Postpartum Depression Causes & Risk Factors

What Causes Postpartum Depression?

Postpartum depression (PPD) is a form of major depression that affects women after childbirth and can last for the first year. In some cases, depression may be present before childbirth; if the depression continues, the condition is called perinatal depression.

PPD has many forms and symptoms, affecting women in different ways. Therefore, it is difficult to attribute this condition to one unique cause.

Instead, medical professionals believe that postpartum depression can have multiple causes. Each woman who develops this type of depression has risk factors that make her more susceptible to its development.

In some cases, it’s unclear as to why and how a woman developed postpartum depression. This uncertainty can make it even more confusing and challenging for those suffering from this crippling depressive disorder.

It is vital for women suffering from postpartum depression to understand that it is not the result of something they did or did not do. In other words, it is never the new mom’s fault that postpartum depression develops.

Postpartum Depression Causes

There are many causes of postpartum depression in women. Potential triggers include genetic predispositions, the mother’s health history, and countless other environmental, physical, and emotional factors.

Physical Causes of Postpartum Depression

The common belief is that postpartum depression stems from the drastic hormonal changes during and after childbirth. Decreased estrogen and progesterone levels place the body into a sudden hormonal shift, and this abrupt change in hormone levels often triggers emotional repercussions.

However, many non-depressed women experience the same hormone drop and have the same estrogen levels as women with PPD.

Sleep deprivation may also play a significant role in causing postpartum depression. Following childbirth, women often do not get enough sleep due to their new responsibilities of caring for their babies. A lack of sleep can significantly impact how a woman functions, feels and handles situations. Without proper and consistent sleep, women may exhibit signs of postpartum depression.

Emotional Causes of Postpartum Depression

In addition to hormonal changes and sleep deprivation, the risk of postpartum depression developing can increase due to other emotional triggers. These emotional situations may include complications during childbirth and general feelings of being overwhelmed by new motherhood.

Stressful life events such as losing a job or the death of a loved one may also encourage the onset of PPD.

Postpartum Depression Risk Factors

Because it is difficult to identify any singular cause of postpartum depression, it is better to isolate specific factors that put women at a greater risk of developing PPD.

Risk factors contributing to postpartum depression include genetics and environmental, emotional, and physical influences. Other risk factors include emotional, physical, and psychological health issues.

Genetic and Medical History Risk Factors

Women with one or more family members who have suffered from postpartum depression have a greater risk of developing it themselves.

Those who have struggled with mood disorders like depression or anxiety or more significant mental illnesses like bipolar disorder are 30% to 35% more likely to face postpartum depression in their lifetime. Women who have experienced postpartum depression in previous childbirths are also much more likely to experience it again.

Recent studies have discovered a possible genetic factor in developing postpartum depression. According to blood tests performed by Johns Hopkins researchers, there are possibly two different genetic alterations that, when present during pregnancy, may predict whether a woman will develop postpartum depression.

A family history of depression or other mental disorders can also contribute to women developing PPD, especially if the mother already has a diagnosed mental health problem.

Environmental Risk Factors

A recent study from the Canadian Medical Association Journal revealed that women who live in big cities have the highest rates of PPD. These higher rates often occur because many women living in larger cities have lower levels of social support.

The study surveyed 6,126 new mothers living in Canada’s metropolitan cities, suburbs, towns, farming communities, and remote areas.

The percentages of new mothers with a risk of screening positive for postpartum depression are displayed below.

Urban Women and Postpartum Depression

This chart displays the percentage of new mothers in various types of locations who are at risk of developing postpartum depression.

The chart reveals that out of all women surveyed, there were more instances of postpartum depression among the women who lived in cities.

Emotional Risk Factors

Women who face emotional and mental stress before, during, or right after pregnancy may be at a greater risk of developing postpartum depression. Stressors may include job loss, financial burdens, the death of a friend or family member, the end of a relationship, or any other type of stressful life situation.

Women may also feel anxious and depressed after childbirth due to new responsibilities or having no time for themselves or social activities.

Additionally, women who lack the support of a partner, family members, or friends during pregnancy may be more likely to experience symptoms of postpartum depression. Women in abusive domestic situations may also be at a greater risk of developing perinatal depression, which is depression during and after pregnancy.

Other Risk Factors

There are a variety of other possible risk factors that play a role in whether a woman will develop postpartum depression.

These other postpartum risk factors include:

  • Having an unplanned or unwanted pregnancy
  • Being under the age of 20 when pregnant
  • Current substance abuse such as drugs or alcohol
  • Abruptly stopping taking medications during or after pregnancy
  • Being single or without a partner to co-parent

Awareness of the potential causes and risk factors of postpartum depression allows women and their families to better prepare for this possible outcome. Then, they can take preventative measures to limit the debilitating effects of this condition.

Talk to your primary care physician or mental health professional if you are concerned about postpartum depression risk factors that may affect you.

When to Seek Help for Postpartum Depression

The Office on Women’s Health (a division of the U.S. Department of Health and Human Services) recommends speaking with your primary care doctor or healthcare professional if your symptoms last for more than two weeks after childbirth.

Your doctor will perform a postpartum depression screening to gather details about your symptoms and other background health information, such as medical history. Your healthcare provider will then discuss treatment options for you after assessing the level of PPD that you might have.

Treating Postpartum Depression

Psychotherapy, or “talk therapy,” is a standard treatment recommendation for postpartum depression. Cognitive-Behavioral Therapy (CBT) and Interpersonal Therapy are just two types of therapy available for treating PPD.

Your healthcare provider may also prescribe you antidepressants (many of which are safe to take while breastfeeding) to help you manage depression and anxiety symptoms. Another medication option is Brenaxolone, which is approved specifically for treating PPD.

Beyond therapy and medication, many women suffering from postpartum depression also find relief by joining support groups. Larger organizations such as Postpartum Support International even offer online support groups for women needing remote attendance.

Support groups provide women with emotional support from other mothers dealing with PPD.

Signs and Symptoms of Postpartum Depression

Women with PPD often experience more than just a depressed mood. Postpartum depression symptoms can include mood swings, anxiety, trouble sleeping, and feelings of sadness, anger, or even worthlessness.

In rare cases, symptoms can include hallucinations, suicidal ideation, and intrusive thoughts about harming oneself or the new baby. This form of PPD is known as postpartum psychosis, and immediate medical intervention is necessary for the safety of the mother and the child.

The recommended treatment for postpartum psychosis includes Electroconvulsive Therapy (ECT), which has proven to be highly effective with minimal side effects.

If you find yourself or a loved one struggling with suicidal thoughts after pregnancy, contact the Suicide Prevention Lifeline at 988. This hotline is free and available 24/7. Team
Reviewed by:Kimberly Langdon M.D.

Medical Editor

  • Fact-Checked
  • Editor

Kimberly Langdon is a Doctor of Medicine and graduated from The Ohio State University in 1991. She completed her residency in Obstetrics and Gynecology at The Ohio State University Hospitals, Department of OB/GYN. Board-Certified in 1997, she is now retired from clinical practice after a long and successful career. Currently, she is the Founder and Chief Medical Officer of a Medical Device Company that is introducing patented products to treat vaginal microbial infections without the need for drugs. She is an expert in Vaginal Infections, Menstrual disorders, Menopause, and Contraception.

Written by:

Jenna Carberg was diagnosed with postpartum depression following the birth of her daughter in 2016. It was a healthy birth but in the following days, Jenna's mood changed quickly. Doctors suggested that it might be the "baby blues", but her husband Chris suggested she seek a second opinion. Jenna was diagnosed with postpartum depression and began a journey that lasted 9 long months with significant ups and downs. Jenna's mental health care and her experiences became a passion for her to share with the world. She and her husband Chris founded as a support website designed to help women suffering in silence and their loved ones.

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