Postpartum Depression Can Last 3 Years After Giving Birth, Study Finds
A new study finds postpartum depression symptoms can linger three years after childbirth. Experts say PPD screenings for mothers after the first year may be necessary.
In recent years, more attention has thankfully been brought on postpartum depression (PPD), which up to 20 percent of moms experience. Those intense symptoms, including depressed mood and excessive crying, typically begin within the first few weeks of giving birth and can also show up later on within the first year.
For some new moms, postpartum depression can last up to three years, reveals a new study from the National Institutes of Health (NIH). The study, which appears in the journal Pediatrics, looked at 5,000 women and found about 1 in 4 had “high levels of depressive symptoms at some point in the three years after giving birth.” The remaining women had low levels of depression throughout the same time period.
This brings attention to the idea mothers may need longer screening for postpartum depression than the American Academy of Pediatrics’ (AAP) already recommended one, two, four, and six months after giving birth.
Longer PPD Screenings May Be Needed
“Our study indicates that six months may not be long enough to gauge depressive symptoms,” Diane Putnick, Ph.D., the main author and a staff scientist in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) epidemiology branch, said in a statement. “These long-term data are key to improving our understanding of mom’s mental health, which we know is critical to her child’s well-being and development.”
Postpartum depression screenings, the authors say, may need to continue for at least two years. “I suggest two years because by then it will be clearer which moms are getting better and which are staying depressed or becoming more depressed,” Dr. Putnick tells Parents.com. That doesn't necessarily mean more screenings are needed, adds Dr. Putnick, but spacing out the four recommended may be more beneficial.
Dr. Putnick notes the height of postpartum depression is considered the first month after birth. Women who experience their first symptoms of depression two years later are generally suffering depression with no peripartum onset. "The only difference in the diagnostic criteria for a regular depressive episode and postpartum depression is when it starts—and not when it ends," says Dr. Putnick. "In this study we were interested in symptoms, regardless of meeting diagnostic criteria, because we wanted to capture these various trajectories after birth."
The research also found that those with underlying conditions, including mood disorders and/or gestational diabetes, had a greater chance of experiencing more depressive symptoms. "Anyone can develop postpartum depression, but certain individuals may be at higher risk, including those with prior mental health disorders, individuals with chronic health conditions, and those who have difficult social situations," says Amy Addante, M.D., an OB-GYN in Illinois and fellow with Physicians for Reproductive Health, who was not part of the study.
But more research needs to be conducted since the participants in this particular study were mainly white, non-Hispanic women. “Future studies should include a more diverse, broad population to provide more inclusive data on postpartum depression,” said Dr. Putnick in the statement.
Still this new study doesn't come as a surprise to Jessika Ralph, M.D., MSCI, a Minnesota-based OB-GYN and fellow with Physicians for Reproductive Health. "Life stressors, such as low income, chronic maternal or child illness, and adequate housing and education, do not necessarily resolve after a certain period of time after birth," says Dr. Ralph, who was also not part of the study. "We must do better to support parents, so that they and their children are happy, healthy, and successful."
Getting Treatment for PPD
But the good news is postpartum depression can be treated no matter when it hits. "Depression is treatable and most people get better with treatment," according to the Centers for Disease Control and Prevention (CDC). "If you think you may be depressed, the first step to seeking treatment is to talk to your health care provider."
Symptoms to look out for include feeling sad, anxious, or irritable; changes to appetite, sleep, or ability to concentrate; and feelings of hopelessness or worthlessness. "Parents should never hesitate to contact their doctor or healthcare provider if they have these feelings," says Dr. Ralph.
Your doctor can connect you with a mental health specialist. The CDC also offers a database of community resources. "The most important thing for new moms to know is that they are not alone," says Dr. Addante. "And most importantly, don't feel afraid or embarrassed to bring up your symptoms with your healthcare provider."
For more information on signs and treatment options, read our guide on postpartum depression.