Postpartum depression

Postpartum depression
Other names	Postnatal depression
Postpartum Depression Venus, a representation of the loss and emptiness felt after childbirth
Specialty	Psychiatry
Symptoms	Extreme sadness, low energy, anxiety, changes in sleeping or eating patterns, crying episodes, irritability[1]
Usual onset	A week to a month after childbirth[1]
Causes	Unclear[1]
Risk factors	Prior postpartum depression, bipolar disorder, family history of depression, psychological stress, complications of childbirth, lack of support, drug use disorder[1]
Diagnostic method	Based on symptoms[2]
Differential diagnosis	Baby blues[1]
Treatment	Counselling, medications[2]
Frequency	~15% of births[1]

Postpartum depression (PPD), also called postnatal depression, is a mood disorder experienced after childbirth, which can affect women.^[3] Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns.^[1] PPD can also negatively affect the newborn child.^[4][2]

While the exact cause of PPD is unclear, the cause is believed to be a combination of physical, emotional, genetic, and social factors.^[1][5] These may include factors such as hormonal changes and sleep deprivation.^[1][6] Risk factors include prior episodes of postpartum depression, bipolar disorder, a family history of depression, psychological stress, complications of childbirth, lack of support, or a drug use disorder.^[1] Diagnosis is based on a person's symptoms.^[2] While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks.^[1]

Among those at risk, providing psychosocial support may be protective in preventing PPD.^[7] This may include community support such as food, household chores, mother care, and companionship.^[8] Treatment for PPD may include counseling or medications.^[2] Types of counseling that are effective include interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and psychodynamic therapy.^[2] Tentative evidence supports the use of selective serotonin reuptake inhibitors (SSRIs).^[2]

Postpartum depression affects roughly 8.9 to 10.1% of women in high-income countries and 17.8 to 19.7% of women in low and middle-income countries.^[9] Postpartum depression commonly affects mothers who have experienced stillbirth, live in urban areas and adolescent mothers.^[10] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.^[3] Postpartum psychosis, a more severe form of postpartum mood disorder, occurs in about 1 to 2 per 1,000 women following childbirth.^[11] Postpartum psychosis is one of the leading causes of the murder of children less than one year of age, which occurs in about 8 per 100,000 births in the United States.^[12]