What is postpartum depression? How is it defined? What are the symptoms? How is it treated? How do you know if you have it?
See below for the answers you’ve been looking for.
1. PPD is a depressive disorder.
What is postpartum depression? According to the leading authority for the definition and diagnosis of mental illness (the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders — DSM for short), postpartum depression is not qualitatively different from depression that occurs at other times, except for the timing of when it occurs.
In other words, the “official” answer to the question, “what is postpartum depression?” is that it is any major or minor depressive episode that occurs within four weeks after childbirth.(1)
2. PPD is a bio-psychosocial phenomenon.
This means that postpartum depression is caused by a complex combination of biological, psychological and social/cultural factors all working together. Contrary to much popular belief, PPD is NOT purely biological in origin.(2-6)
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3. The main symptoms of PPD include:
high levels of anxiety, crying for no apparent reason, immense sadness, insomnia, cognitive impairment, feeling overwhelmed, an inability to care for oneself and/or the baby, a lack of feeling for the baby or others, exaggerated mood swings, feelings of inadequacy, numbness, helplessness, and in some cases, suicidal ideation.(1,7)
Click here for more information about the main symptoms of PPD.
4. Many experts view postpartum depression as primarily an issue of coping and adjustment.
In other words, PPD is seen to exist at one end of an entire continuum of adjustment experiences. Within this perspective, the distinction between PPD and “normal” postpartum adjustment experiences often has more to do with the intensity of feelings and the amount of coping going on, rather than something one does or doesn’t have.(5-6)
5. Like other forms of depression, PPD can be more or less severe.
Sometimes, women suffering from postpartum depression — especially when they have one of its milder forms — will get better on their own. More often, women suffering from postpartum depression get better with a bit of extra help and emotional support, more self-care, and some cognitive shifting of their expectations and beliefs.
Other times, medication is also needed to properly treat PPD. This is particularly the case when mothers are suffering from more major depression.(1-3)
6. The Edinburgh Postpartum Depression Scale is one of the most commonly used screening tools that medical practitioners use to check for PPD.(8) Click here to complete and score this simple 10-item questionnaire yourself.
7. Diagnosing, classifying, and otherwise defining PPD is not always straightforward.(9-11)
There is considerable academic debate around many aspects of the question “what is postpartum depression?” For example, researchers are debating:
- whether PPD is qualitatively unique from other kinds of depression or whether it is similar to depression that occurs at other times
- whether PPD is more biological or social-psychological in origin
- whether PPD only occurs within the first 4-6 weeks postpartum, or whether mothers can get PPD while still pregnant and/or after the initial 4-6 postpartum period
- where the proper “cut-off” point is between difficult (but still “normal”) postpartum adjustment emotions — like guilt, anger, fatigue, loss, overwhelm, and anxiety for example — and symptoms of postpartum depression. For more information about the debates surrounding the question of “what is postpartum depression,”
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Sources for this “What is Postpartum Depression” article:
1. DSM-IV-TR (2000) p.423.
2. Miller, Laura J. 2002. “Postpartum depression,” JAMA 287(6): 762-765.
3. Driscoll, J. 2006. “Postpartum depression: The state of the science,” The Journal of Perinatal and Neonatal Nursing 20(1): 40-42.
4. Corwin, Elizabeth and Kathleen Pajer. 2008. The psychoneuroimmunology of postpartum depression,” Journal of Women’s Health 17(9): 1529-1534.
5. Dennis, Cindy-Lee. 2004. “Preventing postpartum depression part II: A critical review of nonbiological interventions,” Can J Psychiatry 49(8): 526-538.
6. Nicholson, Paula. 1998. Post-Natal Depression: Psychology, Science and the Transition to Motherhood. London: Routledge.
7. Harberger, P.N., Berchold, N.G. and J.I. Honikman. 1992. “Cries for help,” Pp. 41-60 in Hamilton, James Alexander, Harbinger Patricia Neel (eds.) Postpartum Depression: A Picture Puzzle. Philadelphia: University of Pennsylvania Press.
8. Mosack, V., Shore, ER. (2006) “Screening for depression among pregnant and postpartum women,” Journal of Community Health Nursing 23:37-47.
9. Chrisler, Joan C. and Ingrid Johnston-Robledo. 2002. “Raging Hormones? Feminist Perspectives on Premenstrual Syndrome and Postpartum Depression,” Pp. 184-197 In Rethinking Mental Health and Disorder. Edited by Mary and Laura S. Brown Ballou. London: Guilford Press.
10. Knaak, S. 2008. The Process of Postpartum Adjustment. unpublished dissertation, University of Alberta.11. Whiffen, V. E. 1992. “Is postnatal depression a distinct diagnosis?,” Clinical Psychology Review 12: 485-501.
About Stephanie Knaak PhD
