Postpartum Depression: Symptoms, Causes, and More

Postpartum Depression: Symptoms, Causes, and More

Postpartum or perinatal depression is a form of depression that occurs following the birth of a baby. It’s a relatively common but serious medical condition.

Postpartum or perinatal depression is a fairly common form of depression, affecting 1 in 7 new parents. It can make individuals feel empty, emotionless, and sad. It may cause changes in mood, exhaustion, and a general sense of hopelessness for a long time after birth.

If you think you may be experiencing postpartum depression, you are not alone. Talk with a doctor or healthcare professional as soon as possible. Postpartum depression is a serious condition, and there are treatment options that can help you feel better.

People experience several different types of postpartum depression, such as:

Postpartum blues (baby blues)

Many people feel sad, empty, moody, or fatigued within a few days of giving birth — a condition nicknamed “baby blues.” But postpartum depression goes well beyond that, lasting for weeks after you give birth. Its symptoms can be severe and interfere with your ability to function.

Postpartum depression

Postpartum depression can make you feel disconnected from your baby. You may feel as though you don’t love your baby. These feelings are not your fault.

Symptoms of postpartum depression can vary from person to person and even from day to day. While symptoms can develop anytime after childbirth, they often start within 1 to 3 weeks after having a baby.

  • feeling sad or crying a lot
  • feeling overwhelmed
  • having thoughts of hurting the baby or yourself
  • not having an interest in the baby
  • having no energy or motivation
  • feeling worthless, guilty, or like you are a bad parent
  • sleeping too much or too little
  • change in relationship with food
  • feeling anxious
  • having chronic headaches, aches, pains, or stomach problems

Postpartum depression is not your fault, and it doesn’t mean you’re a bad parent. If you notice symptoms, speak with a healthcare professional and seek treatment to feel better.

The most severe form of postpartum depression is postpartum psychosis. Postpartum psychosis is rare, affecting 1 to 2 per 1,000 women after childbirth. It typically develops suddenly within weeks after birth, but cases have occurred up to 6 months after delivery.

The earliest symptoms of postpartum psychosis are restlessness, irritability, and insomnia. Hallucinations — when you see, hear, or smell things that aren’t there — and delusions are also common.

Postpartum psychosis is a psychiatric emergency, and the risk of hurting yourself or your baby — either deliberately or accidentally — is real.

Without treatment, postpartum depression can progressively worsen. It’s most dangerous when it leads to thoughts of suicide, harming yourself, or harming others.

If these thoughts begin to occur, medical intervention is necessary. Severe postpartum depression may be life threatening, but effective treatment options exist.

The partners of birthing parents can also develop a type of postpartum depression called paternal postnatal depression.

Males are less likely to report symptoms of depression, but estimates say between 8% and 10% of fathers have feelings of depression in the first year postpartum. First-time fathers tend to have a higher level of anxiety in the weeks following birth.

Many other potential risk factors might contribute to the development of postpartum depression in males, including a history of depression and relationship problems.

You can get treatment for depression with antidepressant medications, either alone or with therapy.

There are other conditions that may develop during the postpartum period and beyond. While these are different from postpartum depression, treatment options are available.

Postpartum anxiety

Postpartum anxiety is even more common than postpartum depression, with some research suggesting that it affects 20% to 25% of new mothers. Postpartum anxiety often occurs alongside postpartum depression. It can occur anytime within the first year after giving birth.

Common symptoms of postpartum anxiety include episodes of hyperventilation and panic attacks. Other symptoms of postpartum anxiety include:

  • excessive or constant worry
  • feelings of dread
  • difficulty concentrating
  • irritability and tension
  • insomnia
  • chest pain
  • heart palpitations
  • sweating
  • trembling
  • tingling in arms or legs

Postpartum OCD

Postpartum OCD is less common than postpartum depression and anxiety, with a prevalence rate of between 2% and 9%. It usually develops within a week of delivery.

Obsessions could be about anything, but they’re likely to focus on the baby’s safety. If you have postpartum OCD, you might engage in ritualistic behaviors related to those thoughts. These may include:

  • repetitive organizing and cleaning, and obsessing over germs
  • repeatedly checking on your baby during the night
  • mental compulsions, like constantly praying for your baby’s safety

A combination of medication and psychotherapy can be effective in treating postpartum OCD.

If you have symptoms of postpartum depression, you should contact a healthcare professional as soon as possible to start treatment.

Treatment for postpartum depression can include medication, certain forms of therapy, and support groups. Typically, a combination of medication and therapy is the most effective treatment.

Medications for postpartum depression

The most common type of medication for postpartum depression is antidepressants. These drugs can help relieve many of the symptoms of depression, but they take time — typically 6 to 8 weeks — to start working fully.

In some cases, you may need to try a few medications before finding one that works and has manageable side effects.

  • Selective serotonin reuptake inhibitors (SSRIs): SSRIs are common antidepressant medications. They generally have fewer side effects than other antidepressants and include paroxetine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft)
  • Atypical antidepressants: These target several neurotransmitters in the brain that affect mood. They may help treat depression that does not respond to SSRIs. Examples of atypical antidepressants include bupropion (Wellbutrin), trazodone (Desyrel), and nefazodone (Serzone).
  • Tricyclic antidepressants and monoamine oxidase inhibitors: These are two older classes of antidepressants that are less common.
  • Brexanolone: This is given by a healthcare professional through an IV over the course of 60 hours. Doctors often recommend brexanolone to patients who do not respond to other treatments.

All antidepressants can cause side effects, which may vary in severity. Side effects from antidepressants can include feelings of agitation or anxiety, digestive issues, and headaches, among others.

Chestfeeding people have options for medication and treatment. Your doctor can help you choose one that’s a safe choice while chestfeeding.

Hormone therapy

After delivering a baby, levels of the sex hormones estrogen and progesterone drop dramatically.

Researchers theorize that this sudden change in hormones may play a role in people developing postpartum depression. For these reasons, hormone therapy may help manage postpartum depression.

Side effects of hormone therapy with estrogen may include:

Therapy

CBT involves learning and using techniques and strategies that enable you to change your thinking patterns, recognize distortions in thinking, use problem-solving skills to cope with difficult situations and develop greater confidence in your own abilities.

Natural remedies

Postpartum depression is a serious and debilitating condition, and you should not attempt to treat it without a healthcare professional’s input.

But at-home practices like eating a balanced diet, regularly engaging in gentle exercise, practicing meditation or yoga, and spending time in nature may help you feel better, especially when used alongside traditional treatments like medication and therapy.

Self-care

Postpartum depression can feel exhausting and isolating, so it’s important to take time to reach out to family and friends and ask for help when you need it. Joining support groups can also help.

The exact cause isn’t clear, but some factors may contribute to postpartum depression. Postpartum depressive episodes can result from a combination of physical changes and emotional stressors.

While you’re pregnant, your estrogen and progesterone levels are higher than usual. Within hours of giving birth, these levels go back to their previous levels.

Stress during pregnancy may be a factor. Research suggests that undergoing stressful experiences during pregnancy can significantly affect the likelihood of developing postpartum depression.

  • changing hormone levels after delivery
  • having a history of depression or anxiety
  • having family members with depression or mental illness
  • having additional children to care for
  • having the stress of being a new parent (caring for a newborn and all the life changes)
  • having a baby who cries more than expected, has difficulty feeding or sleeping, or is difficult to comfort
  • maternal age being very young or old
  • being a first-time parent
  • having a baby with special needs, medical complications, illness
  • premature delivery
  • external emotional stressors, such as family strife, death in the family, divorce
  • financial difficulties
  • underemployment or unemployment
  • being isolated from friends, family, or your community
  • having a lack of social support

If you experience symptoms of postpartum depression for more than 2 weeks within the first year of giving birth, contact a healthcare professional for a postpartum depression screening.

A medical professional will be able to assess your symptoms and medical history to reach a diagnosis.

They’ll typically look for and ask you about:

  • depression symptoms
  • disturbances to sleep patterns
  • feelings of decreased energy
  • feelings of irritability

As part of the diagnosis, your doctor will identify other risk factors of depression and associated conditions, which include:

  • recent stressful life events
  • a history of depression
  • outside stressors
  • your medication history

They may also order a blood test to check if a disorder like thyroid disease or a nutrient deficiency may be contributing to your depression.

Postpartum depression is common and may not be entirely preventable. However, knowing the signs of postpartum depression may help you manage the condition and get treatment faster should you need it.

Some studies suggest that certain treatments with antidepressants and nutrients during and immediately after pregnancy may reduce your risk of developing severe postpartum depression.

Additionally, participating in interpersonal therapy and CBT during and after pregnancy may reduce the risk of postpartum depression. This is especially helpful for those at an increased risk of developing it.

You can reduce your chances of developing postpartum depression by:

  • finding a support system of friends and families before your baby is born
  • taking antenatal and postnatal educational classes
  • having an arrangement for child care in place so you can take a break
  • eating a balanced diet and getting some exercise and fresh air every day
  • getting adequate sleep and general rest
  • reducing alcohol intake or avoiding it altogether

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