Postpartum depression poorly understood

June 21, 2001

By Dr. Sanjay Gupta CNN Medical Correspondent

Postpartum depression is a widely studied yet poorly understood entity.

Of the nearly 4 million births each year, more than 40 percent of the mothers are affected by a mood disorder. Most commonly, it is the "baby blues," a mild disorder that typically occurs three to five days after the birth and doesn't usually last more than two weeks.

More serious is actual postpartum depression, which affects 10 percent to 15 percent of women. This is characterized by constant fatigue, withdrawal from family, and poor eating and sleeping habits. Postpartum depression starts within four weeks after delivery and can last more than a year if untreated.

Postpartum psychosis is the most dramatic and least common, affecting only 0.1 percent to 0.2 percent of all mothers. It is marked by hallucinations and delusions that often focus on the infant dying or being demonic. Often, mothers are overcome by feelings of worthlessness and inadequacy. The risk of infanticide and suicide is much higher in this group.

Postpartum depression is likely caused by numerous factors. There are likely hormonal factors associated with the delivery of the child. Estrogen levels can drop by 90 percent to 95 percent after birth, and this is associated with mood. There are also psychological factors, such as previous history of depression or a family history of it.

There are treatments available for postpartum depression, even for breast-feeding women. The key still lies in early recognition. If the symptoms persist for more than a few weeks or appear to worsen, a physician should be consulted.