Postpartum depression (PPD) is a mood disorder characterized by feelings of sadness, anxiety and restlessness experienced by women after childbirth. PPD sometimes occurs with panic disorder or obsessive-compulsive disorder (OCD), sometimes provoking undiagnosed OCD or reigniting old cases.

It typically occurs from three days to six weeks after the baby is delivered, but can develop anytime within the first year. PPD can last for months or longer if untreated. It can occur after the birth of any infant, not just a first-born. It may also result from the birth of a stillborn infant or a late-term miscarriage.

PPD is a form of clinical depression, which means that patients experience a range of physical and emotional characteristics that meet criteria accepted by mental health clinicians. Generally, PPD is very similar to other types of depression in that patients tend to have many of the same risk factors and present similar symptoms as depressed individuals who have not recently given birth. However, depression that occurs during the postpartum period is unique because of many factors, including:

• The degree of hormonal fluctuation in the mother following childbirth
• The special stresses and adjustments involved in caring for a new child
• The impact of breastfeeding on treatment choices
• The impact of a history of PPD on family planning

PPD may interfere with a woman’s ability to care for herself or her baby. In addition, women with PPD have an increased risk of adopting negative parenting skills because the mother’s ability to recognize and respond to the baby’s needs is impaired. PPD also interferes with mother-child bonding and affects the social, cognitive, emotional and behavioral development of the infant.

Babies who nurse from depressed mothers tend to gain less weight, possibly because the mother’s condition negatively affects:

• The nutrition and quality of the breast milk
• The mother’s breastfeeding habits
• The mother’s sensitivity to the infant’s cries of hunger

Children of mothers with PPD may also demonstrate reduced self-esteem, increased aggression towards others, helpless behaviors and poorer social skills in early childhood.

PPD affects women of all ages, races, socioeconomic classes and education levels. According to the American College of Obstetricians and Gynecologists (ACOG), about 10 percent of women experience PPD within the first year after birth. This essentially matches the rate of depression in non-pregnant women.

There are other postpartum conditions that are often confused with PPD. They include:

• Postpartum blues. Also referred as the “baby blues,” it is a common condition that affects between 70 to 85 percent of new mothers, according to the ACOG. It usually starts within three days of birth and can last up to 14 days. Postpartum blues usually does not require medical treatment.
• Postpartum psychosis (PPP). This condition affects about 1 in every 1,000 women, according to the ACOG. It most often appears during the first four weeks after delivery. Patients with PPP may experience paranoia, mood shifts or hallucinations and delusions about the baby dying or being demonic. Hallucinations may command the patient to hurt herself, her child or others. PPP requires immediate medical attention and, usually, hospitalization.