What Types of Postpartum Depression

Baby Blues vs Postpartum Major Depression vs Postpartum Psychosis

Postpartum depression
SolStock/Getty Images

You may have heard that there are different types of postpartum depression, or you may be feeling down in the dumps after childbirth and wonder if it is normal baby blues or instead depression. What do you need to know about symptoms of sadness and moodiness after giving birth? Why is it so important to recognize postpartum depression and psychosis?

Different Types of Postpartum Depression

Many people assume that postpartum depression is one, definitive condition.

The truth is that there are many shades of gray. The types of postpartum depression run on a spectrum of severity, ranging from mild baby blues to postpartum major depression to postpartum psychosis.

Baby Blues

When we talk about "baby blues" we mean a short-term, milder type of postpartum depression. The baby blues are experienced by 30 percent to 80 percent of all new mothers. Symptoms often begin within three to ten days of delivery and are usually gone by two to three weeks postpartum.

Symptoms include anxiety, crying, insomnia, tiredness, moodiness, and sadness. During this time women may suddenly feel like they can't possibly handle taking care of a baby no matter how prepared they are as mothers. Fortunately, the symptoms are usually short-lived.

The time shortly after birth is also a let-down period for many women following almost 10 months of pregnancy. Accepting help, talking to other women who have "been there" and especially getting out of the house and having a change of scenery can be very helpful.

Postpartum Major Depression

Unlike the baby blues, postpartum major depression—experienced by about 10 percent of women who have given birth—tends to develop three or more weeks after delivery, and may occur anytime up until your baby is one year of age. Mood symptoms are stronger and last longer.

Symptoms may include:

  • Crying
  • Problems with concentration
  • Difficulty making decisions
  • Feelings of inadequacy (longer lasting that with the baby blues)
  • Sadness

Some women also experience suicidal thoughts.

Physical symptoms similar to hypothyroidism—including sensitivity to cold, slowed thinking, tiredness, dry skin, fluid retention, and constipation—may also be experienced.

If you believe you may have postpartum depression, it's important to see your doctor right away. It's extremely important to get professional help, even if you aren't sure whether you are depressed or just coping with prolonged baby blues. Sadly, only 15 percent of women with postpartum depression receive treatment, and treatment can make a big difference in both your quality of life and that of your baby.

Treatment may include medications, psychotherapy, support groups, and more. Several studies have found that exercise can reduce the symptoms of postpartum depression.

Postpartum Support International offers a free hotline, an online support group, free live phone sessions with an expert, and coordinators who can help connect you with providers in your community 24 hours a day.

Postpartum Psychosis

Sometimes called puerperal psychosis or postpartum psychotic depression, this type of postpartum depression will develop in around one to two in 1,000 women.

Postpartum psychosis usually begins earlier than postpartum depression, within the first two weeks after giving birth. There is a second peak in incidence one to three months after delivery.

Postpartum psychosis may be preceded by agitation, confusion, memory problems, irritability, worsening insomnia, and anxiety.

Postpartum psychosis is distinguished from postpartum depression by the presence of delusions (believing things which aren't actually true) and/or hallucinations (hearing things or seeing things which aren't there.) Other symptoms can include intrusive thoughts and an inappropriate response to or disinterest in one's child.

Postpartum psychosis symptoms may change rapidly, with periods of elevated mood being quickly followed by profound sadness or rage. Periods of lucidity are common and not necessarily an indicator of recovery. Although recovery may occur abruptly, it is more common for postpartum psychosis to evolve into severe, prolonged depression.

Women who have had postpartum psychosis after the birth of one child are at risk of experiencing psychosis again with subsequent pregnancies; at least 40 percent of women will have a recurrence with their next birth.

Treatment may include hospitalization, medications, and assistance in caring for the baby. For women who experienced postpartum psychosis in the past, preventive hormonal therapy postpartum is sometimes used.

Postpartum Anxiety Disorders

Anxiety disorders are also common following childbirth and affect up to 15 percent of women after giving birth. You may find that you are so anxious you find it difficult to care for your baby or seem to be unable to eat or sleep. Some women find themselves afraid that they will harm their baby. Specific anxiety disorders which may occur postpartum include generalized anxiety disorder, obsessive-compulsive disorder, and panic attacks.

Importance of Recognizing Postpartum Mental Health Conditions

Nobody is certain why women experience baby blues and sometimes depression after the birth of a child. It would seem that this is a time period in which you should be happiest, and also a time in which you can least afford to feel down in the dumps.

Whatever the cause, however, we know these disorders not only reduce your quality of life but can be very serious if not life-threatening. If you are wondering at all whether you might be experiencing postpartum depression or postpartum anxiety, make an appointment to talk with your obstetrician right away. Treatments are available which are very effective. Postpartum psychosis is a serious condition and can come on very rapidly. If you or your loved one is experiencing delusions or hallucinations postpartum, seek medical attention immediately.

Many resources, including the hotline above, are available any time of day. Don't hesitate to talk to someone, even if you think it's just the baby blues.

Sources:

Cunningham, F. Gary., and John Whitridge Williams. Williams Obstetrics. New York: McGraw-Hill Education Medical, 2014. Print.

Povatos-Leon, R., Garcia-Hermoso, A., Sanabria-Martinez, G. et al. Effects of Exercise-Based Interventions on Postpartum Depression: A Meta-Analysis of Randomized Controlled Trials. Birth. 44(3):200-208.

VanderKruik, R., Barreix, M., Chou, D. et al. The Global Prevalence of Postpartum Psychosis: A Systematic Review. BMC Psychiatry. 2017. 17(1):272.

Continue Reading