Postpartum Depression (PPD)

Written By: Heather
Heather Kempton Coquitlam Couples Counsellor

Postpartum depression usually sets in soon after childbirth and develops gradually over a period of several months. However, in some women PPD symptoms can come on immediately after childbirth or don’t appear until months after one has given birth. The difference between postpartum depression and what has been refer to as the “baby blues” are that the symptoms in PPD are more severe and last longer.


Signs and Symptoms of PPD:

Anxiety and worry; worry about hurting your baby

Lack of interest in your baby, feeling unable to care for your baby

Recurrent thoughts of death or suicide

Negative feelings: worthlessness, sadness, helplessness, hopelessness, or guilt

Lack of concern for yourself

Fatigue or exhaustion, lack of energy and motivation


Crying or tearfulness

Difficulty concentrating

Irritability or hypersensitivity

Changes in appetite or eating habits

Difficulty sleeping (insomnia vs. sleeping all the time)

Loss of interest in activities you usually enjoy, loss of pleasure

Headaches, stomachaches, muscle or backaches


Causes of Postpartum Depression

Hormonal Changes

After childbirth, women experience a significant drop in estrogen and progesterone. Thyroid levels can also drop, which leads to fatigue and depression. These rapid hormonal changes, along with the changes in blood pressure, immune system functioning, and metabolism that new mother’s experience may trigger postpartum depression.

 Physical Changes

Giving birth brings numerous physical and emotional changes. You may be dealing with physical pain from the delivery or the difficulty of losing the baby weight. This may lead to body distortions and insecurities about your physical appearance and sexual attractiveness.


The stress of caring for a newborn can also take a toll. New mothers are often sleep deprived, feel overwhelmed and anxious about one’s ability to properly care for one’s baby. These adjustments can be particularly difficult if you’re a first time mom who must get used to an entirely new identity.


Risk Factors for Postpartum Depression

A previous history of depression

A history of severe PMS or premenstrual dysphoric disorder (serious premenstrual distress with associated deterioration in functioning)

Medical complications for you or your baby

Relationship difficulties

Lack of support from family or friends

Difficulties with finances


Postpartum Depression – Impact on Baby

Behavioral Problems

Children of depressed mothers are more likely to develop behavioral problems in the future, including sleep problems, temper tantrums, aggression and hyperactivity.


Delays in Cognitive Development

Development is often delayed in babies and children who have depressed mothers. They may learn to walk and talk later than other children. They may also have many other learning difficulties, including problems with school.

 Social Problems

Children of depressed mothers have difficult establishing secure relationships. They may find it hard to make friends in school. They may be socially withdrawn, or they may act out in destructive ways.

 Emotional Problems

Children may have lower self-esteem, are more anxious and fearful, are more passive, and are less independent.


The risk of developing major depression early in life increases for the children of mothers with postpartum depression.


Postpartum Depression and Attachment

Research has shown that depressed mothers interact less with their babies. Women with postpartum depression are less likely to breastfeed, play with, and read to their children. They may also be inconsistent in the way they care for their newborns.

Depressed mothers can be loving and attentive at times, but at other times they may react negatively or they may not respond at all. This inconsistency disrupts the bonding process between mother and child. This emotional bonding process, known as attachment, is the most important task of infancy.

A secure attachment is formed when the mother responds warmly and consistently to her baby’s physical and emotional needs. When the baby cries, the mother quickly soothes him or her. If the baby laughs or smiles, the mother responds in kind. In essence, the mother and child are in synch. They recognize and respond to each other’s signals.

A depressed mother is less likely to pick up on and respond to her baby’s cues. This sets the stage for an insecure attachment. A child who is insecurely attached is a risk for multiple developmental difficulties and delays, including behavioural, emotional, and social problems.