Postpartum Depression: An Overview

Postpartum depression and the more severe postpartum psychosis are psychological disorders that affect new mothers as they have difficulty coping with the transition from pregnancy to motherhood. Postpartum depression is also known as postnatal depression, or PPD.

Feeding, diapering and taking care of a new baby can be overwhelming. Experts estimate that 40 to 85 percent of women experience intense highs and lows as they adjust to life with a new baby. Feeling anxious and crying for reasons she can't explain are actually normal behaviors for the mother of a new baby.

With feedings every few hours, the mother of a new baby is likely to feel tired and have trouble sleeping. She may also have trouble concentrating feel irritable, anxious or overwhelmed. Sudden weight gain and weight loss are both normal, as are fluctuations in appetite.

These are symptoms of the "baby blues." According to most research, these symptoms may last several weeks, often peaking during the first week following delivery. They usually go away by themselves.

If feelings of sadness persist more than a few weeks, a woman may be suffering from postpartum depression. How can you tell the difference?

Having a baby changes many aspects of a woman's life, both physically and emotionally. A woman's body changes drastically. Her personal history and feelings about parenting can bring up very powerful emotions. The family may be financially and emotionally strained. Social pressures may be mounting.

The majority of research into the condition shows that, for about 10 to 15 percent of women and more than a fourth of all adolescent mothers, childbirth results in postnatal depression.

Most women who experience postnatal depression are affected within the first six weeks after childbirth, and often are affected for more than six months. However PPD research reveals that about 25 percent of women who don't get help during this time are still depressed a year later.

A woman with postnatal depression may believe that there is something truly wrong with her abilities as a mother. She may start to distance herself from the baby.

Postpartum psychosis came into the news nationally in 2001 after Andrea Yates, a Texas woman, was accused of drowning her five children in the bathtub. Her attorney had considered an insanity defense based on postpartum depression. Yates was convicted of murder and sentenced to life in prison in March of 2002.

The condition can be truly debilitating. A rare and difficult disorder, it occurs in about one in 1,000 new mothers. It should be treated as a medical emergency. Patients need immediate medical assistance, which almost always includes medication.

Usually, symptoms are evident during the first four to twelve weeks after the birth, but can appear up to ninety days after delivery, and in some cases, 18 to 24 months after the new baby comes. Symptoms are obvious. A woman who suffers from postpartum psychosis loses touch with reality, experiencing hallucinations and delusions, usually with a focus on the baby dying or being divine or demonic. Sufferers may hear voices telling her to hurt herself or others. This is the point of the highest risk for committing infanticide and/or suicide.

This level of disorder often includes bipolar illness, schizophrenia and even organic brain syndromes.

Resources

O'Hara, M.W. (1995). Postpartum depression. Series in Psychopathology, 1-27. Alloy, L. B. (ed). Springer-Verlag, New York.

Troutman, B.R. &Cutrona, C.E. (1990). Nonpsychotic postpartum depression among adolescent mothers. The Journal of Abnormal Psychology, 99(1), 69-78.