Postpartum Depression Months After Birth

When we think about postpartum depression, the focus is typically on the first few weeks after having a baby. It is a serious condition that may include overwhelming fatigue, inability to care for your infant, extreme mood swings, and trouble bonding with the baby. A much milder form of postpartum depression, known as the baby blues, is more common and generally resolves within a couple of weeks. New research, however, suggests that even those who don’t experience the baby blues may be at risk for postpartum depression as time goes on, and because it happens several months after birth, it may be more difficult to recognize.

The study, which took place at Olmstead Medical Center in Rochester, Minnesota, found that the symptoms of depression may not appear in many women until their baby is several months old, or even approaching his or her first birthday.¹ “Signs of Postpartum Depression May Appear Months After Initial Screening.” The Wall Street Journal. 22 June 2015. Accessed 28 June 2015. http://www.wsj.com/articles/signs-of-postpartum-depression-may-appear-months-after-initial-screening-1434989534 The subjects were 1,432 American women who were taking part in a comprehensive study of maternal depression. Residing throughout 16 states, the participants had an average age of 26.7 and roughly one-third had no previous children.

The volunteers answered questionnaires that involved rating their level of hopelessness, trouble concentrating, loss of appetite, thoughts of harming themselves, and other signs of depression. They were instructed to assign each of these issues a number from zero, meaning they were not experiencing it at all, to three, which represented an almost daily occurrence. Those scores reaching 10 or more were considered to show a moderate to severe risk of postpartum depression.

Many of the women who indicated few or no symptoms of depression shortly after having a baby were found to be at greatly increased risk a few months later. In fact, not a single subject scored 10 or above at the initial screening, which was conducted between four and 12 weeks after each woman gave birth. However, at a follow-up screening that took place at the six-month mark, 10.9 percent of the participants had a score of 10 or higher. And 30 percent of those were well above 10, placing them in a very high-risk category.

And instead of resolving over the course of the first year, the number of depressed women actually grew. A second follow-up that took place at the 12-month mark showed 6.1 percent more of the volunteers reaching a score of 10 or higher. The only somewhat bright spot was that the very high-risk group had decreased to 19 percent by that point. Overall, 13.5 percent of the subjects were found to be at an elevated risk for postpartum depression at some time in the first year after giving birth, even though they all showed little sign of mental health issues at their earliest screening.

This is potentially a big problem since postpartum depression is associated with feelings of worthlessness, guilt, and sometimes even thoughts of harming yourself as well as the baby. What’s more, a 2013 study at the University of Pittsburgh in Pennsylvania found that one in seven women experiences postpartum depression.² Wisner, Katherine L.; et al. “Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women With Screen-Positive Depression Findings.” JAMA Psychiatry. May 2013. Accessed 29 June 2015. http://archpsyc.jamanetwork.com/article.aspx?articleid=1666651 Since many of these women are uncomfortable talking about their depression–particularly at what is supposedly to be such a happy time of life with a new baby–they often do not seek help.

There is no standard assessment process during doctor visits in that first year, so we all need to focus on providing a strong support network to our loved ones after a baby is born. Providing the assistance the mother needs, being there to talk, and taking a little of the burden off their shoulders can go a long way. Offering to watch the baby so mom can visit with a counselor and engage in talk therapy can be very beneficial. Or give her an hour to herself as often as possible to get in a little exercise. Numerous studies have demonstrated the tremendous boost working out can provide for combating depression. In fact, they have been shown to do the trick much better than pharmaceutical drugs, and with no nasty side effects to worry about. Also, as Jon Barron has pointed out, the sudden drop in progesterone levels (the happy hormone) after giving birth can be a major factor in the onset of postpartum depression. Supplementing with an all-natural progesterone crème can help.