Postpartum depression (PPD) symptoms overlap with those of major depressive disorder but differ in focus and severity. PPD includes several subtypes ranging from mild to severe. Across these subtypes, depressive and negative symptoms center on the infant and on adjusting to parental care — for example, persistent worry about being a good enough parent, or, in more severe episodes, intrusive thoughts of harming the child.

Rutgers University

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The term "postpartum depression" is the common name for the formal DSM-5 specifier "peripartum onset." This specifier is used for major depressive episodes that begin during pregnancy or within the initial four weeks after giving birth.

Peripartum Onset Specifier (Postpartum Depression)

While there is no one designated cause for PPD, there are a few factors which can contribute to the onset of major depressive disorder after giving birth. 

Similar to the end of the luteal phase in the menstrual cycle, childbirth can lead to a major drop off in serotonin and dopamine producers, estrogen and progesterone. This creates a major deficit in the "happier" sides of emotional regulation and can be part of the hormonal relation to PPD.

Additionally, many different sources have noticed a correlation between those who have low social support and/or high stress during pregnancy and the development of depressive symptoms after childbirth. 

PPD: Causes

PPD: Symptoms

Based on the timing of the symptom onset described in the case study, would a mental health professional consider using the 'peripartum onset' specifier for a major depressive episode? Explain your reasoning.

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