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Postpartum depression

The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.

Many new moms experience the "baby blues" after childbirth, which commonly include mood swings and crying spells that fade quickly. But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme form of postpartum depression known as postpartum psychosis develops after childbirth.

Postpartum depression isn't a character flaw or a weakness. Sometimes it's simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms — and enjoy your baby.

Symptoms Causes Risk factors Complications Prevention

Signs and symptoms of depression after childbirth vary, depending on the type of depression.

Baby blues symptoms

Signs and symptoms of the baby blues — which last only a few days to a week or two — may include:

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Crying
  • Decreased concentration
  • Trouble sleeping

Postpartum depression symptoms

Postpartum depression may appear to be the baby blues at first — but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to care for your baby and handle other daily tasks. Postpartum depression symptoms may include:

  • Loss of appetite
  • Insomnia
  • Intense irritability and anger
  • Overwhelming fatigue
  • Loss of interest in sex
  • Lack of joy in life
  • Feelings of shame, guilt or inadequacy
  • Severe mood swings
  • Difficulty bonding with your baby
  • Withdrawal from family and friends
  • Thoughts of harming yourself or your baby

Untreated, postpartum depression may last for many months or longer.

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first two weeks after delivery — the signs and symptoms are even more severe. Signs and symptoms of postpartum psychosis may include:

  • Confusion and disorientation
  • Hallucinations and delusions
  • Paranoia
  • Attempts to harm yourself or your baby

When to see a doctor

If you're feeling depressed after your baby's birth, you may be reluctant or embarrassed to admit it. But it's important to call your doctor if the signs and symptoms of depression have any of these features:

  • Don't fade after two weeks
  • Are getting worse
  • Make it hard for you to care for your baby
  • Make it hard to complete everyday tasks
  • Include thoughts of harming yourself or your baby

If you suspect that you're developing postpartum psychosis, seek medical attention immediately. Don't wait and hope for improvement. Postpartum psychosis may lead to life-threatening thoughts or behaviors.

There's no single cause of postpartum depression. Physical, emotional and lifestyle factors may all play a role.

  • Physical changes. After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed. Changes in your blood volume, blood pressure, immune system and metabolism can contribute to fatigue and mood swings.
  • Emotional factors. When you're sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive or struggle with your sense of identity. You may feel that you've lost control over your life. Any of these factors can contribute to postpartum depression.
  • Lifestyle influences. Many lifestyle factors can lead to postpartum depression, including a demanding baby or older siblings, difficulty breast-feeding, financial problems, and lack of support from your partner or other loved ones.

Postpartum depression can develop after the birth of any child, not just the first. The risk increases if:

  • You have a history of depression, either during pregnancy or at other times
  • You had postpartum depression after a previous pregnancy
  • You've experienced stressful events during the past year, such as pregnancy complications, illness or job loss
  • You're having problems in your relationship with your spouse or significant other
  • You have a weak support system
  • You have financial problems
  • The pregnancy was unplanned or unwanted

The risk of postpartum psychosis is higher for women who have bipolar disorder.

Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems. Children of mothers who have untreated postpartum depression are more likely to have behavioral problems, such as sleeping and eating difficulties, temper tantrums, and hyperactivity. Delays in language development are more common as well.

Untreated postpartum depression can last for months or longer, sometimes becoming a chronic depressive disorder. Even when treated, postpartum depression increases a woman's risk of future episodes of major depression.

If you have a history of depression — especially postpartum depression — tell your doctor as soon as you find out you're pregnant. Your doctor will monitor you closely for signs and symptoms of depression. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants are recommended — even during pregnancy.

After your baby is born, your doctor may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier it's detected, the earlier treatment can begin. If you have a history of postpartum depression, your doctor may recommend antidepressant treatment immediately after delivery.

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