Affects up to 20% of women in the first year postpartum.
Onset: typically within 24 hrs – 3 months, but can occur any time in first year.
Screening: Universal screening is recommended. – Edinburgh Postnatal Depression Scale (EPDS) commonly used. – Some regions mandate screening by law.
DSM-5: Specifies onset within 4 weeks postpartum, though clinicians recognise episodes within 1 year as PPD.

🧠 Diagnostic Criteria

≥ 5 symptoms for ≥ 2 weeks, including depressed mood OR loss of interest/pleasure.

Sleep disturbance (insomnia or hypersomnia)
Psychomotor agitation or retardation
Fatigue, exhaustion, loss of energy ⚡
Appetite change (↑ or ↓)
Feelings of guilt/worthlessness 😔
Poor concentration, indecisiveness
Recurrent suicidal thoughts/ideation 💭

👩‍👦 Clinical Features

Persistent insomnia, loss of appetite, crying spells 😢
Difficulty coping with daily tasks (“acopia”)
Irritability, anxiety, social withdrawal
Guilt, low confidence, fear of being alone
Loss of joy or pleasure (“anhedonia”)
Suicidal thoughts → ⚠️ Red flag for urgent referral

⚠️ Risk Factors

History of depression or psychiatric illness
Adverse life events (financial stress, bereavement)
Domestic violence or marital conflict 💔
Unplanned/unwanted pregnancy 🤰
Lack of social support or isolation

Unlike obstetric complications, psychosocial stress is the major driver of PPD.

🛠️ Management

Tailored to severity + patient preference → collaborative care 🤝
Psychological therapies: – CBT or IPT are first-line for mild–moderate depression. – Supportive psychotherapy helps with adjustment.
Pharmacological: – SSRIs (e.g. sertraline) = first-line. – Risks/benefits must be weighed if breastfeeding 🤱.
Social interventions: – Family/partner involvement. – Peer support groups. – Health visitor follow-up in UK practice.

📊 Quick Teaching Table

Feature	Postpartum Blues	Postpartum Depression	Postpartum Psychosis
Onset	2–5 days postpartum	Within 1 year (usually 2–12 wks)	2–7 days postpartum
Symptoms	Mood lability, tearfulness	Depressed mood, guilt, anhedonia, fatigue	Delusions, hallucinations, mania/depression
Duration	Resolves in < 2 weeks	≥ 2 weeks, can persist months	Acute, severe, often prolonged
Risk	Self-limiting, no harm	Suicide risk ↑	Life-threatening (suicide/infanticide risk)
Management	Reassurance, support	CBT/IPT, SSRIs, social support	Hospitalisation, antipsychotics, mood stabilisers, ECT

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Postpartum/Postnatal Depression

🌸 Postpartum Depression (PPD)

🧠 Diagnostic Criteria

👩‍👦 Clinical Features

⚠️ Risk Factors

🛠️ Management

📊 Quick Teaching Table

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