Most Common Disorders

Major Depression

People who experience major depression do not take pleasure in activities that were once enjoyable. Other physical and mental problems often experienced include sleep problems, loss of appetite, inability to concentrate, memory problems, and aches and pains. People who suffer from this condition often feel worthless, helpless, and hopeless about their ability to fix things. No matter how hard they try to snap out of it, they feel as though they are falling into an abyss with nothing to hold on to.
Major depression usually strikes people between the ages of 25 and 44, although it can affect any person at any age. For most people, episodes of major depression last from six to nine months. Sometimes, even if major depression goes untreated, it will run its course and leave by itself. Doctors are not sure why this happens, but it is often attributed to the body’s tendency to correct abnormal situations.

What Causes Major Depression

Surprisingly, stress has been shown to play a major role in the patient's first two episodes of major depression, but not in later episodes. Genetics and temperament appear to play the most important role for later episodes of a patient's depression.
It appears that major depression often requires stress to "get the ball rolling", but after a few episodes, the illness develops its own momentum and no longer needs stress to "keep rolling". This is a familiar pattern seen in many medical illnesses. Thus, the treatment of major depression must address the major contribution that stress, genetics and temperament play in this disorder.

Symptoms of Major Depression (MDD)

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either: (1) depressed mood or (2) loss of interest or pleasure. (Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.)

• depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
• markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
• significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
• insomnia or hypersomnia nearly every day
• psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
• fatigue or loss of energy nearly every day
• feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
• diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
• recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Panic Disorder

Panic Disorder is a serious condition that around one out of every 75 people might experience. It usually appears during the teens or early adulthood, and while the exact causes are unclear, there does seem to be a connection with major life transitions that are potentially stressful: graduating from college, getting married, having a first child, and so on. There is also some evidence for a genetic predisposition; if a family member has suffered from panic disorder, you have an increased risk of suffering from it yourself, especially during a time in your life that is particularly stressful.

Panic Attacks: The Hallmark of Panic Disorder

A panic attack is a sudden surge of overwhelming fear that comes without warning and without any obvious reason. It is far more intense than the feeling of being 'stressed out' that most people experience.
Symptoms of a panic attack include:

• racing heartbeat
• difficulty breathing, feeling as though you 'can't get enough air'
• terror that is almost paralyzing
• dizziness, lightheadedness or nausea
• trembling, sweating, shaking
• choking, chest pains
• hot flashes, or sudden chills
• tingling in fingers or toes ('pins and needles')
• fear that you're going to go crazy or are about to die

You probably recognize this as the classic 'flight or fight' response that human beings experience when we are in a situation of danger. But during a panic attack, these symptoms seem to rise from out of nowhere. They occur in seemingly harmless situations--they can even happen while you are asleep.
In addition to the above symptoms, a panic attack is marked by the following conditions:

• it occurs suddenly, without any warning and without any way to stop it.
• the level of fear is way out of proportion to the actual situation; often, in fact, it's completely unrelated.
• it passes in a few minutes; the body cannot sustain the 'fight or flight' response for longer than that. However, repeated attacks can continue to recur for hours.

A panic attack is not dangerous, but it can be terrifying, largely because it feels 'crazy' and 'out of control.' Panic disorder is frightening because of the panic attacks associated with it, and also because it often leads to other complications such as phobias, depression, substance abuse, medical complications, even suicide. Its effects can range from mild word or social impairment to a total inability to face the outside world.
In fact, the phobias that people with panic disorder develop do not come from fears of actual objects or events, but rather from fear of having another attack. In these cases, people will avoid certain objects or situations because they fear that these things will trigger another attack (agoraphobia).

How to Identify Panic Disorder

One study found that people sometimes see 10 or more doctors before being properly diagnosed, and that only one out of four people with the disorder receive the treatment they need. That's why it's important to know what the symptoms are, and to make sure you get the right help.
Many people experience occasional panic attacks, and if you have had one or two such attacks, there probably isn't any reason to worry. The key symptom of panic disorder is the persistent fear of having future panic attacks. If you suffer from repeated (four or more) panic attacks, and especially if you have had a panic attack and are in continued fear of having another, these are signs that you should consider finding a mental health professional who specializes in panic or anxiety disorders.

What Causes Panic Disorder: Mind, Body, or Both?

Body: There may be a genetic predisposition to anxiety disorders; some sufferers report that a family member has or had a panic disorder or some other emotional disorder such as depression. Studies with twins have confirmed the possibility of 'genetic inheritance' of the disorder.
Mind: Stressful life events can trigger panic disorders. One association that has been noted is that of a recent loss or separation. Some researchers liken the 'life stressor' to a thermostat; that is, when stresses lower your resistance, the underlying physical predisposition kicks in and triggers an attack.
Both: Physical and psychological causes of panic disorder work together. Although initially attacks may come out of the blue, eventually the sufferer may actually help bring them on by responding to physical symptoms of an attack.
The right therapy for panic disorder focuses on all aspects -- physical, psychological, and physiological -- of the disorder.

Can People with Panic Disorder lead normal lives?

The answer to this is a resounding YES -- if they receive treatment.
Panic disorder is highly treatable, with a variety of available therapies. Once treated, panic disorder doesn't lead to any permanent complications.

Side Effects of Panic Disorder

Without treatment, panic disorder can have very serious consequences.
The immediate danger with panic disorder is that it can often lead to a phobia. That's because once you've suffered a panic attack, you may start to avoid situations like the one you were in when the attack occurred.

Many people with panic disorder show 'situational avoidance' associated with their panic attacks. For example, you might have an attack while driving, and start to avoid driving until you develop an actual phobia towards it. In worst case scenarios, people with panic disorder develop agoraphobia -- fear of going outdoors -- because they believe that by staying inside, they can avoid all situations that might provoke an attack, or where they might not be able to get help.
Even if you don't develop these extreme phobias, your quality of life can be severely damaged by untreated panic disorder. A recent study showed that people who suffer from panic disorder:

• are more prone to alcohol and other drug abuse
• have greater risk of attempting suicide
• spend more time in hospital emergency rooms
• spend less time on hobbies, sports and other satisfying activities
• tend to be financially dependent on others
• report feeling emotionally and physically less healthy than non-sufferers.
• are afraid of driving more than a few miles away from home

OCD
If you or someone you care about has been diagnosed with Obsessive-Compulsive Disorder (OCD), you may feel you are the only person facing the difficulties of this illness. But you are not alone. In the United States, 1 in 50 adults have OCD, and twice that many have had it at some point in their lives. Today very effective treatments for OCD are now available to help you regain a more satisfying life. Here are answers to the most commonly asked questions about OCD.

What Is Obsessive-Compulsive Disorder?

Worries, doubts, and superstitious beliefs are common in everyday life. However, when they become so excessive such as hours of hand washing or driving around and around the block to check that an accident didn't occur then a diagnosis of OCD is made. In OCD,  the brain gets stuck on a particular thought or urge and just can't let go. People with OCD often say the symptoms feel like a case of mental hiccups that won't go away. OCD is a medical brain disorder that causes problems in information processing. It is not your fault or the result of a "weak" or unstable personality.
Before the arrival of modern medications and cognitive behavior therapy, OCD was generally thought to be untreatable. Most people with OCD continued to suffer, despite years of ineffective psychotherapy. Today, luckily, treatment can help most people with OCD.

What are the symptoms of Obsessive-Compulsive Disorder?

OCD involves having both obsessions and compulsions. A person with OCD may sometimes have one or the other.
Common obsessions are: contamination fears of germs, dirt, etc., imagining having harmed oneself or others, imagining losing control or having aggressive urges, intrusive sexual thoughts or urges, excessive religious or moral doubt, forbidden thoughts, a need to have things "just so," and a need to tell, ask, or confess. Common compulsions are: washing, repeating, checking, touching, and counting. OCD symptoms can occur in people of all ages. Not all Obsessive-Compulsive behaviors represent an illness. Some rituals (e.g., bedtime songs, religious practices) are a welcome part of daily life. Normal worries, such as contamination fears, may increase during times of stress, such as when someone in the family is sick or dying. Only when symptoms persist, make no sense, cause much distress, or interfere with functioning do they need clinical attention.

1. Obsessions
   Obsessions are thoughts, images, or impulses that occur over and over again and feel out of your control. The person does not want to have these ideas. He  finds them disturbing and intrusive, and usually recognizes that they don't really make sense. People with OCD worry excessively about dirt and germs and become obsessed with the idea that they are contaminated or contaminate others.  They may have obsessive fears of having inadvertently harmed someone else even though they usually know this is not realistic. Obsessions are accompanied by uncomfortable feelings, such as fear, disgust, doubt, or a sensation that things have to be done in a way that is "just so."
2. Compulsions
   People with OCD try to make their obsessions go away by performing compulsions. Compulsions are acts the person performs over and over again, often according to certain "rules." People with an obsession about contamination may wash constantly to the point that their hands become raw and inflamed. A person may repeatedly check that she has turned off the stove or iron because of an obsessive fear of burning the house down. She may have to count certain objects over and over because of an obsession about losing them. Unlike compulsive drinking or gambling, OCD compulsions do not give the person pleasure. Rather, the rituals are performed to obtain relief from the discomfort caused by the obsessions.
3. Other features of Obsessive-Compulsive Disorder
   OCD symptoms cause distress, take up time (more than an hour a day), or significantly interfere with the person's work, social life, or relationships. Most individuals with OCD recognize that their obsessions are coming from  their own minds and are not just excessive worries about real problems. They realize that the compulsions they perform are excessive or unreasonable. OCD symptoms tend to wax and wane over time. Some may be little more than background noise; others may produce extremely severe distress.

When does Obsessive-Compulsive Disorder begin?

OCD starts at any time from preschool age to adulthood (usually by age 40). One third to one half of adults with OCD report that it started during childhood.
Unfortunately, OCD often goes unrecognized. On average, people with OCD see three to four doctors and spend 9 years seeking treatment before they receive a correct diagnosis. Studies find that it takes an average of 17 years from the time OCD begins for people to obtain appropriate treatment.
OCD tends to be underdiagnosed and undertreated for a number of reasons. People with OCD are secretive about their symptoms or lack insight about their illness. Many healthcare providers are not familiar with the symptoms or are not trained in providing the appropriate treatments. Some people don't have access to treatment resources. This is unfortunate because earlier diagnosis and proper treatment, including finding the right medications, can help people avoid the suffering associated with OCD. This lessens the risk of developing other problems, such as depression, marital and work problems.

Is Obsessive-Compulsive Disorder Inherited?

No specific genes for OCD have been identified. Research suggests that genes do play a role in the development of the disorder. Childhood-onset OCD runs in families (sometimes in association with tic disorders). When a parent has OCD, there is a slightly increased risk that a child will develop OCD, although the risk is still low. When OCD runs in families, it is the general nature of OCD that is inherited, not specific symptoms. Thus a child may have checking rituals, while his mother washes compulsively.

What causes Obsessive-Compulsive Disorder?

Research suggests that OCD involves problems in communication between the front part of the brain (the orbital cortex) and deeper structures (the basal ganglia). These brain structures use the chemical messenger serotonin. It is believed that insufficient levels of serotonin are involved in OCD. Drugs that increase the brain concentration of serotonin often help improve OCD symptoms. Pictures of the brain at work also show that the brain circuits involved in OCD return toward normal in those who improve after taking a serotonin medication or receiving cognitive-behavioral psychotherapy. When OCD starts suddenly in childhood in association with strep throat, an autoimmune mechanism may be involved, and treatment with an antibiotic may prove helpful.

What other problems are sometimes confused with OCD?

Some disorders that closely resemble OCD and may respond to some of the same treatments. They are trichotillomania (compulsive hair pulling), body dysmorphic disorder (imagined ugliness), and habit disorders, such as nail biting or skin picking.
The most common conditions that resemble OCD are the tic disorders (Tourette's disorder and other motor and vocal tic disorders). Tics are involuntary motor behaviors (such as facial grimacing) or vocal behaviors (such as snorting) that often occur in response to a feeling of discomfort. More complex tics, like touching or tapping tics, resemble compulsions. Tics and OCD occur together much more often when the OCD or tics begin during childhood. Depression and OCD often occur in adults, and, less commonly, in children and adolescents. However, unless depression is present, people with OCD are not sad or lacking in pleasure. People who are depressed but do not have OCD rarely have the kinds of intrusive thoughts that are characteristic of OCD. Stress can make OCD worse. Although most people with OCD report that the symptoms can come and go on their own. OCD is easy to distinguish from a condition called posttraumatic stress disorder, because OCD is not caused by a terrible event. Schizophrenia, delusional disorders, and other psychotic conditions are usually easy to distinguish from OCD. Unlike psychotic individuals, people with OCD have a clear idea of what is real and what is not. OCD may worsen or cause disruptive behaviors in children and adolescents, exaggerate a pre-existing learning disorder, cause problems with attention and concentration, or interfere with learning at school. In many children with OCD, these disruptive behaviors are related to the OCD and will go away when the OCD is successfully treated.

Tourette Syndrome

Tourette Syndrome (TS) is a neurological disorder characterized by tics -- involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the same way.
Diagnostic criteria include:
-Both multiple motor and one or more vocal tics present at some time, although not necessarily simultaneously;
-The occurrence of tics many times a day (usually in bouts) nearly every day or intermittently throughout the span of more than one year;
-Periodic changes in the number, frequency, type and location of the tics, and in the waxing and waning of their severity. Symptoms can sometimes disappear for weeks or months at a time;
-Onset before the age of 18.

Although the word "involuntary" is used to describe the nature of the tics, this is not entirely accurate. It would not be true to say that people with TS have absolutely no control over their tics, as though it was some type of spasm; rather, a more appropriate term would be "compelling." People with TS feel an irresistable urge to perform their tics, much like the need to scratch a mosquito bite. Some people with TS are able to hold back their tics for up to hours at a time, but this only leads to a stronger outburst of tics once they are finally allowed to be expressed.

What causes Tourette Syndrome?

Research is ongoing, but it is believed that an abnormal metabolism of the neurotransmitters dopamine and serotonin are involved with the disorder. It is genetically transmitted; parents having a 50% chance of passing the gene on to their children. Girls with the gene have a 70% chance of displaying symptoms, boys with the gene have a 99% chance of displaying symptoms.

Any related problems?

People with TS are more likely to have any combination of the following problems:
Attention-Deficit/Hyperactivity Disorder (ADHD),
Difficulties with Impulse Control (disinhibition)
Obsessive-Compulsive Disorder (OCD)
Various Learning Disabilities (such as dyslexia)
Various Sleep Disorders

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is more than the normal anxiety people experience day to day. It's chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety.

People with GAD can't seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat. Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too.

Usually the impairment associated with GAD is mild and people with the disorder don't feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don't characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.

GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too.  It's diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems.

Specific Symptoms of Generalized Anxiety Disorder:

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). The person finds it difficult to control the worry.
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months; children don't need to meet as many criteria).

• Restlessness or feeling keyed up or on edge
• Being easily fatigued
• Difficulty concentrating or mind going blank
• Irritability
• Muscle tension
• Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

Additionally, the anxiety or worry is not about having a panick attack, being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder (PTSD). The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Social phobia
People with social phobia have an extreme fear of situations where they may be under the scrutiny of others. They worry that they will not measure up. Exposure to social situations can produce physical symptoms, such as sweating, blushing, muscle tension, pounding heart, dry mouth, shaky voice or trembling. These symptoms can become a source of added concernÐorry that they will result in unwanted and embarrassing attention. People with social phobia either avoid social or performance situations, or endure them with intense anxiety or stress.

It is difficult to say how many people suffer from the disorder. Scholarly studies have used a variety of definitions for social phobia, but such reports put the incidence in the United States at anywhere from five to 13 percent of the population experiencing it during their lifetime.

A variety of studies have demonstrated that social phobia is most likely to develop in the teenage years, though it can start earlier or later. Mental health professionals report that many people suffer quietly for years, looking for help only when their fears have precipitated a major life crisis.

Types of Social Phobia
For some people, almost any social circumstance is a cause for fear and anxiety. These individuals are said to have generalized social phobia. People for whom just one or two situations produce anxiety are considered to have the nongeneralized form of the disorder.

A number of researchers have suggested that another way to group people with social phobia is based on the kind of situation that evokes dread. Two primary categories or groups are performance and interactional.
The performance grouping includes people who have strong anxiety at the idea of doing something in front of, or in the presence of, other people. Such situations include dining out, working, giving a speech or using a public restroom.

The interactional grouping includes people whose fears center on circumstances where they have to converse or otherwise engage with others, such as meeting new people.

Bipolar I
Bipolar I Disorder is one of most severe forms of mental illness and is characterized by recurrent episodes of mania and depression. The condition has a high rate of recurrence and if untreated, it has an approximately 15% risk of death by suicide. It is the third leading cause of death among people aged 15-24 years, and is the (lost years of healthy life) for people aged 15-44 years in the developed world.

Causes
Bipolar I Disorder is a life-long disease and runs in families but has a complex mode of inheritance. Family, twin and adoption studies suggest genetic factors. About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder. If one parent has Bipolar I Disorder, the child will have a 25% chance of developing a mood disorder. If both parents have Bipolar I Disorder, the child has a 50%-75% chance of developing a mood disorder.

Environmental or psychological factors likely play a role in causation. Certain environmental factors (e.g., stimulants) or certain illnesses (e.g., multiple sclerosis, brain tumor, hyperthyroidism) can trigger mania. Mania can be triggered by giving birth, sleep deprivation, and major stressful life events.

Symptoms
In adults, mania is usually episodic with an elevation of mood and increased energy and activity. In adults and children, during depression there is lowering of mood and decreased energy and activity. During a mixed episode both mania and depression can occur on the same day.

Comorbidity

Comorbidity is the rule, not the exception, in bipolar disorder. The most common mental disorders that co-occur with bipolar disorder are anxiety, substance use and Tourette's disorder. The most common general medical comorbidities are migraine, thyroid illness, obesity, type II diabetes, and cardiovascular disease.

Pathophysiology
Research is now showing that this disorder is associated with abnormal brain levels of serotonin, norepinephrine, and dopamine.
Prevalence
Bipolar I Disorder affects both sexes equally in all age groups and its worldwide prevalence is approximately 3-5%. It can even present in preschoolers.

Course
The first episode may occur at any age from childhood to old age. The average age at onset is 21. More than 90% of individuals who have a single Manic Episode go on to have future episodes. Untreated patients with Bipolar I Disorder typically have 8 to 10 episodes of mania and depression in their lifetime. Often 5 years or more may elapse between the first and second episode, but thereafter the episodes become more frequent and more severe.
There is significant symptom reduction between episodes, but 25% of patients continue to display mood instability or mild depression.
Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months). Depressive episodes tend to last longer (median length about 6 months), though rarely for more than a year, except in the elderly.

Bipolar II

Bipolar II is a psychological disorder that involves mood swings from depressed to hypomanic states. Unlike bipolar I, also called manic depression, bipolar II does not involve manic states. However, like bipolar I, the person afflicted suffers from varying degrees of mood. Bipolar II may create depression or anxiety so great that risk of suicide is increased over those who suffer from Bipolar I.

In order to properly diagnose Bipolar II, patients and their doctors must be able to recognize what constitutes hypomania. People in a hypomanic state may experience increased anxiety, sleeplessness, good mood, or irritability.
Hypomania may also cause people to feel more talkative, result in inflated self-esteem, make people feel as though their thoughts are racing, and in some cases result in rash choices, such as indiscriminate sexual activity or inappropriate spending sprees. Often, the person who feels anxious or irritable and also has bouts of depression is diagnosed with anxiety disorder with depression, or merely anxiety disorder. As such, they do not receive the proper treatment, because if given an anti-depressant alone, the hypomanic state can progress to a manic state, or periods of rapid cycling of mood can occur and cause further emotional disturbance.

Ultimately, though, those with bipolar II find that anti-depressants alone do not provide relief, particularly since anti-depressants can aggravate the condition. Another hallmark of bipolar II is rapid cycling between depressed and hypomanic states. If this symptom is misdiagnosed, sedatives may be added to anti-depressants, further creating mood dysfunction.

The frequent misdiagnosis of bipolar II likely creates more risk of suicidal tendencies during depressed states. Patients legitimately trying to seek treatment may feel initial benefits from improper medication, but then bottom out when treatments no longer work

Depression associated with either bipolar I or II is severe. In many cases, depression creates an inability to function normally. Patients suffering from major depression describe feeling as though things will never feel right again.
Severely depressed patients may not leave their homes or their beds. Appetite can significantly increase or decrease. Sleeping patterns may be disrupted, and people may sleep much longer than usual. With treatment, those with bipolar I or II can live healthy normal lives and attain success in work and relationships.

Postpartum Depression

About one out of every eight women has postpartum depression after delivery. It is the most common complication among women who have just had a baby.  Postpartum depression is a serious medical condition. It is not something a woman can control. It is not a sign of being a bad mother. It poses risks for the woman and her baby. The most important things to do are:

• Recognize the signs of postpartum depression (see below)
• Reach out and get help because a range of treatments are available

Medical experts believe that changes in the woman's hormones after delivery cause postpartum depression. Women who have ever been depressed are at greater risk for postpartum depression than other women are.

Postpartum depression is not the same as the postpartum blues. This condition is more common and less serious. It usually ends by the tenth day after the baby is born

What Is Postpartum Depression?
A woman who has postpartum depression feels sad, "down" or depressed. She also has five or more of the following symptoms lasting two weeks or longer:

• Trouble sleeping (even when the baby is asleep or when others are caring for the infant)
• Lack of interest
• Feelings of guilt
• Loss of energy
• Difficulty concentrating
• Changes in appetite
• Restlessness or slowed movement
• Thoughts or ideas about suicide

Postpartum depression can begin at any time within the first three months after delivery. It can seriously threaten both the woman and her baby. Since the mother is seriously ill, she may not be able to care for her baby as she would if she were well. The disease may make it hard for the mother to breastfeed or bond with her baby. For these reasons, postpartum depression is a threat to newborns.