The exact causes of postpartum depression are unknown,but rapid hormonal changes that accompany pregnancy and delivery may trigger depression. 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. Postpartum depression (PPD) is a condition that describes a range of physical and emotional changes that many mothers can have after having a baby.

After Pregnancy Depression after pregnancy is called postpartum depression or peripartum depression. After pregnancy, hormonal changes in a woman's body may trigger symptoms of depression. During pregnancy, the amount of two female hormones, estrogen and progesterone, in a woman's body increases greatly. In the first 24 hours after childbirth, the amount of these hormones rapidly drops back down to their normal non-pregnant levels. Researchers think the fast change in hormone levels may lead to depression, just as smaller changes in hormones can affect a woman's moods before she gets her menstrual period.

Marital/Self-esteem Causes Marital dissatisfaction is not only a risk factor but may also be a cause for PPD. Mothers who are closer to their spouses/partners are less likely to develop PPD. Some research shows that receiving a daily massage from their partner dramatically reduced the incidence of PPD for some mothers. So clearly a poor marital relationship can play a role in PPD, while a good marital relationship appears to reduce PPD symptoms.

Symptoms

If any of the following symptoms endure for more than two weeks after childbirth, women should seek medical attention: Feelings of anxiety, guilt, sadness, worthlessness, restlessness or irritability Sleep disturbances Lack of interest in social or other activities you previously enjoyed Lack of feeling or feelings of resentment, anger or fear about motherhood, your partner or your child The symptoms can range from mild depression to a severe depression with thoughts of ending one's life (suicide). The disorder should be suspected during its peak (four to six weeks after delivery) in a patient who demonstrates signs and symptoms of clinical depression (feelings of worthlessness and hopelessness, changes in eating and sleeping patterns, irritability, difficulty with motivation, and difficulty getting out of bed in the morning). Additionally, patients may be emotionally detached from the infant and unable to display loving affection towards family members.

Treatment

Psychotherapy for the woman and her family can be very helpful in enhancing coping skills, educating them on caring for a newborn, and providing support. SSRIs are secreted into breast milk, however, in varying amounts. Some studies indicate that paroxetine secretes the least amount of medication into breast milk. Breast-feeding women considering taking an antidepressant should discuss medication choices with their doctor. SSRIs can be given two to three weeks before delivery to patients who had a previous episode to avoid recurrence. Some SSRIs include: fluoxetine(Prozac), paroxetine (Paxil), sertraline(Zoloft), and citalopram(Celexa).

Medical Treatment Treatment for postpartum depression depends on the form and how severe it is. Your health care provider may refer you for psychological help and individual or group therapy. Support groups are helpful. Marriage counseling may be part of your treatment plan. It's important for friends and family to understand the illness so they can help.

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