Q: I am expecting my second baby. I had postpartum depression after my first one. Is this likely to happen again?
A: Unfortunately, yes. Women who have experienced postpartum depression (PPD) have a 70 percent risk of recurrence with later deliveries.
Here are some facts and treatments about this extremely serious condition:
What it is (and isn’t)
- PPD is quite common. An estimated 13 percent of new mothers in the U.S. develop it. This rises to 30 percent in women with a history of clinical depression unrelated to pregnancy.
- PPD is not the “baby blues,” which occur in more than half of all mothers. The “baby blues” is a relatively short-lived event caused by the sudden loss of pregnancy hormones produced by the placenta that results in a “hormone down” felt three to five days after delivery. It lasts up to two weeks. This condition can make you feel irritable, sad and edgy, but on the whole does not interfere with your ability to enjoy your newborn.
- PPD, which typically develops six to eight weeks after delivery, is far more serious, and is a form of major clinical depression.
Symptoms and effects of PPD
Symptoms include tearfulness, unrelenting sadness, guilt, anxiety, sleep problems, feelings of inadequacy as a parent, inability to enjoy pleasurable activities, impaired concentration, negative thoughts about the baby and even thoughts of suicide or harming the baby.
- In many cases, PPD interferes with a woman’s ability to care for her newborn. Children of mothers with PPD often have delayed growth and mental development, and are at increased risk for psychiatric disturbances later in life.
Risk factors for PPD
- Women who develop PPD may be more sensitive than others to sudden postpartum hormonal loss. There is also a tendency for the thyroid to underperform after delivery. Low levels of thyroid hormone may contribute to this condition.
- Other known risk factors include a troubled marriage, job loss, a lack of social support, too little sleep, weight issues, feelings of isolation, and worries about handling home, work, family and baby duties.
Therapies for PPD
- It helps to spend time with supportive family and friends, sleep as much as you can, get out of the house and talk to other mothers. This is not a time to bottle up your feelings.
- If your depression lasts more than two weeks, or if you feel that utter sadness you felt last time, see your doctor and get appropriate psychological therapy.
- Your doctor might prescribe an antidepressant that raises serotonin levels, such as Prozac, Zoloft, Paxil, Celexa and Lexapro. Estrogen also can be prescribed. (Though antidepressant drugs may pass through breast milk, there is little evidence that this is harmful to the baby. Lack of treatment is potentially more harmful.)
- We haven’t found a natural treatment that works as well, though it won’t hurt to take vitamins and Omega-3 supplements, or to try acupuncture, massage or other relaxation-enhancing methods.
Finally, there is another serious, albeit rare, condition that can affect new mothers — postpartum psychosis. Within three months of delivery, a woman loses her sense of reality, suffering from delusions and hallucinations. This condition is associated with previous psychosis or bipolar disorder.
You can find more information about PPD at www.DepressionAfterDelivery.com, the Web site of Depression After Delivery, Inc., a support and education group.
Dr. Reichman’s Bottom Line: If you are at risk for postpartum depression, or feel it coming on, get help immediately. Lack of therapy can harm you, your baby and your family.
Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," published by William Morrow, a division of .
PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.