression
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What Is Postpartum Depression?

The terms “postpartum depression” and “baby blues” are often used interchangeably. However, mental health professionals agree that they are different problems. Baby blues refers to the feelings of sadness and depression that can sometimes affect new parents in the first two weeks after the birth. In contrast, PPD lasts longer than two weeks (sometimes up to a year) and causes more severe symptoms.

 

It’s important to know that baby blues and PPD are not indicators of character or personality weaknesses. Every parent with a new baby could potentially develop signs of depression. PPD can adversely affect quality of life and overall wellness, and may interfere with a parent’s ability to care for the child properly.

 

As serious as PPD is, there is treatment available. Receiving care can help parents adjust to life after a new baby, support their ability to parent, and facilitate the child’s healthy development.

Signs and Symptoms of Postpartum Depression

When considering the signs and symptoms of postpartum depression, it can be helpful to differentiate it from the baby blues. The baby blues last a few days up to two weeks after the birth. They are typically characterized by the following:

  • Crying spells

  • Mood swings

  • Anxiety and irritability

  • Feelings of being overwhelmed

  • Impaired concentration

  • Problems sleeping

  • Loss of appetite

Postpartum depression may seem like baby blues at first. However, the symptoms are more severe and last longer. Women and men with PPD may suffer from the following problems:

  • Severe mood swings and excessive crying

  • Problems bonding with the baby

  • Overwhelming fatigue

  • Social withdrawal and a lack of interest in activities

  • Feelings of sadness, worthlessness, shame, or inadequacy

  • Impaired concentration, cognition, and decision making

  • Severe panic attacks that may cause chest pain and difficulty breathing

  • Changes in sleeping and eating habits

In addition, some people with PPD may suffer from suicide ideation. They may have thoughts of harming themselves or their baby. PPD can inhibit parents from taking care of their baby and themselves, and it can prevent a healthy bond from forming.

 

Rarely, new parents may develop postpartum psychosis within the first week of the birth. Postpartum psychosis should be treated as a medical emergency. It involves severe symptoms, including the following:

  • Obsessive or fearful thinking about the baby

  • Attempts to harm the baby or oneself

  • Paranoia

  • Hallucinations or delusions

  • Confusion and disorientation

  • Extreme agitation

Causes and Risk Factors of Postpartum Depression

There may be several factors that contribute to the development of PPD in new mothers and fathers. In new mothers, hormones can play a role. A woman’s hormone levels change during and after pregnancy. Once she has given birth, her estrogen and progesterone levels dramatically drop. The hormones produced by the thyroid gland can also decrease. These drastic hormonal changes can leave women feeling depressed, anxious, sluggish, and tired.

 

In addition, many new parents have difficulty coping with the transition a new baby brings. They may feel a loss of control over their lives or as if their own self-identities are compromised. They may question their abilities to care for the baby. Furthermore, babies require care around the clock. The sleep deprivation all new parents experience will negatively affect their ability to cope with problems.

 

Some people may be at a higher risk of developing PPD. The risk factors include the following:

Personal or family history of mood disorders or other mental illnesses

Multiple births (twins, triplets, etc.)

Difficulty breastfeeding

Financial problems

Baby with health problems or special needs

Unplanned pregnancy

Existence of other stressful events, like job loss

Insufficient social/familial support

PPD can increase a person’s risk of developing depressive disorders in the future. In addition, children of parents with untreated PPD are at a higher risk of behavioral and emotional problems, such as excessive crying and sleeping difficulties. They are also more likely to experience language development delays.

Diagnosis of Postpartum Depression

For many people, a primary care doctor is the first point of contact. It’s not unusual for new parents to suffer from PPD, so don’t be nervous about speaking up when consulting your doctor. The doctor may run a blood test to check the levels of thyroid hormone.

 

However, PPD is generally diagnosed with a mental health assessment. The doctor may ask you to fill out a mental health questionnaire designed to assess your symptoms. Based on the questionnaire, and on your conversation with the doctor, he or she may refer you to a mental health specialist.

Treatment and Care of Postpartum Depression

Parents diagnosed with the baby blues are typically advised to practice good self-care while waiting for the symptoms to resolve. Get plenty of rest, ask friends and family for help with chores and child care, and avoid using alcohol.

 

Postpartum depression requires the specialized care of a mental health professional. Psychotherapy is a cornerstone of PPD treatment. A psychologist or psychiatrist can help new parents understand what they are experiencing, acquire strong coping skills, and learn how to respond to situations in a healthy, appropriate way.

 

Some new parents with PPD may benefit from medications. New mothers who are breastfeeding should be aware that any medications they take may enter the breast milk. However, a psychiatrist or doctor can help the patient find an effective, appropriate antidepressant with a favorable safety profile that doesn’t pose a significant risk to the baby.

 

Postpartum psychosis requires more intensive treatment. The patient may require hospitalization. A combination of antipsychotics, mood stabilizers, and other psychiatric drugs may be needed to manage the symptoms. Since some of these drugs can be harmful to a nursing infant, the mother may be temporarily unable to breastfeed.

 

In some cases, patients with postpartum psychosis may benefit from electroconvulsive therapy (ECT). ECT is generally recommended when medications aren’t sufficient. This treatment involves intentionally triggering a minor seizure by sending electrical currents through the brain. ECT is thought to work by causing changes in brain chemistry.

When to Talk to Someone About Postpartum Depression

Many new parents wait too long to talk to a doctor about what they are experiencing. The longer you wait to seek help, the longer it may take to feel better. If you’re experiencing any possible symptoms of PPD that are severe or that have lasted longer than two weeks, it’s time to reach out to a trusted healthcare professional. New parents are also encouraged to turn to their supportive friends and family members for help.

 

In addition, if you think you or your partner may be suffering from postpartum psychosis, or are having thoughts of harming yourself or others, please call 911 immediately. This is a medical emergency, and help is available. It’s important to seek help before you do something you may regret, such as harm yourself or your baby.

This page offers general health information to facilitate discussion with your telehealth provider. You must not rely on the information on our website as an alternative to medical advice from your doctor, therapist or other professional healthcare provider.

If this is a medical emergency, please call 911. For mental health emergencies, call 988.

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