Topic Overview
What is postpartum depression?
Postpartum
depression is a serious illness that can occur in the first few months after
childbirth. It also can happen after
miscarriage and stillbirth.
Postpartum
depression can make you feel very sad, hopeless, and worthless. You may have
trouble caring for and bonding with your baby.
Postpartum
depression is not the "baby blues," which many women have in the first couple
of weeks after childbirth. With the blues, you may have trouble sleeping and
feel moody, teary, and overwhelmed. You may have these feelings along with
being happy about your baby. But the "baby blues" usually go away within a
couple of weeks. The symptoms of postpartum depression can last for
months.
In rare cases, a woman may have a severe form of
depression called
postpartum psychosis. She may act strangely, see or
hear things that aren't there, and be a danger to herself and her baby. This is
an emergency, because it can quickly get worse and put her or others in
danger.
It's very important to get treatment for depression. The
sooner you get treated, the sooner you'll feel better and enjoy your
baby.
What causes postpartum depression?
Postpartum
depression seems to be brought on by the changes in
hormone levels that occur after pregnancy. Any woman
can get postpartum depression in the months after childbirth, miscarriage, or
stillbirth.
You have a greater chance of getting postpartum
depression if:
- You've had
depression or postpartum depression
before.
- You have poor support from your partner, friends, or
family.
- You have a sick or
colicky baby.
- You have a lot of other
stress in your life.
You are more likely to get postpartum psychosis if you or
someone in your family has
bipolar disorder (also known as
manic-depression).
What are the symptoms?
A woman who has postpartum
depression may:
- Feel very sad, hopeless, and empty. Some
women also may feel
anxious.
- Lose pleasure in everyday
things.
- Not feel hungry and may lose weight. (But some women feel
more hungry and gain weight).
- Have trouble
sleeping.
- Not be able to concentrate.
These symptoms can occur in the first day or two after
the birth. Or they can follow the symptoms of the baby blues after a couple of
weeks.
If you think
you may have postpartum depression, take a short quiz to check your symptoms:
- Interactive Tool: Are You Depressed?
A woman who has
postpartum psychosis may feel cut off from her baby. She may see and hear
things that aren't there. Any woman who has postpartum depression can have
fleeting thoughts of suicide or of harming her baby. But a woman with
postpartum psychosis may feel like she has to act on these thoughts.
If you think you can't keep from hurting yourself, your baby, or someone
else, see your doctor right away or call 911 for emergency medical care. For
other resources, call:
- The
national suicide hotline at 1-800-273-TALK (1-800-273-8255).
- The National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453).
How is postpartum depression diagnosed?
Your
doctor will do a physical exam and ask about your symptoms.
Be
sure to tell your doctor about any feelings of baby blues at your first checkup
after the baby is born. Your doctor will want to follow up with you to see how
you are feeling.
How is it treated?
Postpartum depression is
treated with counseling and antidepressant medicines. Women with milder
depression may be able to get better with counseling alone. But many women need
counseling and medicine. Some antidepressants are thought to be safe for women who
breast-feed.
To help yourself get better, make sure you eat well,
get some exercise every day, and get as much sleep as possible. Seek support
from family and friends if you can.
Try not to feel bad about
yourself for having this illness. It doesn't mean you're a bad mother. Many
women have postpartum depression. It may take time, but you can get better with
treatment.
Frequently Asked Questions
Learning about postpartum depression: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Cause
Postpartum depression (PPD) seems to be
triggered by the sudden
hormone changes that happen after childbirth. These
hormonal changes most commonly lead to postpartum depression when paired with
risk factors such as previous depression (including
bipolar disorder), poor support from your partner,
friends, and family, or a high level of stress.1
The
hormone changes and grief following
miscarriage and stillbirth also trigger PPD in many
women.1
Symptoms
Postpartum blues. A
certain amount of
insomnia, irritability, tears, overwhelmed feelings,
and mood swings are normal during the first days after childbirth. These "baby
blues" usually peak around the fourth postpartum day and subside in less than 2
weeks, when hormonal changes have settled down. If you have postpartum blues
after childbirth, you're not alone—more than half of women have temporary mild
symptoms of depression mixed with feelings of happiness after having a
baby.2
Be sure to report any feelings of
postpartum blues to your doctor at your first postpartum checkup, so he or she
can follow up with you.
Postpartum depression (PPD). Symptoms of
postpartum depression can follow postpartum blues.
They can feel like more of the same or can feel worse than before. Postpartum
depression can also happen months after childbirth or pregnancy loss. In some
cases, symptoms peak after slowly building for 3 or 4 months. Possible PPD
symptoms require evaluation by a doctor.
If you have postpartum
depression, you have had five or more depressive symptoms (including one of the
first two listed below) for most of the past 2 weeks, including:1, 2
- Depressed mood—tearfulness, hopelessness, and
feeling empty inside, with or without severe
anxiety.
- Loss of pleasure in either all
or almost all of your daily activities.
- Appetite and weight
change—usually a drop in appetite and weight but sometimes the
opposite.
- Sleep problems—usually trouble with sleeping, even when
your baby is sleeping.
- Noticeable change in how you walk and
talk—usually restlessness, but sometimes sluggishness.
- Extreme
fatigue or loss of energy.
- Feelings of worthlessness or guilt, with
no reasonable cause.
- Difficulty concentrating and making
decisions.
- Thoughts about death or suicide. Some women with PPD
have fleeting, frightening thoughts of harming their babies. These thoughts
tend to be fearful thoughts, rather than urges to harm.
Early treatment of PPD is important for both you and your
baby. If you think
you may have postpartum depression, take a short quiz to check your symptoms:
- Interactive Tool: Are You Depressed?
Postpartum psychosis. This severe condition is most likely to affect women with
bipolar disorder or a history of
postpartum psychosis. Symptoms, which usually develop
during the first 3 postpartum weeks (as soon as 1 to 2 days after childbirth),
include:13
- Feeling removed from your baby, other people,
and your surroundings (depersonalization).
- Disturbed sleep, even
when your baby is sleeping.
- Extremely confused and disorganized
thinking, increasing your risk of harming yourself, your baby, or another
person.
- Drastically changing moods and
bizarre behavior.
- Extreme agitation or restlessness.
-
Unusual
hallucinations, often involving sight, smell, hearing,
or touch.
- Delusional thinking that isn't based in
reality.
Postpartum psychosis is considered an emergency requiring
immediate medical treatment. If you have any psychotic symptoms,
seek emergency help immediately. Until you tell your
doctor and get treatment, you are at high risk of suddenly harming yourself or
your baby.
What Happens
Postpartum blues and depression
Over half of all
women have some mood-related symptoms during the first 2 weeks after
childbirth. Most women with postpartum blues, or "baby blues," find that their
mood swings, insomnia, overwhelmed feelings, and agitation go away within 2
weeks. But some women have longer-lasting
postpartum depression (PPD) in the weeks to months
after childbirth. The
hormone changes and grief following
miscarriage and stillbirth also trigger PPD in many
women.1
Postpartum depression makes it
hard for you to function well, including caring for and bonding with your baby.
Babies of depressed mothers tend to be poorly attached to their mothers and to
be slower in behavior, language, and mental development.1
Prompt
PPD treatment is important for both you and your baby. The earlier you are
treated, the more quickly you will recover, the less your chances of repeat
depression, and the less your baby's development will be affected by your
condition.
Postpartum psychosis
In rare cases (up to 1 out
of 500), dangerous
postpartum psychosis symptoms—such as bizarre
behavior, sight-, smell-, hearing-, or touch-related hallucinations, feeling
detached from others and reality, and urges to hurt oneself or others—can
suddenly occur within the first 3 postpartum weeks, as soon as 1 to 2 days
after childbirth.1 These symptoms tend to be more
severe than those of
psychosis unrelated to childbirth and can trigger
life-threatening behaviors without warning. Postpartum psychosis is more likely
to affect women who have
bipolar disorder or have had postpartum psychosis
before.1
Postpartum psychosis is
considered an emergency requiring immediate medical treatment and follow-up
care. Often, psychotic symptoms that have been successfully treated can still
be followed by postpartum depression symptoms that require further
treatment.
For more information about what increases your chances
of having postpartum depression and psychosis and of having them after more
than one pregnancy, see the What Increases Your Risk section of this topic.
What Increases Your Risk
Every woman is at risk for
temporary "postpartum blues" during the first 2 weeks after childbirth, because
of sudden
hormone changes and the challenges of caring for a
newborn. Women who have miscarried or had a stillbirth are also at risk.
But there
are also known factors that increase your risk of having long-term depression
after pregnancy. If you have had postpartum depression before, you are at high
risk of having it again. Other risk factors
include:1
- Poor support from family, partner, and
friends.
- High life stress, such as a sick or
colicky newborn, financial troubles, or family
problems.
- Physical limitations or
problem symptoms after childbirth.
- Depression during a current pregnancy.
- Previous depression.
- Bipolar disorder, also known as
manic-depression, which also increases the risk of dangerous
psychotic behavior after childbirth.
- A family history of depression or bipolar
disorder.
- Previous
premenstrual dysphoric disorder (PMDD), which is the
severe type of
premenstrual syndrome (PMS).
Postpartum psychosis
Risk factors for postpartum
psychosis include:1
- A personal or family history of
bipolar disorder. Women with this risk factor are three
times more likely to have postpartum psychosis symptoms than women with no
bipolar history.4
- Previous postpartum
psychosis.
If you have had postpartum psychosis before, you are at
high risk for having psychotic symptoms again in the future.4 Your doctor will want to watch you closely, particularly if
you become pregnant again.
When To Call a Doctor
Call 911 or other emergency services if you think you cannot keep from harming
yourself, your baby, or another person. You can also call the national suicide
hotline at 1-800-273-TALK (1-800-273-8255) or the National Child
Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453).
Call your doctor immediately if:
- You are not having symptoms of
postpartum depression (listed below), but you have
hallucinations involving smell, touch, hearing, or
sight or have thoughts that may not be based in reality (delusions). Examples of delusions are fears that
someone is watching you, stealing from you, or reading your mind.
- You have severe symptoms of postpartum depression.
- You have any
symptoms of depression and have had depression or
postpartum depression before.
- You have had any symptoms of
depression for longer than 2 weeks. You don't necessarily have all possible
symptoms when you have depression. Call sooner rather than later, before your
condition gets worse.
Symptoms of postpartum depression include:
- Depressed mood—tearfulness, hopelessness, and
feeling empty inside, with or without severe
anxiety.
- Loss of pleasure in either all
or almost all of your daily activities.
- Appetite and weight
change—usually a drop in appetite and weight, but sometimes the
opposite.
- Sleep problems—usually trouble with sleeping, even when
your baby is sleeping.
- Noticeable change in how you walk and
talk—usually restlessness, but sometimes sluggishness.
- Extreme
fatigue or loss of energy.
- Feelings of worthlessness or guilt, with
no reasonable cause.
- Difficulty concentrating and making
decisions.
- Thoughts about death or suicide. Some women with PPD
have fleeting, frightening thoughts of harming their babies. These tend to be
fearful thoughts, rather than urges to harm.
Watchful Waiting
If your symptoms are new and not severe, you can
wait up to 2 weeks to see if they will go away. Otherwise, call your doctor as
soon as you notice symptoms. The earlier you are treated, the more quickly you
will recover and the less your baby's development will be affected by your
condition.
Who To See
Your
obstetrician may be the first doctor to note and
diagnose PPD. This is one of many reasons why it's important to have a medical
check 3 to 6 weeks after childbirth. Treatment for PPD ideally involves both
medicine and some form of professional counseling. To effectively treat
depression, it's important that you and your counselor have a comfortable
relationship.
Diagnosis and medication management of postpartum
depression can be provided by a:
Professional counseling can be provided by a:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Postpartum depression is a medical condition that requires treatment, not a sign of
weakness. It isn't always obvious to an observer, and there are no laboratory
tests for depression. This is why it's important that you tell your doctor
about your symptoms.
Your doctor will diagnose and
recommend treatment for postpartum depression if you've had five or more of the
following symptoms (including the first or second) for most of each day over
the past 2 weeks:1
- Depressed mood—tearfulness, hopelessness, and
feeling empty inside, with or without severe
anxiety
- Loss of pleasure in either all or
almost all of your daily activities
- Appetite and weight
change—usually a drop in appetite and weight, but sometimes the
opposite
- Sleep problems—usually trouble with sleeping, even when
your baby is sleeping
- Noticeable change in how you walk and
talk—you may seem restless or move very slowly
- Extreme fatigue or
loss of energy
- Feelings of worthlessness or guilt, with no
reasonable cause
- Difficulty concentrating and making decisions
- Thoughts about death or suicide
If you think
you may have postpartum depression, take a short quiz to check your symptoms:
- Interactive Tool: Are You Depressed?
Although the most disturbing symptoms can be the hardest to
talk about, it's especially important to tell your doctor about any urges to
harm yourself or your baby. If you have compelling thoughts about hurting
yourself or others, you must tell your doctor immediately and get
treatment.
In addition to screening you for depression, your
doctor may also check your
thyroid-stimulating hormone (TSH) levels to make sure
a
thyroid problem isn't contributing to your
symptoms.
Early Detection
If you have had
depression,
postpartum depression, or
postpartum psychosis before, are now pregnant and have
depression, or have
bipolar disorder, ask your doctor and family members
to watch you closely. Some experts suggest that high-risk women have their
first postnatal checkup 3 or 4 weeks after childbirth, rather than the usual 6
weeks.
Treatment Overview
Early treatment of
postpartum depression (PPD) is important for you, your
baby, and the rest of your family. The sooner you start, the more quickly you
will recover, and the less your depression will affect your baby. Babies of
depressed mothers can be less attached to their mothers and lag behind
developmentally in behavior and mental ability.1
Treatment choices for postpartum depression include:
- Counseling for both you and your
partner. Cognitive-behavioral therapy helps you take charge of the way
you think and feel.
Interpersonal counseling is also a good treatment
choice for postpartum depression. (You may find a counselor who offers both
cognitive-behavioral therapy and interpersonal counseling.) Interpersonal counseling focuses on
relationships and the personal changes that come with having a new baby. It
gives you emotional support and helps with problem solving and goal setting.
For your partner, counseling may help with the demands of having a new baby. It
can also help your partner support you.
- Antidepressant medicine, which effectively
relieves symptoms of postpartum depression for most women. Breast-feeding is
also important for your baby, so talk to your doctor and your baby's doctor
about an antidepressant medicine you can use while breast-feeding. Certain
selective serotonin reuptake inhibitors (SSRIs) and
tricyclic antidepressants are considered relatively
safe for use while you are breast-feeding.5
Talk to your doctor about your symptoms and decide on what
type of treatment is right for you. Counseling and support are considered a
first-line treatment for mild to severe PPD. Women with mild PPD are likely to
benefit from counseling alone. Those with moderate to severe PPD are advised to
combine counseling with antidepressant medicine.
You may also benefit from:
- A part-time or full-time mother's helper.
- Parent coaching or infant massage classes, for
strengthening mother-baby attachment.
Your doctor may recommend a licensed counselor who
specializes in treating postpartum depression.
What To Think About
Can I take antidepressant medicine and breast-feed my baby?
Treating your depression is very important for your baby.
Breast-feeding is good for your baby's health and your
baby's bond with you, too. At best, you will be able to treat your depression
and breast-feed your baby. But if you decide to choose
between taking medicine and breast-feeding, treat your depression.
Talk to your doctor and your baby's doctor about your antidepressant
choices. Any antidepressant can get into breast milk, but some antidepressants
do so in such small amounts that they can't be measured in the baby's blood.
- Of the SSRIs, sertraline (Zoloft) is
usually the first-choice medicine for breast-feeding mothers. It is most
studied and generally does not seem to affect breast-feeding babies.5
- There have been reports of side effects in
babies exposed to paroxetine (Paxil), fluoxetine (Prozac), and citalopram
(Celexa).6, 7
- Fluvoxamine (Luvox) has not been well studied.
Some SSRIs, such as fluoxetine, are passed on to the
breast-fed baby more than others. And every woman uses (metabolizes) and passes
on medicine in different amounts. The level of medicine in your breast milk
depends in part on when you take your daily dose. Talk to your doctor about
when the level of medicine in your breast milk is lowest.
Researchers are studying children who breast-fed while their mothers took
SSRIs. So far, they have seen no signs of unusual problems in these children
into their preschool years.4
How long do I need to take antidepressant medicine for postpartum depression?
Antidepressants are typically used for 6
months or longer, first to treat postpartum depression and then to prevent a
relapse of symptoms. To prevent a relapse, your doctor may recommend that you
take medicine for up to a year before considering tapering off of it. Women who have had several bouts of depression may need to take medicine for a long time.
Prevention
Although you can't prevent the postpartum
hormone changes that cause
postpartum blues, you can take steps to prevent
ongoing
postpartum depression (PPD). If you have a history of
depression or postpartum depression, you and your doctor have some other
prevention options.
Basic prevention measures for every woman
To
minimize the effects of postpartum hormonal changes and stress, keep your body
and mind strong.
- Ask for help from others, so you can get as
much sleep, healthy food, exercise, and overall support as possible.
- Stay away from alcohol, caffeine, and other drugs or medicines
unless recommended by your doctor.
- Close monitoring after
childbirth is important. If you are worried about developing PPD, have your
first postnatal checkup 3 or 4 weeks after childbirth rather than the typical 6
weeks.
Prevention measures for high-risk women
If you
have had depression or postpartum depression before, you and your doctor can
plan ahead to reduce your higher risk of postpartum depression. Think about the
following options if you have:
- A history of depression. If you have no depressive symptoms late in a first
pregnancy,
watchful waiting is recommended. But if you have a
history of severe depression, some experts recommend counseling and support
before childbirth. You and your doctor may choose to start antidepressant
medicine after the birth to prevent PPD, particularly if you have had PPD
before.
Depression: Should I Take Antidepressants While I'm Pregnant?
- A history of PPD. After
childbirth, don't wait till symptoms develop—start with counseling and support
(some women start counseling a couple of months before childbirth). You and
your doctor may choose a combination of counseling and an
antidepressant.
- Depression during pregnancy. If you are taking an
antidepressant medicine during pregnancy, continue taking it into the
postpartum period to reduce your high risk of postpartum depression.
Home Treatment
Postpartum depression is a medical condition, not a sign of weakness. Be honest
with yourself and those who care about you. Tell them about your struggle. You,
your doctor, and your friends and family can team up to treat your
symptoms.
- Schedule outings and visits with friends and
family, and ask them to call you regularly. Isolation can make depression
worse, especially when it's combined with the stress of caring for a
newborn.
- Eat a balanced diet. If you have little appetite, eat
small snacks throughout the day. Nutritional supplement shakes are also useful
for keeping up your energy.
- Get regular daily exercise, such as
outdoor stroller walks. Exercise helps improve mood.
- Get as much
sunlight as possible. Keep your shades and curtains open, and get outside as
much as you can.
- Ask for help with food preparation and other daily
tasks. Family and friends are often happy to help a mother with newborn
demands.
- Avoid alcohol and caffeine. Avoid using alcohol or other
substances to feel better (self-medicating). Talk to your doctor if you're
having symptoms that need treatment.
- Don't overdo it, and get as
much rest and sleep as possible. Fatigue can increase depression.
-
Join a support group of new mothers. No one can better understand and support
the challenges of caring for a new baby than other postpartum women. For more
information on support groups, talk to your doctor or see the Web site of
Postpartum Support International at www.postpartum.net.
For more information on how to cope with your symptoms,
see:
Depression: Managing Postpartum Depression.
The potential for domestic violence increases during a
woman's pregnancy and when a couple is adjusting to a new baby. If your partner
is violent or emotionally abusive, you and your baby are physically at risk,
and you have an higher risk of postpartum depression. Now more than ever, it's
crucial that you protect yourself and your baby—seek support and help. For more
information, see the topic
Domestic Violence.
Medications
Antidepressants are commonly used to treat
postpartum depression (PPD), usually in combination
with counseling and support.
- For moderate to severe PPD, experts recommend
an antidepressant combined with support and counseling.
- Some
experts recommend starting an antidepressant for prevention in women at high
risk for PPD, but so far no studies have shown this to be effective.6
Breast-feeding is good for you and your baby, both
physically and emotionally. For this reason, experts have studied which
antidepressants seem safest for breast-feeding babies. So you need not stop
breast-feeding while taking an antidepressant for postpartum
depression.
Whether or not you are
breast-feeding, your doctor is likely to recommend a selective serotonin
reuptake inhibitor (SSRI).2 This class of medicine is effective for
most women, with fewer side effects than tricyclics.
Most tricyclic antidepressants can also be used with minimal risk while a woman is
breast-feeding. But for the mother, side effects are sometimes a
problem.
Your doctor may start you out with a low dose to help you
adjust to the medicine.
Medication Choices
Selective serotonin reuptake inhibitors (SSRIs) are
usually the first-choice medicine for treating postpartum depression. Most
SSRIs are thought to be safe for use while a woman is breast-feeding, because in
general SSRIs pass into the breast milk at low levels.
Tricyclics have not caused any known breast-feeding
baby problems and are not passed on to a breast-feeding baby in measurable
amounts (with the exception of doxepin [Silenor, Zonalon], which is not
considered safe while breast-feeding).6
You may start to feel
better within 1 to 3 weeks of taking antidepressant medicine. But it can take
as many as 6 to 8 weeks to see more improvement. If you have questions or
concerns about your medicines, or if you do not notice any improvement by 3
weeks, talk to your doctor.
- Depression: Taking Antidepressants Safely
- Depression: Dealing With Medicine Side Effects
What To Think About
Antidepressants are typically
used for at least 6 months, first to treat postpartum depression and then to
prevent a relapse of symptoms. To prevent a relapse, your doctor may recommend
that you take medicine for up to a year before thinking about discontinuing it.
Women who have had several bouts of depression may need to take medicine for a long time.
Never suddenly stop taking an SSRI. An SSRI should
be tapered off slowly and only under the supervision of a doctor. Abruptly
stopping SSRI medicine can cause flu-like symptoms, headaches, nervousness,
anxiety, or insomnia.
If you are breast-feeding and taking an
antidepressant or any other medicine, let your baby's doctor know.
Taking an antidepressant you've taken before.
After having your baby, talk to your doctor before taking any medicine,
especially if you are breast-feeding. You may be more sensitive to medicine
side effects during your postpartum period, and you may need a lower dose than
before. Some medicines are considered safer than others for a woman who is
breast-feeding.
Hormone therapy.Estrogen treatment for PPD has been studied on a
limited basis.8 Estrogen therapy is unlikely to become a
common treatment for PPD, because it increases the risk of blood clots (deep vein thrombosis) and of cancer in the uterine lining (endometrium).
Other Treatment
Poor family and social support
and high stress raise the risk of
postpartum depression (PPD). For this reason, every
woman with a new baby needs plenty of support from family and friends. Any
special care you get will help you get through the challenges of the postpartum
period.
More formal PPD treatment and prevention measures include
cognitive-behavioral or interpersonal counseling. Light therapy has shown
promise as a nonmedication treatment of depression, but has not been studied
for postpartum depression. Parent coaching and infant massage can further
enrich your relationship with your baby.
In rare cases,
electroconvulsive therapy (ECT) is used to treat
severe forms of depression. Studies have shown that ECT is an effective
short-term treatment for depression.9, 10
Other Treatment Choices
Counseling
Counseling helps
prevent and treat depression during pregnancy and after childbirth. Experts recommend that both parents participate to improve
treatment success.6Cognitive-behavioral therapy and interpersonal
counseling are used to treat PPD.
- Cognitive-behavioral therapy helps you take
charge of the way you think and feel.
-
Interpersonal counseling (focusing on your relationships and the personal
adjustments of having a new baby) provides emotional support and help with
problem solving and goal setting.
Alternative therapies
- Light therapy can be used to treat depression, and it
does not have severe side effects. Studies have shown that it improves
depression during pregnancy, winter-related depression (seasonal affective disorder), and general
depression.11 It has not yet
been widely studied for postpartum depression. For light therapy, you sit in
front of a high-intensity (2,500 to 10,000 lux) fluorescent lamp every morning,
gradually building up to 1 to 2 hours a day.
- Parent coaching
offers both education and support for handling baby care and problems as well
as for the personal and couple transition into parenthood.
- Infant
massage classes teach you skills for physically and emotionally bonding with
your baby and give you a chance to spend time with other postpartum mothers.
What to Think About
Counseling and support are
considered a first-line treatment for mild to severe PPD. Women with mild PPD
are likely to benefit from counseling alone. Women with moderate to severe PPD
are advised to combine counseling with antidepressant medicine.
Other Places To Get Help
Organizations
| American Congress of Obstetricians and Gynecologists
(ACOG) |
| 409 12th Street SW |
| P.O. Box 96920 |
| Washington, DC 20090-6920 |
| Phone: | (202) 638-5577 |
| Email: | resources@acog.org |
| Web Address: | www.acog.org |
| |
American Congress of Obstetricians and Gynecologists
(ACOG) is a nonprofit organization of professionals who provide health care for
women, including teens. The ACOG Resource Center publishes manuals and patient
education materials. The Web publications section of the site has patient
education pamphlets on many women's health topics, including reproductive
health, breast-feeding, violence, and quitting smoking. |
|
| American Pregnancy Association |
| 1425 Greenway Drive |
| Suite 440 |
| Irving, TX 75038 |
| Phone: | 1-800-672-2296 |
| Fax: | (972) 550-0800 |
| Email: | questions@americanpregnancy.org |
| Web Address: | www.americanpregnancy.org |
| |
The American Pregnancy Association is a national health
organization committed to promoting reproductive and pregnancy wellness through
education, research, advocacy, and community awareness. You can call a
toll-free helpline or use the Web site to request patient education materials.
|
|
| Mental Health America |
| 2000 North Beauregard Street, 6th Floor |
| Alexandria, VA 22311 |
| Phone: | 1-800-969-NMHA (1-800-969-6642) referral service for help with depression
(703) 684-7722 |
| Fax: | (703) 684-5968 |
| TDD: | 1-800-969-6642 |
| Web Address: | www.mentalhealthamerica.net |
| |
Mental Health America (formerly known as the National
Mental Health Association) is a nonprofit agency devoted to helping people of
all ages live mentally healthier lives. Its Web site has information about
mental health conditions. It also addresses issues such as grief, stress,
bullying, and more. It includes a confidential depression screening test for
anyone who would like to take it. The short test may help you decide whether
your symptoms are related to depression. |
|
| National Women's Health Information
Center |
| 8270 Willow Oaks Corporate Drive |
| Fairfax, VA 22031 |
| Phone: | 1-800-994-9662
(202) 690-7650 |
| Fax: | (202) 205-2631 |
| TDD: | 1-888-220-5446 |
| Web Address: | www.womenshealth.gov |
| |
The National Women's Health Information Center (NWHIC)
is a service of the U.S. Department of Health and Human Services Office on
Women's Health. NWHIC provides women's health information to a variety of
audiences, including consumers, health professionals, and researchers. |
|
| Postpartum Support International |
| 927 North Kellogg Avenue |
| Santa Barbara, CA 93111 |
| Phone: | (805) 967-7636 |
| Fax: | (805) 967-0608 |
| Email: | PSIOffice@postpartum.net |
| Web Address: | www.postpartum.net |
| |
Postpartum Support International offers information and support not
only to women who are coping with postpartum depression and anxiety after
childbirth but also to their families. The Web site also includes the Mills
Depression and Anxiety Symptom-Feeling Checklist for evaluating your
symptoms. |
|
References
Citations
- O'Hara MW, Segre LS (2008). Psychologic disorders of pregnancy and the postpartum period. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 504–514. Philadelphia: Lippincott Williams and Wilkins.
- Cunningham FG, et al. (2010). Psychiatric disorders section of neurological and psychiatric disorders. In Williams Obstetrics, 23rd ed., pp. 1175–1184. New York: McGraw-Hill.
- Spinelli MG (2009). Postpartum psychosis: Detection of risk and management. American Journal of Psychiatry, 166(4): 405–408.
- Yonkers KA (2009). Management of depression and psychoses during pregnancy and the puerperium. In RK Creasy et al., eds., Creasy and Resnik's Maternal Fetal Medicine, 6th ed., pp. 1113–1122. Philadelphia: Saunders.
- Whitby DH, Smith KM (2005). The use of tricyclic
antidepressants and selective serotonin reuptake inhibitors in women who are
breastfeeding. Pharmacotherapy, 25(3):
411–425.
- Brockingham I (2004). Postpartum psychiatric
disorders. Lancet, 363(9405): 303–310.
- Weissman AM, et al. (2004). Pooled analysis of
antidepressant levels in lactating mothers, breast milk, and nursing infants.
American Journal of Psychiatry, 161:
1066–1078.
- Craig M, Howard L (2009). Postnatal depression, search date May 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Barbui C, et al. (2007). Depression in adults (drug
and other physical treatments), search date April 2006. Online version of
Clinical Evidence:
http://www.clinicalevidence.com.
- UK ECT Review Group (2003). Efficacy and safety of
electroconvulsive therapy in depressive disorders: A systematic review and
meta-analysis. Lancet, 361(9360): 799–808.
- Golden RN, et al. (2005). The efficacy of light
therapy in the treatment of mood disorders: A review and meta-analysis of the
evidence. American Journal of Psychiatry, 162(4):
656–662.
Other Works Consulted
- American College of Obstetricians and Gynecologists (2010). Screening for depression during and after pregnancy. ACOG Committee Opinion No. 453. Washington, DC: American College of Obstetricians and Gynecologists.
- American College of Obstetricians and Gynecologists
(2008, reaffirmed 2009). Use of psychiatric medications during pregnancy and lactation. ACOG
Practice Bulletin No. 92. Obstetrics and Gynecology,
111(4): 1001–1020.
- Sadock BJ, et al. (2007). Postpartum depression. In
Kaplan and Sadock's Synopsis of Psychiatry, Behavioral Sciences/Clinical Psychiatry, 10th ed., pp. 859–869. Philadelphia:
Lippincott Williams and Wilkins.
- Spinelli MG (2009). Postpartum psychosis: Detection of risk and management. American Journal of Psychiatry, 166(4): 405–408.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Lisa S. Weinstock, MD - Psychiatry |
|---|
| Last Revised | November 5, 2010 |
|---|
O'Hara MW, Segre LS (2008). Psychologic disorders of pregnancy and the postpartum period. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 504–514. Philadelphia: Lippincott Williams and Wilkins.
Cunningham FG, et al. (2010). Psychiatric disorders section of neurological and psychiatric disorders. In Williams Obstetrics, 23rd ed., pp. 1175–1184. New York: McGraw-Hill.
Spinelli MG (2009). Postpartum psychosis: Detection of risk and management. American Journal of Psychiatry, 166(4): 405–408.
Yonkers KA (2009). Management of depression and psychoses during pregnancy and the puerperium. In RK Creasy et al., eds., Creasy and Resnik's Maternal Fetal Medicine, 6th ed., pp. 1113–1122. Philadelphia: Saunders.
Whitby DH, Smith KM (2005). The use of tricyclic
antidepressants and selective serotonin reuptake inhibitors in women who are
breastfeeding. Pharmacotherapy, 25(3):
411–425.
Brockingham I (2004). Postpartum psychiatric
disorders. Lancet, 363(9405): 303–310.
Weissman AM, et al. (2004). Pooled analysis of
antidepressant levels in lactating mothers, breast milk, and nursing infants.
American Journal of Psychiatry, 161:
1066–1078.
Craig M, Howard L (2009). Postnatal depression, search date May 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Barbui C, et al. (2007). Depression in adults (drug
and other physical treatments), search date April 2006. Online version of
Clinical Evidence:
http://www.clinicalevidence.com.
UK ECT Review Group (2003). Efficacy and safety of
electroconvulsive therapy in depressive disorders: A systematic review and
meta-analysis. Lancet, 361(9360): 799–808.
Golden RN, et al. (2005). The efficacy of light
therapy in the treatment of mood disorders: A review and meta-analysis of the
evidence. American Journal of Psychiatry, 162(4):
656–662.
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