Postpartum Depression

Postpartum Depression (PPD) is a major depressive disorder occurring in the postnatal period. PPD can affect the mother’s mood and behavior as well as the infant’s development.

Baby blues is not Postpartum Depression. Baby blues occurs in 26-85% of postpartum women and is considered to be part of the normal reaction to childbearing. Symptoms include unhappy mood, tearfulness, irritability, anxiety, and sleep disturbances. Baby blues peaks around day 3 or 4 postpartum and resolves within 7-10 days.


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Prevalence and Risk Factors

Postpartum depression occurs in 10-15% of postpartum women. Symptoms are similar to baby blues but are more severe in intensity and impairment in ability to function. PPD can linger well into the first postnatal year if not treated.

  • Previous episode of Major Depressive Disorder
  • Depression during the pregnancy
  • Personal history of severe premenstrual dysphoria
  • Lack of a confiding, supportive relationship
  • Multiple stressful events in previous year

Symptoms

  • Depressed mood
  • Anxiety
  • Frequent or intense mood and/or emotional changes or shifts
  • Irritability
  • Inappropriate guilt
  • Decreased interest in usual activities
  • Difficulty concentrating
  • Low energy
  • Appetite changes
  • Difficulty sleeping but tired
  • Feeling overwhelmed
  • Suicidal/infanticidal thoughts
  • Obsessions

Screening Tools

Edinburgh Postnatal Depression Scale
(J.L. Cox, J.M. Holden, R. Sagovsky, Department of Psychiatry, University of Edinburgh)

The Edinburgh Postnatal Depression Scale (EDPS) was developed in 1987 to help doctors determine whether a mother may be suffering from postpartum depression. The scale has since been validated, and evidence from a number of research studies has confirmed the tool to be both reliable and sensitive in detecting depression.

The Edinburgh Postnatal Depression Scale (EPDS) is the screening instrument most commonly used to identify women with postpartum mood disorders.

Postpartum Depression Screening Scale

Treatment Options

Treatment options can include education, psychotherapy, group support, and sometimes psychotropic medication. Interpersonal therapy and cognitive-behavioral therapy have been found to be effective in treating postpartum depression.