Postpartum depression usually means a major depression with typical symptoms and without psychotic features. The woman also feels inadequate as a mother. These depressions usually begin within weeks of delivery and may last for weeks to months, even beyond the first year if not treated. Their incidence is thought to be 10 to 20 percent. Unfortunately, few women with postpartum depression seek or receive treatment.
Postpartum psychosis consists primarily of depression and mania with psychotic features.
The psychosis usually begins within two weeks of delivery and requires hospitalization. The incidence of postpartum psychosis is 1 to 2 per 1,000 births. Risk factors include a personal or family history of psychoses and having just delivered one's first baby. Long-term treatment of postpartum psychosis includes antipsychotic medications for several months and then mood medications indefinitely if there have been recurrent episodes not related to pregnancy. For women taking lithium, careful contraception is to be encouraged, and when a pregnancy is planned, the need to continue lithium should be weighed according to clinical factors.