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Tests and diagnosis

By Mayo Clinic staff

Managing Depression

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The Diagnostic and Statistical Manual of Mental Disorders (DSM) considers postpartum depression a subtype of major depression. The DSM, published by the American Psychiatric Association, 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. Also, your doctor likely will perform blood tests to determine whether an underactive thyroid is contributing to your signs and symptoms.

Treatments and drugs Preparing for your appointment
References
  1. Depression during and after pregnancy fact sheet. National Institutes of Health. http://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.cfm. Accessed Aug. 1, 2012.
  2. Pearstein T, et al. Postpartum depression. American Journal of Obstetrics & Gynecology. 2009;200:357.
  3. Lusskin SI, et al. Postpartum blues and depression. http://www.uptodate.com/index. Accessed Aug. 2, 2012.
  4. Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-4/0/1528/0.html. Accessed Aug. 6, 2012.
  5. Depression. National Institutes of Mental Health. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml. Accessed Aug. 6, 2012.
  6. 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 Aug. 6, 2012.
  7. Hirst KP, et al. Postpartum major depression. American Family Physician. 2010;82:926.
  8. Postpartum depression. The American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq091.ashx. Accessed Aug. 7, 2012.
  9. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 22, 2012.
  10. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 27, 2012.
DS00546 Sept. 11, 2012

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