Postpartum refers to the period immediately after childbirth. When a woman has significant symptoms of depression during this period, she is said to have postpartum depression.
Postpartum depression is not the same as the "baby blues," a much more common condition that affects as many as 85% of new mothers. New moms often are emotionally sensitive and tend to cry easily. The baby blues is uncomfortable, but usually doesn't interfere with functioning as a mother, and it almost always goes away within a few weeks.
Postpartum depression is a different matter. It affects up to 15% of new mothers. It may begin at any time in the first two to three months after giving birth. The mother feels sad or hopeless and sometimes guilty or worthless. She is unable to concentrate and unable to take any interest in anything, even the baby. In some cases, the mother may feel overwhelmed by the baby's needs and become intensely anxious. This may lead to persistent troubling thoughts or obsessions about the baby's well-being and compulsive repetitive actions, such as checking on the baby constantly or phoning the pediatrician repeatedly to ask questions.
A woman is more likely to develop postpartum depression if she has:
A previous history of depression, including depression during pregnancy
A troubled marriage
Very few supportive family members or friends
A recent stress
Difficulty caring for her new infant, especially if the child has serious medical problems
Teenage mothers, particularly if they come from families with few economic resources, have a particularly high risk of postpartum depression.
In a rare form of this disorder, which occurs in 1 out of 1,000 births, the mother becomes psychotic, that is, she is unable to recognize reality. This condition is sometimes called postpartum psychosis. The mother may have hallucinations (altered perceptions, for example, hearing or smelling things that are not there) or delusions (false beliefs, such as the idea that her baby is possessed by the devil).
This condition is most commonly associated with bipolar disorder. It is extremely dangerous for both the mother and the baby. And once it has happened it is highly likely to happen again if the mother has another child.
Researchers have many reasons to assume that biological changes contribute to these mood problems. In the weeks after delivery, significant swings occur in sex hormone levels and in the regulation of stress hormones. In postpartum depression, perhaps as a response to the hormonal shifts, there may be subtle changes in the parts of the brain that process emotion and in the brain regions responsible for managing social interactions. These changes are important not just for the mother, but also for the new baby.
Fewer than half of women with postpartum depression seek treatment for the problem. Some new mothers are unaware that postpartum depression is a real, treatable illness. Others believe that they are expected to feel happy after having a baby, and are so embarrassed about their symptoms that they do not ask for help.