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What Causes Postpartum
Mood Disorders?
The first year postpartum may be a very stressful time.
There are many changes the mother will undergo after
the baby is born and typically it is a combination of such
factors that causes a Postpartum Mood Disorder.
There are three main categories of changes that may
combine to cause a Postpartum Mood Disorder.
Physiological Factors
In pregnancy, reproductive hormone levels in a woman's body are 20-30 times greater than normal. At
delivery, hormone levels drop abruptly, along with changes in amino acids, neurotransmitters, and thyroid
hormones. The sudden drop in estrogen, progesterone, endorphins, and other hormones may trigger
depression the same way moodiness may be triggered by premenstrual changes in these hormones. Thyroid
levels may also drop sharply after birth. A new mother may develop a thyroid deficiency that can produce
symptoms that mimic depression. (It is always recommended that a woman have a thorough physical
examination for this reason).
Sleep Deprivation
Many women feel exhausted after labor and delivery and may need a long time to fully recover. Cesarean
births require an even longer recovery. New mothers rarely get adequate rest. In the hospital, they are
awakened by nurses and the baby's feedings. At home, feedings continue every 2-4 hours, around the clock,
along with usual household tasks. When a mother is sleep deprived, her ability to cope with stressors will be
significantly impaired. This extreme lack of sleep continues for weeks and months and can be a major reason
for depression.
Psychosocial Factors
Babies who are born prematurely or with a birth defect may present the new mother with even more stress and
the overwhelming realization that her baby is not the 'perfect' being she had envisioned.
Other tasks which may pose a stress on a new mother include:
- establishing successful breast/bottle-feeding
- coping with sleep deprivation
- forming an attachment to the child
- re-negotiating family relationships and responsibilities
- giving up the fantasy of what the baby would look like or be like
- facing whether or not one is an adequate parent
Feelings of loss are very common after childbirth.
These 'losses' include:
- loss of freedom
- feeling tied down
- loss of an old identity
- loss of control
- loss of a slim figure
- loss of a sense of attractiveness
Since motherhood is typically viewed as a 'happy time' and childbirth is seen as an event from which a woman
should 'bounce back' within a few days, many women experience a lack of understanding and/or support from
those around them. (See "Myths" section of this website).
Mothers need significant coping skills to deal with so many new challenges. Four aspects of the postpartum
period which demand significant coping abilities are:
1) the physical adjustment
2) initial insecurities about oneÕs ability to parent
3) relying on support systems for tasks that one feels she 'should'
do
4) loss of a previous identity as one who is taken care of and the
birth of a new identity as the caretaker.
Genetic Factors
Genetic factors are also important in determining who may develop a PPMD. Women with a family history of
mood disorders are at an increased risk for developing a postpartum mood disorder. If a woman has
previously been diagnosed with a mood or psychotic disorder, she is at a greater risk of PPMD as well.
