Postpartum Depression

Both maternity blues and postpartum depression are depressive states that occur after delivery. Maternity blues develops between 3 and 7 days after delivery, presenting as mild depression. The major symptoms of the blues include a depressed mood and tearfulness. In Japan, it occurs in 9% to 25% of all postpartum women. The symptoms are usually transient and disappear after about 2 weeks. Although the blues generally resolve without treatment, transformation to postpartum depression occurs in about 5% of patients. Consequently, caution must be exercised when the blues develops. Postpartum depression usually develops between 2 and 5 weeks after delivery. Like endogenous depression, it presents with a depressed mood, loss of energy, insomnia, and other symptoms. The patient may have hallucinations or suicidal ideation and may attempt suicide. The incidence of postpartum depression in Japan is 3–9%. It lasts for 3–6 months and then subsides or resolves. It is treated with the same drugs that are used for endogenous depression. It is also important to adjust the environment to make it easy for the patient to get some rest. Puerperal psychosis, relapse of schizophrenia or depression, and depressive states due to a somatic disease may also present as depression after delivery. Therefore, such depressive illnesses need to be differentiated from postpartum depression.