You've just had a baby, one of the most important and happiest events in your life. "What could make a woman happier than a new baby?" you wonder. So why are you so sad?

We don't know for sure, but you are not alone. As many as 80% of women experience some mood disturbances after pregnancy ("postpartum"). They feel upset, alone, afraid, or unloving toward their baby, and guilt for having these feelings.

For most women, the symptoms are mild and go away on their own. But 10-20% of women develop a more disabling form of mood disorder called postpartum depression.
 

• The "baby blues" are a passing state of heightened emotions that occurs in about half of women who have recently given birth.
   

• This state peaks 3-5 days after delivery and lasts from several days to 2 weeks.
   

• A woman with the blues may cry more easily than usual and may have trouble sleeping or feel irritable, sad, and "on edge" emotionally.
   

• Because baby blues are so common and expected, they are not considered an illness.
   

• Postpartum blues do not interfere with a woman's ability to care for her baby.
   

• The tendency to develop postpartum blues is unrelated to a previous mental illness and is not caused by stress. However, stress and a history of depression may influence whether the blues go on to become major depression.
   

• Postpartum depression is depression that occurs soon after having a baby. Some health professionals call it postpartum nonpsychotic depression.
   

• This condition occurs in about 10-20% of women, usually within a few months of delivery.
   

• Risk factors include previous major depression, psychosocial stress, inadequate social support, and previous premenstrual dysphoric disorder (see premenstrual syndrome for more information).
   

• Symptoms include depressed mood, tearfulness, inability to enjoy pleasurable activities, trouble sleeping, fatigue, appetite problems, suicidal thoughts, feelings of inadequacy as a parent, and impaired concentration.
   

• If you experience postpartum depression, you may worry about the baby's health and well-being. You may have negative thoughts about the baby and fears about harming the infant (although women who have these thoughts rarely act on them).
   

• Postpartum depression interferes with a woman's ability to care for her baby.
   

• When a woman with severe postpartum depression becomes suicidal, she may consider killing her infant and young children, not from anger, but from a desire not to abandon them.
   

• Postpartum (puerperal) psychosis is the most serious postpartum disorder. It requires immediate treatment.
   

• This condition is rare. A woman with this condition experiences psychotic symptoms within 3 weeks of giving birth. These include false beliefs (delusions), hallucinations (seeing or hearing things that are not there), or both.
   

• This condition is associated with mood disorders such as depression, bipolar disorder, or psychosis.
   

• Symptoms can include inability to sleep, agitation, and mood swings.
   

• A woman experiencing psychosis can appear well temporarily, fooling health professionals and caregivers into thinking that she has recovered, but she can continue to be severely depressed and ill even after brief periods of seeming well.
   

• Women who harbor thoughts of hurting their infants are more likely to act on them if they have postpartum psychosis.
   

• If untreated, postpartum psychotic depression has a high likelihood of coming back after the postpartum period and also after the birth of other children.
   

• Postpartum Depression Symptoms
   

• Symptoms usually appear any time from 24 hours to a few months after delivery. If you have these, it is important to see a health care provider, who will look for other conditions that can cause similar symptoms.
   

• Sad mood, frequent crying
   

• Lack of pleasure or interest in activities that once gave pleasure
   

• Sleep disturbance
   

• Weight loss
   

• Loss of energy
   

• Agitation or anxiety
   

• Feelings of worthlessness or guilt
   

• Trouble concentrating or making decisions
   

• Thoughts of death or suicide
   

• Decreased interest in conjugal intimacy
   

• Feelings of rejection
   

• Physical symptoms such as frequent headaches, chest pain, rapid heart beat, numbness, shakiness or dizziness, and mild shortness of breath suggest anxiety. Postpartum anxiety disorder is a separate disorder from postpartum depression, but the two often occur together.
   

• If you have any of the following symptoms, it is important to contact a medical professional immediately.
   

• Inability to sleep more than 2 hours per night
   

• Thoughts of hurting or killing yourself
   

• Thoughts of hurting your baby or other children
   

• Hearing voices or seeing things
   

• Thoughts that your baby is evil
   

• Too often, depressive symptoms are dismissed as normal for a woman who has just experienced childbirth. If you have had depression in the past, or have risk factors for depression, talk with your doctor before getting pregnant or early in your pregnancy.