Frequently Asked Questions - Postpartum Depression

Postpartum mood disorders encompass a wide range of conditions which differ in scope, symptoms, duration, and severity ranging from the well-known “baby or maternity blues”, which affects an estimated 85% of women, to the most severe form of PPD, postpartum psychosis, which affects an estimated 0.1% to 0.2% of women.

The “baby or maternity blues”  

Typically begins on the third or fourth day after delivery and may include such symptoms as tearfulness, anxiety, irritability, insomnia, poor concentration, fearfulness, and emotional instability. This condition is often transient and disappears by about one to two weeks. For a few women, however, the condition may last longer and become a
more serious mood or anxiety disorder.

Postpartum depression (major depressive disorder with postpartum onset)

This condition is estimated to affect approximately 10 to 15% of women and often begins within two weeks to six months after delivery. In addition to some of the classic symptoms of depression or anxiety, women might also exhibit extreme irritability, panic attacks, obsessive-compulsive symptoms, and intrusive thoughts about harming the baby. This condition is more common in women who have previously experienced depression but many women experience first episodes after pregnancy. This condition responds well to treatment.

Postpartum psychosis

The most serious of the postpartum disorders, this condition affects about 1 to 2 in 1,000 new mothers. Onset is rapid, sudden, and very dramatic, often within days to weeks of delivery. It can be characterized by psychotic depression, mania, hallucinations (hearing or seeing things that other people cannot),delusions (fixed, false beliefs), extreme confusion and suicidal thoughts. It is a serious condition that requires rapid treatment for the safety of the mother and her baby. This condition is more common in women with bipolar disorder.

Postpartum mood disorders can develop after the birth of any child. Women may be a greater risk of developing a postpartum mood disorder if:

• Feeling restless or slowed down
• Feeling sad most of the day
• Loss of interest or pleasure in all or most things, including the baby
• Extreme irritability, frustration, or anger
• Feelings of hopelessness
• Trouble sleeping even when the baby is sleeping
• Loss of appetite or eating too much
• Difficulty thinking, concentrating or making decisions
• Crying for no reason
• Overwhelming feelings of guilt, worthlessness or inadequacy
• Scary thoughts about harming your baby
• Anxiety or panic attacks
• No desire to be with friends or family
• Excessive worrying about your baby’s health
• Suicidal thoughts or frequent thoughts of death

Postpartum Psychosis:

• Hallucinations and delusions
• Paranoia
• Confusion and disorientation
• Attempts to harm yourself or the baby

If you are experiencing some of these symptoms, and they have lasted for more than two weeks, you may be experiencing a postpartum mood disorder and should seek prompt professional help. 

• Write down any symptoms you’ve had, and for how long
• Write down key personal information
• Make a list of all medications you are taking, and any previous mood disorders you have had
• Write down questions to ask your doctor
• Take a family member or friend along

Discuss all of your symptoms with your doctor and describe how they are affecting your life (e.g. inability to care for the baby). Your doctor can suggest or provide appropriate therapy. Make sure to discuss all of the available treatments and medications and their benefits and side effects before making any decisions.

There are a variety of very effective treatments for postpartum mood disorders including:

•  Psychotherapy(individual or family)
•  Participation in postpartum support groups
•  Antidepressant medications

The most important step to take is to become more knowledgeable about PPD and seek help.

• Stick to your treatment plan. Don’t skip psychotherapy sessions. Even if you’re feeling well, continue to take medication as prescribed.
• Set realistic expectations. Be kind to yourself. Don’t pressure yourself to do everything. Ask for help when you need it.
• Learn about postpartum mood disorders. Empower yourself by learning about your condition.
• Pay attention to the warning signs. Find out what triggers your mood disorder. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes. Ask friends or family to watch out for warning signs.
• Get exercise. Physical activity may help reduce symptoms.  Take a daily walk with your baby, or get together with other new moms for regular exercise.
• Maintain an adequate diet. The Canada Food Guide is a useful reference in helping you choose how to eat well. Choose more protein and Omega 3, and fewer simple carbohydrates.
• Avoid alcohol and illicit drugs. It may seem like they lessen your problems, but in the long run, they generally worsen symptoms and make the depression harder to treat.
• Get adequate sleep. This is especially important. Ask for support from friends and family in minding the baby so you can get some sleep.

Women’s Peer Support Group
Mood Disorders Association of Ontario 36 Eglinton Avenue West, Suite 602, Toronto, ON Telephone: 416.486.8036 Toll-free: 1.866.486.6663

Maternal Support Programs
Women’s Health Centre St. Joseph’s Health Centre,Toronto, ON Telephone: 416.530.6850

Postpartum Support Group, London
Child Reach Resource Centre 265 Maitland Street, London
every Thursday morning (group not available in July and August)
Telephone: 519.434.3644

Mothers Offering Mothers Support, Ottawa
Parent Resource Centre Telephone: 613.565.2467 ext. 410

Postpartum Support International (information for moms, their partners and link to chat room)

Online Postpartum Depression Support Group

Pacific Postpartum Support Society

Postpartum Depression