Postpartum Depression Disease Summary

Overview

Postpartum depression is the occurrence of a major depressive episode within 4 weeks following delivery or up to a year after childbirth. It may peak at 2-4 weeks and 10-14 weeks after childbirth.
Symptoms are similar to that of major depression but with additional features distinctive of the postpartum period like feelings of being overwhelmed and inadequate as a parent and being highly preoccupied with the baby’s feeding and health. Suicidal thoughts and infanticide have also been noted in severe cases.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria for postpartum depression have a peripartum onset specifier (ie onset of depressive symptoms occurs during pregnancy or within 4 weeks after delivery) that can be applied to major depressive episode criteria.
Treatment goals include diminishing depressive symptoms, preventing suicide and infanticide, and restoring patient’s functionality.
For patients with mild symptoms, psychosocial interventions are encouraged, eg peer and partner support, nondirective counseling.
For patients with moderate symptoms and those who are unresponsive to psychosocial interventions, a formal psychotherapy is considered .
Indications for pharmacotherapy includes postpartum depression symptoms unresponsive to psychosocial interventions or psychotherapy, severe symptoms needing immediate treatment, high risk of relapse, or patient preference.

For further information regarding the management of Postpartum Depression, please refer to Disease Algorithm for the Treatment Guideline.