By Zaira Salvador BSc, MSc (embryologist).
Last Update: 10/12/2018

Postpartum depression (PPD), also known as postnatal depression, is a mood disorder that typically affects women after giving birth. Common symptoms include extreme sadness.

In general, postpartum depression is a temporary disorder that occurs in about ten percent of women, in spite of having had a normal delivery. It is commonly referred to as baby blues.

Baby blues is characterized by a series of mood swings following the baby’s birth, including happiness mixed with sadness, irritability, and crying episodes.

Types

In most of the cases, women experience mild postpartum depression, typically starting within two or three days after giving birth, and can be extended by two weeks approximately.

No specific treatment is required in cases of mild postpartum depression. Moreover, it rarely has a negative impact on the woman’s mental health.

However, a small percentage will develop a severe type of postpartum depression, which can appear after birth and may prolong itself in time.

Phases of postpartum depression

Postpartum depression can be classified into three types: mild, moderate, and severe. Oftentimes, it is present during the three next months after the birth of the baby.

Throughout this time period, women go through three phases that are described below:

First phase
The woman finds her own self again after various months carrying a baby on her belly.
Second phase
The baby becomes the main character, and the mother is pushed into the background.
Third phase
A peaceful situation is recovered progressively, and the woman assumes her new situation, and learns how to live with it.

After childbirth, emotional support from the partner and beloved ones is crucial for the woman’s wellbeing. Within a few days, this situation will vanish. Returning home will be such a grateful experience that taking care of the baby will eventually become a normal situation in her daily routines.

Causes

The precise causes of postpartum depression are actually unknown. However, hormonal changes that occur in the woman during pregnancy and after childbirth can have an extremely negative impact on her state of mind.

Moreover, the woman may feel sad due to other reasons aside from the baby’s birth itself:

  • Body changes
  • Work and social relationship changes
  • Insufficient sleep
  • Being unable to make time for herself
  • Concerns about the baby and feeling unconfident about caring for the baby

Also, there exist certain risk factors that can increase the chances for a woman to develop postpartum depression, including teenage motherhood, unwanted pregnancy, single motherhood, unsupportive partner and/or family, financial issues, etc.

Symptoms

Symptoms of postpartum depression are quite similar to those of a depression, except for some particularities that we will explain in the following paragraphs.

The most common feelings in women who have just given birth are anxiety, irritability, extreme sadness, crying episodes, and restlessness. These symptoms are commonplace amongst women who develop the so-called baby blues. As explained earlier, baby blues is not considered a concerning mood disorder.

When these feelings of sadness persist or become worse, a severe type of depression may develop, which may be extended by several months or even years.

Although real cases of postnatal depression are sparse, they are associated with a series of concerning symptoms or negative signs, including:

  • Feelings of guilt about the reaction to the newborn
  • Lack of interest in daily activities
  • Trouble sleeping, insomnia
  • Loss of appetite
  • Lack of concentration
  • Not being able to complete everyday tasks
  • Over-concern for the baby
  • Fear of harming a baby or herself
  • Being scared to be alone with the baby

Treatment

When the woman herself or a close relative detects any of these feelings or suspects that the baby is being left unattended, seeking the help of a well-versed professional is essential.

The treatment of postpartum depression is a simple one, and can involve some or all of these options:

Antidepressants
As long as they do not have a negative impact on breast milk while breastfeeding the baby.
Psychological support
A handful of sessions with a psychologist that has experience in treating postpartum depression may be enough.
Other non-medical treatments
Doing sports like yoga or acupressure can help as a relief for the symptoms of depression.

In most cases, medical providers recommend a combined approach, that is, following all three treatments.

Tips to cope with postpartum depression

Whether the woman is on treatment or not, there exist a series of recommendations to be followed on a daily basis that may help cope with postpartum depression, including:

  • Exteriorize your feelings and concerns with a close relative, friend, or trusted person
  • Seek help when you feel overwhelmed, whether you need someone to help you take care of the baby or carry out a specific task
  • Go walking, spend time outdoors seeing a friend or doing any other leisure activity
  • Make time to relax everyday and just do nothing
  • Try to avoid staying alone all day with the baby
  • Start planning your post-pregnancy fitness regimen
  • Make time for postpartum sex and intimacy
  • Make an effort to meet other moms, or try to find like-minded moms by participating in support groups
  • Try to keep your old friendships alive

All woman who have just been through childbirth can follow these tips, including those without signs of postpartum depression. All in all, it also helps you to lower the risk of developing it in the future.

FAQs from users

How long does postpartum depression last?

By Zaira Salvador BSc, MSc (embryologist).

In most of the cases, postpartum depression manifests in just the form of baby blues and lasts two weeks.

Only 10 percent of women develop more serious symptoms, which can be present for over two months or even years if it is not treated adequately.

What is a dad to do when his wife has postpartum depression?

By Zaira Salvador BSc, MSc (embryologist).

Often, when the new mum is struggling with postnatal depression, her partner finds himself in a complicated situation where he doesn’t know how to react or what to do. Firstly, it is key to be supportive and never judge her actions. We recommend that they visit a doctor or psychologist as well in order to learn about the best way to react behind baby blues or postpartum depression, and be helpful. For women in such situation, having a supportive patient by their side is essential.

Additionally, some may develop postpartum depression as well (known as Paternal Postnatal Depression or PPND).

What are the effects of postpartum depression on the baby?

By Zaira Salvador BSc, MSc (embryologist).

Indeed, mothers can transfer their state of mind to the baby, causing irritability on him or her. For this reason, it is crucial that the mother is not always alone with the baby. Care from other people is also helpful for the baby to feel good.

Breastfeeding can reduce the impact of postpartum depression, although nursing a baby is not easy when self-esteem is so low. In these cases, antidepressants that are compatible with breastfeeding are recommended.

Suggested for you

If you are a first-time mom, it is likely that you wish to learn more about baby care. In such case, you may enjoy some further information reading this: Newborn Baby Growth & Development.

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References

Beck, C. T. (1995). The effects of postpartum depression on maternal-infant interaction: a meta-analysis. Nursing Research, 44, 298-304.

Caplan, H. L., Cogill, S. R., Alexandra, H., Robson, K. M., Katz, R., & Kumar, R. (1989). Maternal depression and the emotional development of the child. British Journal of Psychiatry, 154, 818-822.

Cooper, P. J. & Murray, L. (1997). The impact of psychological treatments of postpartum depression on maternal mood and infant development. In L.Murray & P. J. Cooper (Eds.), Postpartum depression and child development (pp. 201-220). New York: Guilford Press.

Field, T. (1998). Maternal depression effects on infants and early interventions. Preventive Medicine, 27, 200-203.

Horowitz, J. A., Bell, M., Trybulski, J., Munro, B. H., Moser, D., Hartz, S. A. et al. (2001). Promoting responsiveness between mothers with depressive symptoms and their infants. J.Nurs.Scholarsh., 33, 323-329.

McMahon, C., Barnett, B., Kowalenko, N., Tennant, C., & Don, N. (2001). Postnatal depression, anxiety and unsettled infant behaviour. Australian and New Zealand Journal of Psychiatry, 35, 581-588.

Murray, L. & Cooper, P. (1997a). Effects of postnatal depression on infant development. Arch.Dis.Child, 77, 99-101.

Newport, D. J., Hostetter, A., Arnold, A., & Stowe, Z. N. (2002). The treatment of postpartum depression: minimizing infant exposures. Journal of Clinical Psychiatry, 63 Suppl 7, 31-44.

Stewart, D.E., Robertson, E., Dennis, C-L., Grace, S.L., & Wallington, T. (2003). Postpartum depression: Literature review of risk factors and interventions.

Wisner, K. L., Parry, B. L., & Piontek, C. M. (2002). Clinical practice. Postpartum depression. N.Engl.J.Med., 347, 194-199.

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Authors and contributors

 Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia (UPV). Embryologist specializing in Assisted Procreation, with a Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI). More information
License: 3185-CV
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