Postpartum depression (PPD), also called postnatal depression, is a type of clinical depression which can affect both sexes after childbirth. Symptoms may include sadness, low energy, changes in sleeping and eating patterns, reduced desire for sex, crying episodes, anxiety, and irritability. While many women experience self-limited, mild symptoms postpartum, postpartum depression should be suspected when symptoms are severe and have lasted over two weeks.
Although a number of risk factors have been identified, the causes of PPD are not well understood. Hormonal change is hypothesized to contribute as one cause of postpartum depression. The emotional effects of postpartum depression can include sleep deprivation, anxiety about parenthood and caring for an infant, identity crisis, a feeling of loss of control over life, and anxiety due to lack of support from a romantic or sexual partner. Many women recover with treatment such as a support group, counseling, or medication.
Between 0.5% to 61% of women will experience depression after delivery. Postpartum psychosis occurs in about 1–2 per thousand women following childbirth. Among men, in particular new fathers, the incidence of postpartum depression has been estimated to be between 1% and 25.5%.
Onset and duration
Postpartum depression usually begins between two weeks to a month after delivery. Recent studies have shown that fifty percent of postpartum depressive episodes actually begin prior to delivery. Therefore, in the DSM-5, postpartum depression is diagnosed under “depressive disorder with peripartum onset”, in which “peripartum onset” is defined as anytime either during pregnancy or within the four weeks following delivery. PPD may last several months or even a year.Postpartum depression can also occur in women who have suffered a miscarriage.
Parent-infant relationship
Postpartum depression can interfere with normal maternal-infant bonding and adversely affect child development. Postpartum depression may lead mothers to be inconsistent with childcare.Children of mothers with PPD have been found to have higher rates of emotional problems, behavioral problems, psychiatric diagnoses (such as oppositional defiant disorder and conduct disorder), and hyperactivity.
In rare cases, or about 1 to 2 per 1,000, the postpartum depression appears as postpartum psychosis which may adversely affect the infant’s health. In these, or among women with a history of previous psychiatric hospital admissions, may occur. In the United States, postpartum depression is one of the leading causes of annual reported infanticide incidence rate of about 8 per 100,000 births.
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