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Postpartum Depression

Postpartum depression is not really a separate mood disorder from major depression or bipolar disorder. The word, "postpartum" is a specifier used as additional diagnostic information to describe the onset or occurrence of the depressive episode associated with major depression or bipolar disorder. For instance, a person could receive the following diagnosis:

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This Isn't What I Expected: Overcoming Postpartum Depression,
by K. Kleiman, V. D. Raskin

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Major Depressive Disorder, Single Episode, Moderate, With Postpartum Onset

"With Postpartum Onset" describes an uncommon depressive episode that begins within four weeks of giving birth to a child and may affect up to 10% of new mothers. It is very different than the "baby blues" that women can experience usually 3-7 days after delivery. Many women with postpartum depression may experience great anxiety, panic attacks, spontaneous crying, difficulty sleeping, and a lack of interest in their new child. A woman's mood may fluctuate and seem inconsistent, and there may even be the presence of psychotic features (delusions, hallucinations). If this is the case, a woman should receive immediate medical attention and hospitalization may be necessary. Whether or not psychotic features are present, a woman may have suicidal thoughts, continuous thoughts about violence towards her child, a difficulty with concentration, and she may feel and appear to be quite agitated.

With regard to psychotic features, if a woman experiences delusions they may be about the child. For instance, a woman may believe that her child is evil, that he/she is doomed somehow, or that he/she is gifted with magical powers. Although a woman may harm or even kill her child when she is not experiencing psychotic symptoms, it tends to be more common when a psychosis is present. She may hear voices telling her to kill the child, or may harm the child as a result of certain delusions or beliefs about the child.

Psychotic symptoms may occur in 1in 500-1000 births and may be more frequent in women who have given birth for the first time. If a woman experiences a postpartum depression with psychotic features, her risk of developing it again with future deliveries may be between 30% and 50%. For those who have already had postpartum depression, their risk of a second episode with psychotic features is higher. The risk is also higher for those who previously have had a mood disorder.

Many women are frequently reluctant to tell anyone about their negative or depressive thoughts and feelings. They often feel quite guilty about them since they believe that having a new child is a time when they should feel very happy. Postpartum depression is a condition that is very treatable. Leaving it untreated can sometimes affect the quality of bonding and relationship between a mother and her child.



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