Postpartum Depression Screening

What is a postpartum depression screening?

A postpartum depression screening is a standard set of questions you answer to help your health care provider find out whether you have depression related to having a baby. Postpartum means "after birth."

Postpartum depression is a common but serious mood disorder. Though there is no clear cause for this condition, there are several factors that may increase your risk of getting it. These include:

• Sudden changes in hormone levels that happen after pregnancy.
• Lack of sleep.
• Stress from new routines.

It differs from what are commonly called the "baby blues." With the baby blues, you may feel sad, weepy, or anxious starting about three days after childbirth. These feelings tend to come and go and usually get better on their own within a week or two. Postpartum depression, however, may:

• Last for months.
• Cause more intense symptoms than the baby blues.
• Affect how you think and behave.
• Lead to feelings of extreme hopelessness and/or a lack of interest in the baby.
• Not get better without treatment.

Symptoms of postpartum depression usually start between one to three weeks after birth. However, they may begin at any time during the first year of parenthood. Because of this, your and/or your baby's provider may repeatedly screen you for postpartum depression throughout the first year of your baby's life. Doing so can help them detect signs of postpartum depression early, and so better treat it [Note: Two paragraphs deleted or moved from here.]with medicine and/or talk therapy.

Other names: postpartum depression assessment, EPDS test

What is it used for?

Your provider will use a postpartum depression screening to help find out if you have depression after giving birth. This screening is usually part of a routine checkup a few weeks after your baby is born and may include questions about:

• Your mood since having the baby.
• Your sleep habits.
• Sources of stress in your life, such as new routines.
• Personal or family history of depression.

Why do I need postpartum depression screening?

Because anyone who has had a baby can develop postpartum depression, you'll likely be tested for it shortly after childbirth. However, if you have symptoms of postpartum depression before or after your routine checkup, contact your provider as soon as possible.

Symptoms of postpartum depression include:

• Feeling sad or empty most of the time.
• Eating too much or too little.
• Sleeping too much or too little.
• Crying more than usual or for no clear reason.
• Feeling more angry than usual.
• Pulling away from family and friends.
• Worrying or feeling anxious often.
• Not having any interest in your baby.
• Constant doubts about your ability to care for your baby.
• Thinking about hurting yourself or your baby.

If you have thoughts about suicide, or hurting yourself or your baby get help right away:

• Call 911 or go to your local emergency room.
• Contact a crisis hotline. In the United States, you can reach the National Suicide and Crisis Lifeline at any time:
  • Call or text 988
  • Chat online with Lifeline Chat
  • TTY users: Use your preferred relay service or dial 711 then 988
• Veterans can contact the Veterans Crisis Line:
  • Call 988, then press 1
  • Text 838255
  • Chat online
• Call your mental health provider or other provider.
• Reach out to a loved one or close friend.

Postpartum depression can happen after any childbirth. However, you may be more likely to develop this condition if you:

• Have had depression or bipolar disorder or a family health history that includes these conditions.
• Don't have support from family or friends.
• Had a multiple birth (twins, triplets, or more).
• Gave birth while in your teens.
• Had health problems during pregnancy.
• Went into preterm labor or had any other birth problems.
• Have a baby with special needs.
• Have ever experienced domestic violence.
• Experience financial difficulties.
• Had an unplanned pregnancy.

You may also be screened if you have depressive symptoms during pregnancy. This is called perinatal depression, and it has many of the same symptoms as depression after birth. If left untreated, it can:

• Increase the risk of your depressive symptoms lasting into the first weeks or months of parenthood.
• Make it harder to bond with your baby.
• Contribute to sleeping problems.
• Cause difficulties with breastfeeding.

Because of this, medical experts recommend that providers screen for depression during routine pregnancy checkups.

What happens during a postpartum depression screening?

During a postpartum depression screening you'll answer a set of questions. Your provider may ask the questions, or you may fill out a questionnaire form to discuss with your provider later. One of the most common questionnaires is called the Edinburgh Postnatal Depression Scale (EPDS). The EPDS includes 10 questions about your mood and thoughts.

Your provider may also order a blood test to find out if a physical condition, such as hyperthyroidism or hypothyroidism, may be causing your depression.

During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for a postpartum depression screening?

You usually don't need any special preparations for a postpartum depression screening.

Are there any risks to screening?

There is no risk to having a physical exam or taking a questionnaire.

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your screening shows you may have postpartum depression, it's important to get treatment as soon as possible. You may need treatment from a mental health provider. A mental health provider is a health care professional who specializes in diagnosing and treating mental health problems. They may treat you using:

• Counseling (also called talk therapy).
• Medicine, such as antidepressants. If you are breastfeeding your baby, let your provider know. This may affect what medicines your provider can give you.

A mental health provider may also follow-up with you throughout your treatment to monitor your progress.

Along with these treatment options, there are things you can do at home that may help you feel better, such as:

• Asking for help caring for the baby and doing other household chores.
• Spending time with other adults.
• Taking time for yourself.
• Getting some physical activity, such as walking.
• Resting when the baby rests.
• Joining a support group for new moms.

In the most serious cases, when symptoms don't respond to medicine or any other treatment, your provider may use brain stimulation therapies, such as electroconvulsive therapy (ECT), also called "shock therapy."

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a postpartum depression screening?

A rare but more serious form of postpartum depression is called postpartum psychosis. Postpartum psychosis may cause hallucinations (seeing or hearing things that aren't real) and confusion. It is a medical emergency and it's important to get help immediately by calling 911 or going to the nearest emergency room.