Causes of Postpartum Depression

No one knows the exact causes of postpartum depression. Postpartum depression is more than the "baby blues" — it lasts longer and is more severe. Unlike the baby blues, which typically resolve within 10 days after delivery, postpartum depression symptoms linger. The baby blues cause mild sadness and mood swings. Postpartum depression causes severe depression and loss of interest in life.

After pregnancy, progesterone levels fall drastically. Like progesterone, the levels of estrogen, a hormone that seems to be important in memory and mood, fall dramatically in the first 48 hours following delivery. Thyroid levels may also drop sharply after birth. A thyroid deficiency can produce symptoms that mimic postpartum depression, such as:

• Anxiety
• Fatigue
• Insomnia
• Mood swings
• Severe agitation.

Postpartum Depression Causes

Common emotional postpartum depression causes include:

• Deep concern and pressures about being the "perfect mother"
• Feelings of loss (loss of identity, loss of control, loss of body image)
• Financial worries
• Personal history and feelings about parenting
• Resurgence of sad feelings about past losses
• Sadness about having less time to spend with the baby's father
• Stress related to a woman's job and responsibilities outside and inside the home.

Some physical causes of postpartum depression symptoms include:

• Confinement to indoors for long periods of time
• Shifts in the levels of hormones like progesterone, estrogen and thyroid during pregnancy and after birth
• Sleep deprivation and exhaustion, especially after a cesarean delivery.

Researchers are also investigating possible genetic causes of postpartum depression.

Who Is at Risk for Postpartum Depression?

Postpartum depression can affect any woman who has recently given birth. Women can experience postpartum depression symptoms regardless of:

• Age
• Number of children born
• Number of pregnancies
• Socioeconomic status.

Pregnancy itself can put a woman at risk for postpartum depression. Any woman who has recently delivered a baby, miscarried or weaned a child from breastfeeding can suffer from postpartum depression symptoms. In fact, even women who have adopted a child can suffer from postpartum depression symptoms — this is called post-adoption depression.

Women who are at a particularly high risk for postpartum depression are those who:

• Have a family history of depression or anxiety disorders
• Have been victims of physical or sexual abuse, either in childhood or as an adult
• Have lost a child.

Other possible postpartum depression causes or risk factors include:

• A history of severe PMS
• Previous episodes of postpartum depression
• Unplanned pregnancy.

Women who go through particularly stressful pregnancies, with problems such as prenatal complications or a difficult delivery, stand a greater chance of developing postpartum depression symptoms than women with routine pregnancies.

Resources

Mayo Clinic Staff. (2008). Postpartum depression. Retrieved April 22, 2010, from the Mayo Clinic website: http://www.mayoclinic.com/health/postpartum-depression/ds00546/dsection=symptoms.

O'Hara, M.W. (1995). Postpartum depression. Series in Psychopathology, 1-27. Alloy, L. B. (ed). Springer-Verlag, New York.

Smith, M. and Jaffe, J. (2007). Postpartum depression and the baby blues. Retrieved April 22, 2010, from the Help Guide website: http://helpguide.org/mental/postpartum_depression.htm#causes.