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It is not always easy to diagnose postpartum depression.

It is not always easy to diagnose postpartum depression. There are several reasons for this.¹

• It can be confused with a common condition called the baby blues. For information more, see The baby blues.
• Some of the warning signs, such as weight loss, sleep problems and exhaustion, are a normal part of being a new mother.
• Women are often reluctant to talk about their feelings because they worry that other people will think they are bad mothers.

But it is important to see your doctor early on if you think you may be depressed. There are treatments that may help you get better faster.

Here are some things your doctor might do to help figure out if you have postpartum depression.

Your doctor may ask you some questions about how you feel.²

• Do you feel depressed for most of the day?
• Have you lost interest or pleasure in things that usually make you happy, like playing with your baby?
• Do you feel tired and like you don't have any energy?

Your doctor will probably say you have postpartum depression if you answer 'yes' to the questions above and to any four of the following ones.

• Have you lost your confidence and self-esteem?
• Do you feel guilty for no reason?
• Have you been thinking a lot about killing yourself (suicide) or about death, either your death or your baby's?
• Is it hard for you to concentrate?
• Do you feel agitated or slowed down?
• Are you sleeping too little or too much?
• Are you eating too little or too much?

Your doctor will probably say you have mild depression if you have four of these last seven symptoms. If you have five or six symptoms, you have medium depression (your doctor might call this moderate depression). And if you have all seven, your depression is very bad (your doctor might say you have severe depression).³

If you answer "yes" to either of the questions below, you may have a more serious illness called postpartum psychosis.⁴

• Have you had four days in a row when you felt so good, high, excited or "hyper" that other people thought you were not your normal self or you got into trouble?
• Have you had four days in a row when you were so irritable that you shouted at people or started fights or arguments?

If you have postpartum psychosis, you will need to see a specialist called a psychiatrist. Also, you will probably need to be cared for in the hospital. For more on that illness, see Postpartum psychosis.

There aren't any physical signs of postpartum depression. But your doctor may still do some or all of the following:

• Feel your tummy to see if your womb (uterus) is getting back to normal
• Check your blood pressure, if it has been high
• Examine your birth canal (vagina) if you have had any tearing, bleeding or pain
• Check your pulse and temperature if you are feeling unwell.

There aren't any physical tests for postpartum depression. But there are questionnaires that doctors and other health professionals can use to help spot postpartum depression.

The most popular questionnaire is called the Edinburgh Postpartum Depression Scale (EPDS for short).⁵

This questionnaire is a kind of screening. With a screening, a doctor, nurse or other health professional tests everybody to see if they might have a condition. That means testing whether you have clear symptoms or not. For more information, see Screening for postpartum depression.

Your doctor may also offer you a blood test to check for problems with your thyroid gland. You are more likely to get thyroid problems in the weeks and months after having a baby than at other times.⁴ Problems with your thyroid gland can affect your mood.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.