Postpartum depression Health Article

Definition

Postpartum depression is a depression that can range from mild to suicidal and can occur anytime after delivery up to one year later.

Description

Postpartum depression is an affective disorder (any mental disorder characterized by a consistent change in mood that affects thoughts and behaviors) that can occur after pregnancies of all duration, from spontaneous (not induced) abortions, also called miscarriages, to full-term deliveries. The depression can take a mild clinical course or it can range to suicidal ideations (thoughts). The depression can occur anytime post-delivery to one year after delivery. Symptoms commonly start within four to six weeks after delivery. Differentiating postpartum depression from "maternity blues" or the stressfrom the pregnancy and delivery can be difficult. Postpartum depression can be differentiated from other types of depression if the mother exhibits signs of ambivalence to the infant and neglectof other family members.

Causes

The cause of postpartum depression has been extensively studied. Alterations of hormone levels for prolactin, progesterone, estrogen, and cortisol are not significantly different from those of patients who do not suffer from postpartum depression. However, some research indicates a change in a brainchemical that controls the release of cortisol.

Research seems to indicate that postpartum depression is unlikely to occur in a patient with an otherwise psychologically uncomplicated pregnancy and past history. There is no association of postpartum depression with marital status, social class, or the number of live children born to the mother. However, there seems to be an increased chance to develop this disorder after pregnancy loss.

Certain characteristics have been associated with increased risk of developing postpartum depression. These risk factors include:

• medical indigence— being in need of health care and not being able to receive it, possibly due to lack of medical insurance
• being younger than 20 years old at time of delivery
• being unmarried
• having been separated from one or both parents in childhood or adolescence
• receiving poor parental support and attention in childhood
• having had limited parental support in adulthood
• poor relationship with husband or boyfriend
• economic problem with housing or income
• dissatisfaction with amount of education
• low self-esteem
• past or current emotional problem(s)
• family history of depression