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Postpartum depression (PPD) is different from the "baby blues" and tends to begin later than the common postpartum blues. PPD occurs in about 10 to 20 percent of women and typically develops over the first two to three months after having a baby but it may occur at any time after delivery. A common symptom of PPD is anxiety. Women may worry that they are not doing a good enough job in caring for the baby. These symptoms can worsen to the point of impairing a woman's ability to care for herself or the baby. Anxiety is common, but some women also develop panic attacks or hypochondriasis (excessive worrying about illness). Postpartum obsessive-compulsive disorder (OCD) has also been reported, where women report disturbing and intrusive thoughts of harming their infant. 

What Causes PPD?
Within the first 48 hours of delivery, significant changes occur in the hormones estrogen and progesterone. These hormones play an important role in regulating mood. Researchers think that some women are particularly sensitive to these hormonal changes which may increase their risk for PPD. Stressful life events occurring either during pregnancy or near the time of delivery appear to increase the likelihood of PPD and tends to be more common in women who report dissatisfaction in their marriage. Additionally, women with a history of major depression or bipolar disorder and more vulnerable to PPD and will often go on to have recurrent episodes of depression unrelated to pregnancy or childbirth. 

What are the symptoms of PPD?
Symptoms of PPD may include:

  • Feeling sad, hopeless, empty, or overwhelmed
  • Crying more often than usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Feeling moody, irritable, or restless
  • Oversleeping, or being unable to sleep even when the baby is asleep
  • Having trouble concentrating, remembering details, and making decisions
  • Experiencing anger or rage
  • Losing interest in activities that are usually enjoyable
  • Suffering from physical aches and pains, including frequent headaches, stomach problems, and muscle pain
  • Eating too little or too much
  • Withdrawing from or avoiding friends and family
  • Having trouble bonding or forming an emotional attachment with the baby
  • Persistently doubting the ability to care for the baby
  • Thinking about harming yourself or the baby

How is PPD treated?
Effective treatments are available for PPD and based on the severity and types of symptoms present. Before beginning psychiatric treatment, medical causes for mood disturbances (for example thyroid dysfunction) should be ruled out. Balance providers can help you choose the best treatment by conducting a thorough history, physical examination, and routine lab tests. 

Medications
Antidepressant medications act on the brain chemicals that are involved in mood regulation and can help treat PPD. Many experts believe these medications pose no danger but it is crucial to discuss with your doctor the potential risks and benefits of treatment. 

Counseling (Talk Therapy)
Counseling involves talking one-on-one with a mental health professional and is an effective PPD treatment, particularly for those women reluctant to take medications. 

  • Cognitive behavioral therapy (CBT) helps people recognize and change negative thoughts and behaviors. It is an effective treatment that can alleviate PPD symptoms and improve the quality of life for new moms.  
  • Interpersonal therapy (IPT) is a type of talk therapy that focuses on relationships with other people. It has been shown to be effective for the treatment of women with mild to moderate postpartum depression. Not only is IPT effective for treating the symptoms of depression, women who receive IPT also benefit from significant improvements in the quality of their interpersonal relationships.

Women with more severe PPD may choose to take medications, either in addition to or instead of counseling. 

Please remember this information is intended for educational purposes only and should not substitute medical advice from a healthcare provider.