POV: date=January 2008

Postpartum depression (PPD, also called postnatal depression) is a form of clinical depression which can affect women, and less frequently men, after childbirth. Studies report prevalence rates among women from 5% to 25%, but methodological differences among the studies make the actual prevalence rate unclear.Agency for Health Care Research and Quality: Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes 1

Postpartum Exhaustion

Relation to baby blues

Baby or maternity blues are a mild and transitory moodiness suffered by up to 80% of postnatal women (and in some cases fathers who also suffer from the baby blues and/or postpartum depression). Symptoms typically last from a few hours to several days, and include tearfulness, irritability, hypochondriasis, sleeplessness, impairment of concentration, isolation and headache. The maternity blues are not the same thing as postpartum depression, nor are they a precursor to postpartum depression or postnatal psychosis.

Symptoms

Symptoms of PPD can occur anytime in the first year postpartumThe Boston Women's Health Book Collective: Our Bodies Ourselves, pages 489–491, New York: Touchstone Book, 2005 and include, but are not limited to, the following:

• Sadness
• Hopelessness
• Low self-esteem
• Guilt
• Sleep disturbances
• Eating disturbances
• Inability to be comforted
• Exhaustion
• Emptiness
• Inability to enjoy things one previously enjoyed
• Social withdrawal
• Low or no energy
• Becoming easily frustrated
• Feeling inadequate in taking care of the baby (or feeling like one cannot take care of the baby)
• Impaired communication in speech and writing
• Spells of anger towards others
• Increased anxiety or panic attacks

Risk factors

While not all causes of PPD are known, a number of factors have been identified as predictors of PPD (the effect size is given in parentheses, where larger values indicate larger effects):

• Formula feeding rather than breast feeding (2.04)
• A history of depression (1.87) (.38 to.39) Beck (2001)
• Cigarette smoking (1.58)
• Low self esteem (.45 to. 47) Beck (2001)
• Childcare stress (.45 to .46) Beck (2001)
• Prenatal depression during pregnancy (.44 to .46) Beck (2001)
• Prenatal anxiety (.41 to .45) Beck (2001)
• Life stress (.38 to .40) Beck (2001)
• Low social support (.36 to .41) Beck (2001)
• Poor marital relationship (.38 to .39) Beck (2001)
• Infant temperament problems/colic (.33 to .34) Beck (2001)
• Maternity blues (.25 to .31) Beck (2001)
• Single parent (.21 to .35) Beck (2001)
• Low socioeconomic status (.19 to .22) Beck (2001)
• Unplanned/unwanted pregnancy (.14 to .17) Beck (2001)