Postpartum depression can strike fathers and adoptive parents, not only birth mothers
Roughly 10 to 20 percent of new mothers develop depression after birth, and in about half of cases seen at one clinic it began before delivery. It is not only mothers: estimates suggest 8 to 10 percent of fathers are affected too, and adoptive parents report similar struggles with sleep loss and stress.
Most women feel a short spell of worry or low mood after childbirth. Postpartum depression is suspected when symptoms are severe and persist beyond two weeks: deep sadness, exhaustion, anxiety, irritability, a sense of failing as a carer and loss of pleasure in ordinary life. It usually begins between two weeks and a month after delivery but can appear any time in the first year and may last for months. Officially, the DSM-5 does not treat it as a separate disorder but as a major depressive episode with peripartum onset.
The cause is unknown, and likely mixes hormones, sleep deprivation, genetics and social pressures. Estrogen and progesterone fall back to pre-pregnancy levels within a day of birth, and that abrupt drop is one suspect. Allopregnanolone, a progesterone derivative that acts on the brain's calming GABA receptors, also plunges after delivery. Brain scans show mothers with the condition have reduced activity in the left frontal lobe and weaker links between regions such as the amygdala and hippocampus. Earlier depression, bipolar disorder, a difficult birth and lack of support all raise the risk.
The effects ripple outward. Babies of affected mothers cry more and sleep worse, and breastfeeding is started and sustained less often. Untreated cases have been linked with later difficulties in children's emotional control. A 2013 Japanese study found 13.6 percent of fathers affected within four months, with male cases peaking three to six months after birth and tracking the mother's mood; children of fathers with depression face a 33 to 70 percent higher risk of emotional or behavioural problems.
Support at home, such as help with meals, chores and companionship, may protect those at risk. Talking therapies including cognitive behavioural and interpersonal therapy are effective, and there is tentative evidence for SSRI antidepressants. A much rarer and more severe condition, postpartum psychosis, affects about 1 to 2 in every 1,000 women after childbirth.
Source: Postpartum depression
