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.
Terrifying Postpartum Story
"I didn't tell anyone I had postpartum depression"
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More about postpartum depression
Here is a checklist to see if you might be at risk.
- Poor support from family, partner, and friends.
- High life stress, such as a sick or colicky newborn, financial troubles, or family problems.
- Physical limitations or problem symptoms after childbirth.
- First-time pregnancy.
- Depression during a current pregnancy: 75% of women who are depressed during pregnancy will also have postpartum depression.
- Previous depression: 25% of women who have ever had depression will have PPD.
- Bipolar disorder, also known as manic-depression, which also increases the risk of dangerous psychotic behavior after childbirth.
- A family history of depression or bipolar disorder.
- Previous premenstrual dysphoric disorder (PMDD), which is the severe type of premenstrual syndrome (PMS).
Last Updated: June 24, 2008 "I felt so deeply alone"
Katherine Stone, 38, of Atlanta, says her postpartum depression made her feel dissociated from reality, but she was aware enough to hide her condition from her friends. Once, when her son was two months old, she hosted a luncheon at her house.
"When the women came over, I'll never forget having one of the oddest feelings I've ever had," Stone says. "I felt like I was inside of a bubble. Or like I was hovering over the party watching it but that my guests couldn't see or hear me.
"I was shocked at how disconnected I felt from the world, and it seemed like it didn't really matter whether I was there or not. I tried to make small talk, but it seemed like the sentences just didn't come out right and that I wasn't making any sense. It was almost like the air had been replaced by water that blurred my vision and muffled my sound."
To this day, she says, everyone but her recalls the party as a lovely occasion. But after the guests left, she laid down on the couch and sobbed for hours.
"One of the truly awful feelings you experience during postpartum mood disorders," explains Stone, "is that sense of disconnection from the world, from your friends and family, from your baby, and most of all, from yourself. I felt so deeply, deeply alone."