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Hi,

Do you think we can talk about this?

I know postpartum depression isn't at all uncommon - 10 to 14% of all mothers get it, I read. What I'd like to know more about is the underlying causes, and the risk factors. (I am going to assume that a history of depression is one of the risk factors for postpartum depression. What are the others?)

I am also curious if women who are at risk of postpartum depression can take any preventative steps, like starting therapy in pregnancy? (I think antidepressants in pregnancy are generally avoided?)

Anyway, if you've got anything to say on this topic, please share. :)

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Some of the risk factors for postpartum depression are:

* Prior depression like you said, or a family history, or previous postpartum depression

* Bipolar disorder

* Recent extreme stress

* A baby with additional medical needs or things like colic

* Financial problems, marital problems, etc

I do think healthcare providers keep a special eye open for mothers who have known risk factors, if they can. It depends on which country you're in and how much time the healthcare provider gets to spend with individual patients, I suppose. Anyone who does have these risk factors can also self monitor, and ask for help as soon as they notice any signs of postpartum depression.  

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Thanks. And what about things like post traumatic stress disorder, anxiety disorders, obsessive compulsive disorder, that kind of thing? Wouldn't those also be risk factors for postpartum depression?

Or what about things like being a teenage mother, or having gotten pregnant accidentally, or working a high stress job while also being a new parent?

And if you look at those two different kinds of situations, mental illness vs a stressful life, might it be fair to say that one kind of postpartum depression is more chemical, and another more situational?
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Having a baby can certainly be overwhelming, and more so for mothers who do not have much social support or who are struggling financially. Sleep deprivation messes with your brain, and it may be very hard to adjust to life with a new baby if you're used to doing something completely different. 

Motherhood can be stressful without it causing postpartum depression. 

There is no such thing as different types of postpartum depression, clinically. If you meet the diagnostic criteria for postpartum depression, you have it, regardless of possible contributing factors (and there aren't always obvious ones.)

Does that make sense?

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It does to me. :)

Looking back, things were really stressful for me when I had my first child. I was 19 and people weren't very supportive outside of my immediate family. Everything that happened or that I did wrong, people blamed on my age, even if older mothers would experience the same thing. I am 100% sure I didn't have postpartum depression, but there were plenty of "life is tough" moments, not about my son because I was happy to have him, but about the way people treated me. If what I went through had to have a diagnosis, I think it would be more along the lines of social anxiety caused by rude people than anything else. 

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OK, this is starting to get really interesting. So I have another question. Can you have depression during the postpartum period without it being postpartum depression, or is any new depression that shows up within, I don't now, a year of having a baby automatically called postpartum depression?

It's my understanding that depression has a brain chemistry component and that hormones also play a role in the case of postpartum depression. Is that correct, or am I off here? If nasty life circumstances lead to depression, isn't that a different kind of depression than if it is caused by factors inside the body?

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I think the causes of postpartum depression are more complex and more varied than most people probably know. 

I had complications during delivery. I hemorrhaged badly, and my baby had to spend time in the NICU. I barely saw her during the first five days of her life, and I wasn't able to breastfeed in the end, either. It was so very different from the perfect moment I had imagined: the doctor holding my baby up and saying she was healthy, followed by immediate skin to skin and nursing surrounded by loved ones. Instead, I barely had any idea what was happening and we were both lucky to be alive.

Had that all been different, I am sure I would not have developed postpartum depression. My postpartum depression was directly caused by a traumatic birth, lingering medical issues, and being separated from my child during those first days.

So, you can add a traumatic birth to the list of risk factors for postpartum depression.  

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I am sorry you went through that, last poster before me. That sounds incredibly traumatic. Do you think you had just postpartum depression or was there post traumatic stress syndrome as well? What treatment did you get?

To the young mother, that also makes a lot of sense. You did not have postpartum depression, but you may have had situational depression because you weren't able to enjoy motherhood the same way you might have if you had been older, because of people's reactions. In that case, there's an obvious "cure", for other people to behave more nicely, whereas true depression doesn't have a simple cure at all.

I think I get it now. It's not depression even if you feel terrible if it could all go away with extra support, more sleep, or whatever, but it is depression if you feel bad no matter what support you have.
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