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Symptoms and Signs of Postpartum Depression

Doctor's Notes on Postpartum Depression

Postpartum depression (PPD) is a significant form of clinical depression that occurs in some women soon after having a baby. The condition can be disabling and women may feel anxious, upset, alone, afraid, unloving toward their baby, and guilt for feeling this way.

Symptoms of postpartum depression can begin any time from 24 hours to a few months after delivery and include sadness, frequent crying, lack of pleasure or interest in activities that once gave pleasure, sleep disturbance, weight loss, loss of energy, agitation, anxiety, feelings of worthlessness or guilt, trouble concentrating or making decisions, thoughts of death or suicide, thoughts of homicide of the baby, decreased interest in sex, or feelings of rejection. Physical symptoms such as frequent headaches, chest pain, rapid heart beat, numbness, shakiness or dizziness, and mild shortness of breath may indicate postpartum anxiety, which is a separate disorder but may occur at the same time as postpartum depression.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Postpartum Depression Symptoms

Signs and symptoms usually appear any time from 24 hours to a few months after delivery.

  • If you have these, it is important to see a health care professional, who will look for other conditions that can cause similar symptoms.
    • Sad mood, frequent crying
    • Lack of pleasure or interest in activities that once gave pleasure
    • Sleep disturbance
    • Weight loss
    • Loss of energy
    • Agitation or anxiety
    • Feelings of worthlessness or guilt
    • Trouble concentrating or making decisions
    • Thoughts of death, suicide or homicide of the baby
    • Decreased interest in sex
    • Feelings of rejection
  • Physical symptoms such as frequent headaches, chest pain, rapid heart beat, numbness, shakiness or dizziness, and mild shortness of breath suggest anxiety. Postpartum anxiety disorder is a separate disorder from postpartum depression, but the two often occur together.
  • See the introduction to this article for symptoms specific to the types of postpartum depression.

Postpartum Depression Causes

No specific cause of postpartum depression has been found.

  • Hormone imbalance is thought to play a role.
    • Levels of the hormones estrogen, progesterone, and cortisol fall dramatically within 48 hours after delivery.
    • Women who go on to develop postpartum depression may be more sensitive to these hormonal changes.
  • Other known risk factors
    • Mental illness before pregnancy
    • Mental illness, including postpartum depression, in the family
    • Postpartum mental disorder after an earlier pregnancy
    • Conflict in the marriage, loss of employment, or poor social support from friends and family
    • Pregnancy loss such as miscarriage or stillbirth
      • The risk of major depression after miscarriage is high for women who are childless. It occurs even in women who were unhappy about being pregnant.
      • The risk for developing depression after miscarriage is highest within the first few months after the loss.
  • Childbirth is a time of great change for a woman. The adjustment to these changes can contribute to depression.
    • Physical changes after delivery
      • Many changes occur after delivery, including changes in muscle tone and difficulty losing weight.
      • Many new mothers are very tired after giving birth and in the weeks afterward.
      • Soreness and pain in the perineal area (area around the birth canal) makes many women uncomfortable. Physical recovery after cesarean delivery may take even longer than after vaginal delivery.
      • Changes in hormones can affect mood.
    • Common emotional changes after delivery
      • Feelings of loss of an old identity, feeling trapped at home
      • Feeling overwhelmed with responsibilities of motherhood
      • Feeling stress from changes in routine
      • Feeling fatigue because of broken sleep patterns
      • Feeling less attractive physically and sexually
  • A mother's age and the number of children she has had do not relate to her likelihood of getting postpartum depression.
  • Men whose partners suffer from postpartum depression have been found to be at higher risk for developing a similar condition or other mental health problems at that time.

Postpartum Depression Symptoms, Causes, and More in Pictures Slideshow

Postpartum Depression Symptoms, Causes, and More in Pictures Slideshow

New Mothers Can Suffer

This is a mood disorder that affects some women after pregnancy and childbirth. A woman who has just given birth may feel anxiety, deep sadness, and exhaustion afterwards. Symptoms can be so severe that they interfere with a mom's ability to carry out daily activities and care for themselves, their babies, and others.

A Real Mental Health Condition

Postpartum depression is more than just the baby blues. It is not possible to just "snap out of" it. Postnatal depression is a real mental health condition that requires proper diagnosis and treatment. The feelings of sadness and depressive symptoms a mother has postpartum cannot be talked away. This is a physical illness that responds to medical intervention. Baby blues is less severe and resolves more quickly than PPD.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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