Round 2: Does Postpartum Depression (PPD) Lead to Major Depressive Disorder (MDD)?

In the second round of this debate, the experts discuss the question: Does PPD lead to MDD?

Transcript:

Dr Jennifer Payne: Hello, everyone, and welcome back to our Great Debates in Psychiatry Series, brought to you by Psych Congress Network. We are now in round two of this debate, where we'll be discussing whether postpartum depression leads to major depression. Dr Barrett…

Dr Melanie Barrett: There are different trajectories for postpartum depression, and for some women, symptoms can last for years after giving birth. This highlights the importance of early detection and prompt and adequate treatment of postpartum depression.

Dr Jennifer Payne: Women who don't have a prior psychiatric history and who develop postpartum depression are at an elevated risk of developing major depression outside of the peripartum time. Women who have a history of major depression or another type of mood disorder are also at elevated risk for postpartum depression. So it's a two-way street. A small number of women only experience postpartum depression during the perinatal. Most go on to have major depression outside of the perinatal. I once heard an obstetrician refer to pregnancy as the ultimate stress test and that medical complications during pregnancy are indicative of medical risks outside of pregnancy. So, if a woman has gestational diabetes, she's at elevated risk for diabetes outside of pregnancy. The same is true for psychiatric illness.

Dr Melanie Barrett: PPD can lead to chronic depression if not treated quickly and effectively. Even if fully treated, PPD can be a risk for future episodes of major depression. PPD can also trigger a depressive episode in the father or partner, as this represents a stressor for the entire family. We also know that children born to mothers with PPD are at increased risk for depression and earlier onset of depression themselves.

Dr Jennifer Payne: To summarize, postpartum depression is a subtype of major depression that in some women, is triggered by mood sensitivity to estrogen level changes, and in others, is likely triggered due to stress and/or vulnerability to major depression. Experiencing a postpartum depression episode is generally associated with a greater vulnerability to developing major depression outside of the perinatal period and vice versa; that is, major depression and postpartum depression are related to each other. Though they may have different biological and environmental triggers that result in what we clinically call depression. Thank you, Dr Barrett, for making such great points. This concludes round two of our great debate series. Be sure to tell us who you think won this round by answering the poll question you see on your screen. And don't forget to join us next time for our third round, where we're going to be discussing who should be responsible for identifying postpartum depression.