This study identifies three main types of postpartum depression (PPD) that are most commonly seen.

The most common is known as the “postpartum blues,” and is the shortest-lasting of the three. It occurs in 50% of people who give birth, with high emotional vulnerability and irritability, peaking within the first week post-natal, and ending after a few weeks. The study claims that is no association between an individual having a history of mental health disorders or strong environmental stressors and this form of PPD.

Postpartum non-psychotic depression is another common form of PPD. This occurs in 10-20% of people who given birth, within the first 6 months postpartum. Unlike the blues, this form of PPD is associated with individuals who have a history of major depressive disorder, PMDD, and psychosocial stress. Patients diagnosed with this disorder tend to have strong feelings of inadequacy as a parent, sleep and appetite disturbances, and general low mood; they also tend to have obsessive ego-dystonic thoughts about harming themselves or their infants, but don’t act on them.

Postpartum psychotic depression is the last common form of PPD that this study focuses on. Mostly seen in a similar way to high-functioning depression, this disorder is characterized by an individual who is seemingly able to “trick” others into believing that they’re not suffering, yet might be facing delusions, hallucinations, or both. Unlike the non-psychotic form, individuals with this form of PPD are more likely to act on their ego-dystonic thoughts. Those with pre-existing psychiatric disorders, medical conditions, and substance use problems may be more likely to have this form of PPD.

Summary: Types of PPD

According to this study, those who undergo miscarriage or stillbirth (and have no history of depression) are equally as likely to develop PPD as those who also have no history of depression and deliver a living child.

Those who undergo miscarriage or stillbirth (and do have history of depression) are two times as likely to have recurrent episodes of PPD compared to those who deliver a living child.

Those who have a miscarriage and did not want to be pregnant can also experience depressive episodes after losing the pregnancy.

Those who have a premature birth of living child are more likely to experience ptsd, but there is no association between premature childbirth and PPD. 

Summary: Pregnancy Loss and Premature Birth

The major hypotheses regarding causes for PPD are mostly focused on hormonal involvement during both pregnancy and postpartum, primarily the major drop in progesterone and estrogen after giving birth, alongside the involvement of the oxytocin hormone in attachment between parent and child.

There seem to be cultural differences in rates of PPD — cultures which provide high amounts of social support to those who have just given birth are seen to have lower rates of PPD. This is especially true if their cultural traditions involve helping with childcare and providing particular rituals to the healing parent.

Untreated PPD can lead to long-term mental and emotional wellness struggles for the birthing parent, their partner, and the child.

A combination of pharmacologic and psychosocial treatments are ideal for PPD, but more intense cases (such as psychotic PPD) might call for more intense — and faster-acting, treatments — such as electroconvulsive therapy. 

Conclusions of the Study

Miller, L. J. (2002). Postpartum depression. Jama, 287(6), 762-765.

Rutgers University

References for Pregnancy & Mental Health

Postpartum Depression

Weinstock, M. (2005). The potential influence of maternal stress hormones on development and mental health of the offspring. Brain, behavior, and immunity, 19(4), 296-308.

The Potential Influence of Maternal Stress Hormones on Development & Mental Health of Offspring

Wieczorek, K., Targonskaya, A., & Maslowski, K. (2023). Reproductive hormones and female mental wellbeing. Women, 3(3), 432-444.

Reproductive Hormones & Female Mental Wellbeing

O'Hara, M. W. (2009). Postpartum depression: what we know. Journal of clinical psychology, 65(12), 1258-1269.

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