Postpartum Depression

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I decided to write a blog about postpartum depression (PPD) because I was glad and encouraged to see new mothers seeking help in my private practice to treat it. This is a promising new trend (at least in my practice) considering it is one of the most common problems associated with childbirth and general statistics show that 50% of mothers suffering from PPD go undetected. In the absence of treatment, the patient and their family could feel great deal of inadequacy, insecurity, anxiety, and emotional pain. Therefore, their presence in my office means that they were able to recognize the signs of PPD and were able to seek help for it. I would like to think that a combination of public health education and doctor’s conscientiousness has alerted the general public to this common problem. Or, perhaps hearing disclosures from celebrities, such as Courtney Cox and Brooke Shields have also helped women better understand the symptoms and effects of PPD and reduce the cultural stigma of dealing with this mental illness.

All the same, this blog will reinforce the message that PPD is not a trifle, but an important problem in its own right. Postpartum depression is essentially major depression, which has its onset postpartum. For those of you who are currently questioning whether you are experiencing PPD, here is some information to help you decide whether you might need to seek help and support:

How To Recognize Postpartum Depression

The symptoms of PPD resemble major depression but are triggered by the onset of childbirth. It affects the patient’s level of functioning and quality of life.

  • Crying often or tearful
  • Little interest in the baby
  • Loss of energy, appetite, and motivation to do things
  • Feeling irritable, agitated or anxious
  • Have negative feelings, such as sadness, worthlessness, hopelessness, helplessness, and guilt
  • Having difficulties falling asleep, staying asleep, or sleeping more than usual
  • Questioning whether life is worth living
  • Experiencing fatigue and exhaustion
  • Usually occurs within the first 3 months after delivery but can occur up to a year later

Not all mothers or fathers seeking help for PPD in my practice actually have it because it is often confused with having baby blues. Instead, they are informed them that the majority of new mothers and 10% of fathers experience baby blues, which is a less severe form of PPD. They may experience to a lesser degree some fatigue, difficulties sleeping, loss of appetite, mood swings, and feelings of anxiety. However, these symptoms do not interfere with the patient’s daily life, lasts less than 2 weeks after giving birth, and does not require treatment.

Causes of Postpartum Depression

Different investigators agree that there is no single cause for PPD but rather a combination of hormonal, psychological, environmental, and genetic factors that predispose a patient to develop PPD.

Known Risk Factors

  • History of depression or bipolar disorder
  • Victims of partner abuse, including emotional abuse
  • Marital problems and dissatisfaction
  • Stressful life events
  • Low income
  • Lack of social support

If you suspect that you might be experiencing the symptoms of PPD, you can answer and score the Edinburgh Scale Test found in the pdf version below to determine whether you need to speak to mental health provider. This test alone is not diagnostic of PPD but helps screen for symptoms that are a sign of PPD. If you score 10 or more or answer 1 to question #10, then speak to your family doctor or mental health provider immediately.

Edinburgh Scale Test

Reference for Edinburg’s Scale Test and Scoring Instructions:
Cox, J.L., Holden, J.M., & Sagovsky, R., 1987. Detection of postnatal depression:
Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782-786.

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About the Author:

Dr Chow is a licensed clinical psychologist with a private clinic in Saint-Laurent (Montreal) and in Saint-Lambert on the South Shore. She received her doctorate in Clinical Psychology from Concordia University. She is also a member of the Order of Psychologists of Quebec.