Postpartum depression (PPD) may be overlooked in many cases because attention is typically directed toward the infant rather than the mother. To counter this risk, screening for PPD is becoming much more common, and may take place anytime between the initial postpartum follow-up visit and the six-week postpartum follow-up visit.

Some women may be diagnosed with PPD following a physical examination that includes a complete medical history. A blood test may also be performed to determine whether a patient has a disorder of the thyroid (a gland that produces the thyroid hormone, which regulates growth and metabolism). An underactive thyroid may make the patient feel tired, sluggish or depressed. An overactive thyroid may cause depression, anxiety or psychosis.

In other cases, a review of signs and symptoms experienced during the postpartum period may be sufficient for diagnosis of PPD or the postpartum blues, a more common and transient condition. Patients experiencing symptoms of depression may also be referred to a psychiatrist (mental health physician) for a mental health evaluation. 

There are screening instruments that may aid physicians in detecting PPD. Among these is the Edinburgh Postnatal Depression Scale, a diagnostic tool developed in 1987 that contains 10 questions pertaining to emotions experienced in the previous week. This tool may be used in the six to eight weeks following childbirth.

Some questions that are usually asked during the Edinburgh Postnatal Depression Scale include:

• How often have you been able to laugh and see the funny side of things?
• How often have you looked forward with enjoyment to things?

Women experiencing symptoms of PPD and/or confusion or agitation may be screened for postpartum psychosis (PPP), an extreme form of PPD that is often accompanied by hallucinations and delusional thinking. To determine whether a patient is experiencing PPP, the physician may ask questions such as:

• Have you heard voices or seen things that others do not see or hear?
• Have you had thoughts of harming the baby or others?