Postpartum depression Other names Postnatal depression Specialty Psychiatry Symptoms Extreme sadness, low energy , anxiety , changes in sleeping or eating patterns, crying episodes, irritability [1] Usual onset A week to a month after childbirth [1] Causes Unclear [1] Risk factors Prior postpartum depression, bipolar disorder , family history of depression , psychological stress , complications of childbirth , lack of support, drug use disorder [1] Diagnostic method Based on symptoms [2] Differential diagnosis Baby blues [1] Treatment Counselling , medications [2] Frequency ~15% of births [1] Postpartum depression ( PPD ), also called postnatal depression , is a type of mood disorder associated with childbirth , which can affect both sexes. [1] [3] Symptoms may include extreme sadness, low energy , anxiety , crying episodes, irritability, and changes in sleeping or eating patterns. [1] Onset is typically between one week and one month following childbirth. [1] PPD can also negatively affect the newborn child. [4] [2] While the exact cause of PPD is unclear, the cause is believed to be a combination of physical, emotional, genetic, and social factors. [1] [5] These may include factors such as hormonal changes and sleep deprivation . [1] [6] Risk factors include prior episodes of postpartum depression, bipolar disorder , a family history of depression , psychological stress , complications of childbirth , lack of support, or a drug use disorder . [1] Diagnosis is based on a person's symptoms. [2] While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks. [1] Among those at risk, providing psychosocial support may be protective in preventing PPD. [7] This may include community support such as food, household chores, mother care, and companionship. [8] Treatment for PPD may include counseling or medications. [2] Types of counseling that have been found to be effective include interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and psychodynamic therapy . [2] Tentative evidence supports the use of selective serotonin reuptake inhibitors (SSRIs). [2] Postpartum depression affects roughly 15% of women after childbirth. [9] [10] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers. [3] Postpartum psychosis , a more severe form of postpartum mood disorder, occurs in about 1 to 2 per 1,000 women following childbirth. [11] Postpartum psychosis is one of the leading causes of the murder of children less than one year of age , which occurs in about 8 per 100,000 births in the United States. [12] Contents 1 Signs and symptoms 1.1 Emotional 1.2 Behavioural 1.3 Cognition 1.4 Neurobiology 1.5 Onset and duration 1.6 Parent-infant relationship 2 Causes 2.1 Risk factors 2.2 Violence 3 Diagnosis 3.1 Criteria 3.2 Differential diagnosis 3.2.1 Postpartum blues 3.2.2 Psychosis 4 Screening 5 Prevention 6 Treatments 6.1 Therapy 6.2 Medication 6.3 Breastfeeding 6.4 Other 7 Epidemiology 8 History 8.1 Prior to the 19th century 8.2 19th century and after 9 Society and culture 9.1 Media 10 See also 11 References 12 External links Signs and symptoms [ edit ] Symptoms of PPD can occur any time in the first year postpartum. [13] Typically, a diagnosis of postpartum depression is considered after signs and symptoms persist for at least two weeks. [14] Emotional [ edit ] Persistent sadness, anxiousness or "empty" mood [13] Severe mood swings [14] Frustration, irritability, restlessness, anger [13] [15] Feelings of hopelessness or helplessness [13] Guilt, shame, worthlessness [13] [15] Low self-esteem [13] Numbness, emptiness [13] Exhaustion [13] Inability to be comforted [13] Trouble bonding with the baby [14] Feeling inadequate in taking care of the baby [13] [15] Thoughts of self-harm or suicide [16] Behavioural [ edit ] Lack of interest or pleasure in usual activities [13] [15] [14] Low libido [17] Changes in appetite [13] [15] Fatigue, decreased energy [13] [15] and motivation [15] Poor self-care [14] Social withdrawal [13] [14] Insomnia or excessive sleep [13] [14] Cognition [ edit ] Diminished ability to make decisions and think clearly [15] Lack of concentration and poor memory [15] Fear that you can not care for the baby or fear of the baby [13] Worry about harming self, baby, or partner [14] [15] Neurobiology [ edit ] A review of various fMRI studies show significant differences in brain activity between mothers with postpartum depression and those without. When at rest, that is not cued by anything in the environment, mothers with PPD have less activity in the left frontal lobe and increased activity in the right frontal lobe when compared with healthy controls. They also have decreased connectivity between vital brain structures including the anterior cingulate cortex , dorsal lateral prefrontal cortex , amygdala , and hippocampus . These areas are important for empathy , memory , and emotion regulation and may explain depressive symptoms as well as decreased motivation toward caregiving. Brain activation differences between depressed and nondepressed mothers is even more pronounced when stimulated by infant and non-infant emotional cues.