Postpartum Depression

Postpartum depression (PPD) is a mood disorder occurring after childbirth, characterized by persistent sadness, anxiety, irritability, and impaired maternal functioning, beyond the transient 'baby blues'.

Definition

Postpartum depression (PPD) is a mood disorder occurring after childbirth, characterized by persistent sadness, anxiety, irritability, and impaired maternal functioning, beyond the transient 'baby blues'.

Epidemiology

Affects 10–20% of new mothers worldwide
Typically develops within the first 4–12 weeks postpartum, but can occur up to 1 year
Risk factors include previous depression, lack of social support, and stressful life events
Higher prevalence in women with complicated pregnancies or deliveries
Can occur after both vaginal and cesarean deliveries

Etiology

Hormonal changes postpartum (rapid drop in estrogen and progesterone)
Psychosocial stressors: sleep deprivation, role transition, lack of support
History of depression or anxiety disorders
Complications during pregnancy or delivery
Socioeconomic stressors and relationship difficulties
Genetic vulnerability and neurobiological factors

Pathophysiology

Altered neurotransmitter function: serotonin, dopamine, norepinephrine
HPA axis dysregulation and stress response changes
Neuroinflammatory changes contributing to mood dysregulation
Sleep disruption exacerbating emotional dysregulation
Cognitive and emotional processing alterations
Interaction of hormonal and environmental stressors
Epigenetic changes may increase susceptibility in vulnerable individuals