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Scientists Discover Three Sub-types of Postpartum Depression

Like many women, soon after my son was born, I had a brief period of the “baby blues.” My best friend was not so lucky, and suffered from severe postpartum depression that lasted for several months. She required treatment with multiple antidepressants, and was afraid to have a second child in case she went through the same nightmare experience again. Now scientists are finding that when it comes to postpartum depression, one size does not fit all - and depression may even set in before a woman’s baby is born.

Researchers at the University of North Carolina School of Medicine have found that women with postpartum depression may experience one of three distinct sub-types of the condition, each with important implications for their prognosis and the best treatments to use.

"Clinicians should be aware of the diverse presentation of women with postpartum depression," said Samantha Meltzer-Brody, MD, MPH, director of the Perinatal Psychiatry Program at the UNC Center for Women's Mood Disorders and corresponding collaborator of the study. “A thorough assessment of a woman's history is necessary to guide appropriate clinical and treatment decisions. We now understand that postpartum depression can have an array of symptoms that may begin in pregnancy. Improved understanding of the differences in clinical presentation of postpartum depression impacts the implementation and interpretation of screening, diagnosis, treatment, and research of perinatal mood disorders.” 

In the study, data collected from more than 10,000 women in previous studies was analyzed for the presence of depressive symptoms. The characteristics that were found to be most important in defining the three subtypes were the time when the symptoms began (during pregnancy or after birth), the severity of symptoms, any history of a previous mood disorder, and whether or not the women had experienced medical complications during pregnancy or childbirth. 

The researchers found that women who experienced symptoms of depression during pregnancy were at risk for more severe postpartum depression, including thoughts of suicide, especially when compared to those women who developed postpartum depression after birth. 

If you believe you or someone you know may be experiencing postpartum depression, it’s important to know the symptoms. These include loss of appetite, insomnia, intense irritability and anger, fatigue, lack of joy in life, feelings of shame, guilt or inadequacy, and severe mood swings. Some women have difficulty bonding with their baby and withdraw from family and friends. At its extreme, post-partum depression can lead to thoughts of harming yourself or the baby, so women with suspected postpartum depression should see a doctor or psychiatrist as soon as possible. 

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