Postpartum Depression: Major Depression or just the blues?

Postpartum Feelings: Major Depression or

Just the Blues? 

When her baby

is born, a woman anticipates joy and looks forward to

relief from the discomforts of the later months of

pregnancy. However, many women experience a period of

sadness, irritability and feelings of inadequacy. Why

should the birth of a new child be followed by tears?

The Baby Blues


America, about 50% to 80% of new mothers experience a

mild, self-limited period of depression, anxiety, and

emotional reactivity called the postpartum blues. This

usually occurs about three to five days after delivery.



, a more severe,

lasting depression is experienced by up to 12% of women

after delivery. Symptoms may include hopelessness,

guilt, difficulty concentrating, poor appetite, and

thoughts of suicide. Frequent trips to the baby’s

pediatrician may be a sign of depression.



is much rarer. It

is associated with about once in a thousand deliveries.

The new mother may have paranoia, hallucinations, rapid

speech, confusion and mood shifts. This condition is

often associated with Bipolar Disorder.

Risk Factors


with a prior history of major depression or postpartum

problems may have more difficulty with postpartum

depression. Other factors associated with increased risk

are: difficult labor, a premature child, severe PMS, low

self-esteem, unwanted pregnancy, and lack of social




The incidence of

postpartum psychosis is fairly similar around the world.

However, there is much less postpartum blues or

depression in more traditional cultures. In these

cultures, there may be special rituals that help

transition the woman into her new role as a mother.

Extended family gather to provide support and

instruction. In our more mobile culture, the extended

family is less available to provide extended support.

The new mother may be expected to get her parenting

instructions from books or simply to “know” it. Our more

flexible view of the role of a mother can be liberating

but can also be overwhelming.

Getting Support


supportive spouse who can take time off work, or the

presence of older family members can ease the transition

to motherhood. Some new mothers hire a “baby nurse” or a

housekeeper to help out for several weeks.


Psychiatric Help

Most women with

postpartum depression are not diagnosed or treated. This

may lead to long-term depression and difficulty bonding

with the baby. One study showed that young children of

depressed mothers are more likely to have problem

behaviors and to score lower on standardized tests.

Fortunately we now have effective treatments for

postpartum depression. Counseling and support groups are

helpful. For some women, antidepressant medication can

make a big difference. Often a woman can, after

consulting with her doctor, continue breastfeeding while

taking these medications. With successful treatment, the

new mother is more fully able to enjoy her baby.

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Women’s Mental Health