Postpartum Mood Disorders

Postpartum depression is different from the “baby blues,” which begin within the first three or four days of giving birth, require no treatment and lift within a few hours or days. PPD is a deeper depression that lasts much longer. It usually starts within the first month after childbirth (although it can occur any time within the first year) and can last weeks to months. In more serious cases, it can develop into chronic episodes of depression.

Apart from the fact that it happens soon after childbirth, PPD is clinically no different from a depressive episode that occurs at any other time in a woman’s life. PPD symptoms are the same as in general depression and must meet the same criteria for diagnosis. However, not surprisingly, the symptoms of PPD often focus on motherhood or infant care.

Postpartum psychosis refers to the sudden onset of psychotic symptoms after childbirth. This condition is rare—approximately 1-2 cases per 1000 births. Treatment recommendations are similar to those for other forms of psychosis.

Signs & Symptoms

Every woman is different, but these are some of the more common signs and symptoms of PPD:

  • depressed mood or depression with anxiety
  • anhedonia, which involves a loss of interest in things that would normally bring pleasure, including the baby
  • changes in weight or appetite, which may involve gaining or losing weight
  • sleep disturbance and fatigue—common symptoms of depression but very difficult to gauge, since both are normal for new mothers
  • physical feelings of being slowed down or restlessness, jumpiness and edginess
  • excessive feelings of guilt or worthlessness, which can be exacerbated by not bonding with the baby, when feelings of extreme joy and love are expected
  • diminished concentration and inability to think clearly, which can be worsened by sleep deprivation
  • recurrent thoughts of death or suicide. For example, the woman may catch herself thinking that the baby and she are better off dead, or that “the world is such an awful place to bring a new child into that we would be better out of it.”

Signs of depression are often missed in new mothers because significant changes in sleeping patterns, interests, cognitions, energy levels, moods and body weight are a normal part of new motherhood.

New mothers often resist acknowledging these signs even to themselves because of the pressure to meet societal expectations of what it means to be a “good mother,” including how she should be feeling, thinking and behaving.

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Postpartum Mood Disorder Resources

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