Causes and Risk Factors of Postpartum Depression (PPD)

Postpartum depression (PPD), sometimes called perinatal depression, is a type of severe depression that happens to some people after giving birth. In most cases, PPD occurs within the first three months after birth, but it can happen anytime within the first year.

Postpartum depression is different from “the baby blues” because it lasts longer than the first two weeks after birth, is more severe, and affects your ability to take care of yourself or your baby.

Researchers aren’t completely sure what causes PPD, but they believe a combination of factors likely contribute. Hormonal changes, genetics, lack of social support, and environmental factors may all play a role in causing PPD.

Certain risk factors may also make you more likely to experience PPD. Still, postpartum depression can happen to anyone after childbirth, regardless of risk factors or other contributing causes.

The exact cause of postpartum depression is unknown, but it can be helpful to look at some of the theories surrounding its causes. Here are the possible factors that may trigger PPD in certain people:

Hormonal Changes

During pregnancy, your levels of estrogen and progesterone are extremely high. Within 24 hours after giving birth, these levels drop quickly back to what they were before you were pregnant. Some experts theorize that the quick drop in these hormones may trigger depression in some people.

Stress

Major life stressors can affect anyone’s mental health, and having a new baby is a huge life transition and stressor. It’s believed that stressors such as sleep deprivation, identity changes, lack of support, and the responsibility of caring for a newborn, coupled with hormone shifts, can cause postpartum depression.

The stressors are more likely to impact someone who has a genetic susceptibility to stress.

Thyroid Imbalances

Besides changes in hormones like estrogen and progesterone, thyroid hormone levels can also shift after giving birth. If your body isn’t producing enough thyroid hormone, you may develop symptoms of depression.

Many postpartum thyroid symptoms go undiagnosed, which is why if you experience depression after having a baby, it’s important to ask your healthcare provider to check your thyroid levels. Thyroid imbalances can usually be adjusted with medication.

There isn’t one single gene that causes postpartum depression, and researchers are still learning more about the genetic causes of PPD.

People who have a history of mental health disorders in their family are more likely to develop PPD. This may be due to genetics, but environmental factors from childhood and a lack of support from your family in the postpartum period may also play a role in why PPD can impact families with mental health issues.

Certain individuals may be more susceptible to postpartum depression than others.

People with a family or personal history of psychiatric disorders are more likely to experience PPD. These include mental health challenges like anxiety or depression. People who’ve experienced sexual abuse are also more likely to have PPD.

Premenstrual syndrome (PMS) may also increase your chances of experiencing postpartum depression. You may also be more likely to experience the type of depression if you feel uncomfortable or unhappy about your baby’s sex.

Many other factors may put you at increased risk for postpartum depression. An increased risk for PPD may occur for those who:

• Have a challenging or traumatic pregnancy or birth
• Lack support from partners, friends, or family
• Live with domestic violence
• Are single or have relationship issues with their partner
• Are younger than 25 years old
• Have breastfeeding challenges
• Have a premature baby or baby with complex medical needs
• Have experienced an unplanned pregnancy
• Misuse alcohol or drugs
• Experience a significant stressor during pregnancy, such as an illness or death of someone close to them
• Go through financial stress or trouble securing enough food or stable housing

Certain risk factors may make you more likely to experience postpartum depression. These include environmental and medical factors, social factors, lifestyle factors, and other factors.

Medical Risk Factors

People who have had a history of medical issues during pregnancy are more likely to experience postpartum depression. Medical issues include having had a high-risk pregnancy, experiencing a hospital stay during your pregnancy, or having had a traumatic birth. Instances of traumatic births that increase risk include emergency C-section births, the passage of meconium (newborn baby’s first bowel movement) during labor, and umbilical cord prolapse.

Medical circumstances after birth, like giving birth to a preterm baby or a baby with a low birth weight, may also increase PPD risk.

Social Risk Factors

One of the strongest factors that can contribute to postpartum depression is poor social support, which could include a lack of support from your partner, family, friends, or local community. New parents who experience isolation are much more likely to experience PPD than those who have any type of support.

Lifestyle Risk Factors

Although an unbalanced diet and lack of exercise don’t cause postpartum depression, lifestyle factors like these may influence the likelihood of developing the condition. Some lifestyle factors that may contribute include poor eating habits, an inactive lifestyle, and extreme sleep deprivation. Experiencing vitamin B6 deficiency may contribute to PPD, too.

Parenting and Infant Risk Factors

Having a colicky baby, which is a baby who cries constantly and can’t easily be consoled, can increase your risk of postpartum depression. Having a baby with special medical needs, illness, or who was born prematurely may also increase your risk. People who are first-time parents or who became parents at a young or older age may also be at increased risk for PPD.

Experts haven’t determined the precise cause of postpartum depression, but it’s likely caused by a combination of factors, including genetic, hormonal, and social factors. Certain factors may also increase your risk of developing it.

Knowing the potential causes and risk factors of postpartum depression can help you better understand what you or a loved one is going through.