Postpartum Depression

Postpartum depression must be distinguished from two other mood disorders which occur after the birth of a child. The first is the maternity blues, a common disturbance in mood, which arises in the first few days following delivery and usually remits within a week or two, and is characterised by marked swings in mood (lability). It is not, in itself, of psychiatric significance. The second category of disorder is the postpartum psychoses which arise in the early weeks following delivery. These disorders affect around one in one thousand postpartum women. They cover a wide spectrum of psychiatric conditions, the most common being manic in form. They are of major psychiatric significance and frequently require hospital admission. In terms of severity, postpartum depression lies between these two classes of disturbance. The clinical profile is the same as depressions arising at other times (Cooper et al. 1988; O'Hara 1997). Thus, central to the depression is a protracted period of low mood accompanied, in varying combinations and to varying degrees, by a loss of interest and pleasure, sleep and appetite disturbance, concentration problems, irritability, feelings of guilt and worthlessness, anxiety symptoms, and, on occasion, suicidal thoughts.