Depression - postpartum; Postnatal depression; Postpartum psychological reactions
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.
The exact causes of postpartum depression are unknown. Changes in hormone levels during and after pregnancy may affect a woman's mood. Many non-hormonal factors may also affect mood during this period:
You may have a higher chance of postpartum depression if you:
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." They 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.
The symptoms of postpartum depression are the same as the symptoms of depression that occurs at other times in life. Along with a sad or depressed mood, you may have some of the following symptoms:
A mother with postpartum depression may also:
Exams and Tests
There is no single test to diagnose postpartum depression. Diagnosis is based on the symptoms you describe to your health care provider.
Your provider may order blood tests to screen for medical causes of depression.
A new mother who has any symptoms of postpartum depression should contact her provider right away to get help.
Here are some other tips:
The treatment for depression after birth often includes medicine, talk therapy, or both. Breastfeeding will play a role in what medicine your provider recommends. You may be referred to a mental health specialist. Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are types of talk therapy that often help postpartum depression.
Support groups may be helpful, but they should not replace medicine or talk therapy if you have postpartum depression.
Having good social support from family, friends, and coworkers may help reduce the seriousness of postpartum depression.
Medicine and talk therapy can often successfully reduce or eliminate symptoms.
Left untreated, postpartum depression can last for months or years.
The potential long-term complications are the same as in major depression. Untreated postpartum depression may put you at risk of harming yourself or your baby.
When to Contact a Medical Professional
Call your provider if you have any of the following:
Do not be afraid to seek help right away if you feel overwhelmed and are afraid that you may hurt your baby.
Having good social support from family, friends, and coworkers may help reduce the seriousness of postpartum depression, but may not prevent it.
Women who had postpartum depression after past pregnancies may be less likely to develop postpartum depression again if they start taking antidepressant medicines after they deliver. Talk therapy may also be helpful in preventing depression.
American Psychiatric Association. Depressive disorders. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013:155-233.
Nonacs RM, Wang B, Viguera AC, Cohen LS. Psychiatric illness during pregnancy and the post-partum period. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 31.
Siu AL; US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, et al. Screening for depression in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(4):380-387. PMID: 26813211 www.ncbi.nlm.nih.gov/pubmed/26813211.
Review Date: 7/8/2018
Reviewed By: Ryan James Kimmel, MD, Medical Director of Hospital Psychiatry at the University of Washington Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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