Who Gets Postpartum Depression?

Many women who suffer postpartum depression have a past history of depression. Research suggests other predictors are a history of premenstrual syndrome (PMS), an unsupportive spouse or family, or having a colicky baby.

One study suggests that women who conceive through assisted reproduction are at higher risk as well, perhaps because they are older, are more likely to have surgically assisted births, and have higher odds of delivering twins or triplets.

The shock of new motherhood
But women who have been through the experience say the shock and awe of new motherhood, combined with sleep deprivation and surging postpartum hormones, can send even the most stable new mom into tailspin.
One former sufferer calls the first six months of parenthood a "recipe for mental illness." Suzanne, 35, of New Paltz, N.Y., agrees. She recalls having no feeling for her new baby boy and was overwhelmed with sadness. For two and a half months she kept her feelings to herself. "I put on good show for my husband because I didn't want this person to be me," she says.

Looking back, she now sees that isolation contributed to her state of mind. "We had just moved to our new home before our son was born," Suzanne says. "I didn't know anyone here. We had no family or friends in this area."

What puts new moms at risk
Ann Dunnewold, PhD, a Dallas-based psychologist who specializes in postpartum depression, says hormonal fluctuations also play a role. "Hormones reach their maximum levels in late pregnancy, and their lowest within 72 hours after the delivery. This fluctuation causes the nearly universal mild, short-lived condition called the 'baby blues.' But some women's levels take longer to return to normal, and the severity of the blues can predict the severity of postpartum depression at 10 to 12 weeks.

Dunnewold says there are some surprising times when women are also vulnerable to depression, such as 10 weeks after delivery. "Support is gone at that point. Everyone expects you to be on your feet. The fatigue starts stacking up." Some women also get delayed depression when they quit breast-feeding and their hormones shift again.