Postpartum Depression (PPD)

Postpartum Depression (PPD): Depression Symptoms Guide

This article is part of the Depression Symptoms Guide. In this part of the series, we will examine the type of depression known as Postpartum Depression (PPD).

Postpartum Depression is a type of unipolar disorder, also called postnatal depression. It occurs most frequently in women, and rarely in men some time within the first year after the birth of a child.

PPD is a form of clinical depression, with symptoms not unlike major depressive disorder. It is most likely to onset within the first few months after childbirth.^[1] Previous research has disagreed on the percentage of woman who will develop PPD, with figures ranging from 5% to 25%, but more recent data suggests the rate to be within the 5-9% range.

One cause of postpartum depression is thought to be the significant changes in a woman’s hormones during and after pregnancy, with another being vitamin deficiencies.^[2] In one study, three major causes of PPD were identified as: formula feeding rather than breastfeeding, a history of depression, and cigarette smoking.^[3]

Symptoms

Due to PPD’s similarity with major depressive disorder, many of the symptoms are common to the two disorders. Symptoms may include:

Feelings of sadness and hopelessness.
Low self-esteem.
Guilt.
Anhedonia.
Low levels of energy and exhaustion.
Increased or decreased appetite.
Insomnia or hypersomnia.
Feeling inadequate in taking care of the baby.
Fears of hurting themselves or the baby.
Irritability and feelings of anger towards others.
Decreased sex drive.
Anxiety or panic attacks.

Less then 20% of women suffering from PPD will seek medical help for the condition, despite the fact that postpartum depression can become serious enough to require hospitalisation. Many women recover due to being involved in a support group, or seeking counseling.^[4]

Diagnosis

Postpartum depression should not be confused with ‘postpartum blues’ or ‘baby blues’, a condition experienced by as many as 80% of new mothers, and characterised primarily by mood swings. These ‘blues’ usually begin a few days after giving birth, and subside within one or two weeks. In cases where ‘the blues’ worsen and continue for longer than a week, postpartum depression may be suspected.

As with seasonal affective disorder, the DSM-IV-TR Diagnostic Criteria does not regard PPD as a separate depressive disorder;^[5] rather the term ‘postpartum’ is used as a specifier to identify a subtype of major depressive disorder or bipolar disorder.

Diagnosis for postpartum depression usually involves blood and other medical tests (to rule out any other causes for the symptoms), as well as some form of depression screening test. When used to diagnose postpartum depression, the DSM-IV-TR considers the postpartum-onset specifier in patients with a depressive onset within four weeks of delivery, and requires:

A minimum of five symptoms of those listed above, present during the same two week period, and which represent a change from previous functioning.
One of these symptoms must be either:

A highly prevalent depressed mood, or
Anhedonia.

Getting Help

Some women feel embarrassed, guilty or ashamed about feeling depressed at a time when they ’should’ be happy. They may even consider themselves unfit parents, but this is simply not true. Postpartum depression can happen to any woman, and it in no way suggests you are a bad mother.

If you feel that your ‘baby blues’ have gone beyond the normal mood swings and one or two week duration, then you need to speak to your doctor or other medical professional about your feelings.

There are many effective treatment options for PPD, and in many cases postpartum depression is entirely preventable with early identification and early treatment.