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Tests and diagnosis
By Mayo Clinic staffThe Diagnostic and Statistical Manual of Mental Disorders (DSM) considers postpartum depression a subtype of major depression. The DSM is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
According to the DSM, in order for postpartum depression to be diagnosed, signs and symptoms of major depression must develop within four weeks of giving birth.
Signs and symptoms of a major depressive episode include, in part:
- Depressed mood most of the day, nearly every day
- Reduced interest and pleasure in activities you used to enjoy
- Significant change in your appetite or unintended change in your weight
- Inability to sleep (insomnia) or excessive sleepiness (hypersomnia)
- Restlessness or notable slowed movements
- Fatigue or loss of energy
- Feelings of worthlessness
- Diminished ability to think, concentrate or make decisions
- Recurrent thoughts of death or suicide
To distinguish between a short-term case of the baby blues and a more severe form of depression, your doctor may ask you to complete a depression-screening questionnaire.
In addition, your doctor likely will perform blood tests to determine whether an underactive thyroid is contributing to your signs and symptoms.
- Pregnancy Risk Assessment Monitoring System (PRAMS): PRAMS and postpartum depression. Centers for Disease Control and Prevention. http://www.cdc.gov/prams/PPD.htm. Accessed March 10, 2010.
- Depression during and after pregnancy. National Institutes of Health. http://www.womenshealth.gov/faq/depression-pregnancy.cfm. Accessed March 10, 2010.
- Pearlstein T, et al. Postpartum depression. American Journal of Obstetrics & Gynecology. 2009;4:357.
- Lusskin SI, et al. Postpartum blues and depression. http://www.uptodate.com/home/index.html. Accessed March 10, 2010.
- Wisner KL, et al. Psychiatric disorders. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Churchill Livingstone; Maryland Heights, Mo.: 2007. http://www.mdconsult.com/das/book/body/187831438-3/0/1528/496.html#4-u1.0-B978-0-443-06930-7..50052-9--cesec15_2201. Accessed March 10, 2010.
- Depression. National Institutes of Mental Health. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml. Accessed March 10, 2010.
- Mischoulon D. Update and critique of natural remedies as antidepressant treatments. Obstetric and Gynecologic Clinics of North America. 2009;36:789.
- Shyn SI, et al. The genetics of major depression: Moving beyond the monoamine hypothesis. Psychiatric Clinics of North America. 2010;33:125.
- Major depressive episode. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 10, 2010.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. April 7, 2010.
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