Postpartum Depression

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Overview

When a new baby is on the way or has just been born, most people expect moms to be happy and joyous. Yet for many women, childbirth brings on an unexpected mood — depression. We call such episodes of sadness “postpartum depression,” even though the depressive episode can also start before the child’s birth. Postpartum depression is experienced most often by mothers either during or after childbirth (although it can affect fathers as well).

If your post-birth baby blues don’t resolve on their own within two weeks after the birth of your child, it’s possible you may have something more than just normal “baby blues.” Postpartum depression is a serious, debilitating illness that mothers have no control over. Like all types of depression, this is not the result of a character flaw, weakness, or anything the mom has done. Instead, it is a serious mental illness that needs attention and treatment.

 

Symptoms

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Fear that you’re not a good mother
  • Overwhelming fatigue or loss of energy
  • Withdrawing from family and friends
  • Problems with appetite (loss of appetite or eating more than usual)
  • Problems with sleep (problems falling asleep or sleeping too much)
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability or irrational anger
  • Feelings of worthlessness, shame, guilt, or inadequacy
  • Difficulty in thinking clearly, concentrating, or making decisions
  • Severe anxiety or panic attacks
  • Thoughts of harming yourself or your baby
  • Thoughts of death or suicide

It is thought that between 3 and 6 percent of women will experience major depressive symptoms during pregnancy or in the weeks or months following delivery. Women who have a preexisting history of symptoms of bipolar disorder or depression have a higher likelihood of experiencing mood disturbances during and/or after pregnancy.

Fifty percent of “postpartum” major depressive episodes actually begin prior to delivery. Thus, these episodes are referred to collectively as peripartum episodes in the DSM-5.

Women with peripartum major depressive episodes often have severe anxiety and even panic attacks during the peripartum period. Moreover, studies examining women pre-to-post-pregnancy demonstrate that those with anxiety or the “baby blues” during pregnancy are at increased risk for postpartum depression.

Mood episodes during postpartum depression can present either with or without psychotic features. Most women who have postpartum depression do not have psychotic features. The risk of postpartum episodes with psychotic features is particularly increased for women with a pre-existing mood disturbance (especially bipolar I disorder), a previous psychotic episode, and those with a family history of bipolar disorders. There can be some rare but extreme events associated with postpartum depression with psychotic features.

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