Postpartum Depression
Although the current available information divides the spectrum of postpartum mood disorders into three distinct categories, these classifications frequently blend at the margins. At the mildest end of the spectrum is the "maternity blues" or "baby blues." Because this condition arises after 40% to 85% of deliveries, practitioners and patients often view it as normal. Nonetheless, patients and their families are distressed by the patients' depressed mood, irritability, anxiety, confusion, crying spells, mood liability, and disturbances in sleep and appetite. These symptoms usually reach their peak between postpartum days 3 and 5, and typically resolve spontaneously within 24 to 72 hours. The primary treatment is supportive care and reassurance about the nature of the condition. One of the primary risks of postpartum depression is a continued or relapsing illness. Doctors must recognize that the highest risk of relapse is in subsequent deliveries, where the recurrence risk is much higher. The risk of recurrence may also be correlated to the severity of the initial symptoms; in a subset of women with onset of psychotic symptoms within the first 24 months postpartum, the recurrence risk approaches 100%. Given this impact, the identification of patients that are suffering from postpartum depression should be a priority for all physicians who treat the women. The diagnostic criteria for a major depressive