If you’re pregnant (or your partner is), you’re probably already thinking about what your new baby will be like and what kind of parent you’ll be. Maybe you’ve decorated the nursery and started daydreaming about first giggles and first steps.
But you may also feel fearful about all the changes and new responsibilities. You may be concerned about how you’ll cope emotionally and mentally with a little one, especially if you have a personal history of mental health issues like depression. If your grandma, mom or sister experienced postpartum depression, you might be wondering if it’s genetic. Here, we’ll discuss postpartum depression, genetics and other risk factors — plus provide options for treatment.
What is postpartum depression?
Postpartum depression, sometimes called PPD, is a condition in which a woman feels sad, hopeless, tired or anxious for more than two weeks after having a baby. It’s considered a form of perinatal depression (depression occurring during pregnancy or within a year of giving birth). However, postpartum depression is different from postpartum dysphoria, or the “baby blues,” which are temporary feelings of fatigue, sadness or anxiety that generally last only a few days. In contrast to those with the baby blues, women with postpartum depression do not feel relief as their bodies recover from the strain of childbirth.
In addition to feeling sad, worried or tired (although some fatigue is expected when caring for a newborn!), women with postpartum depression may have trouble bonding with their baby. They may feel like their baby is not their own, or they may feel like they don’t love their child. They may also have difficulty caring for the baby. In very severe cases, these women may even try to harm themselves or their child. Some other symptoms of postpartum depression include:
- Anger or rage.
- Extreme mood swings.
- Frequent frustration.
- Restlessness.
- Irritability.
- Guilt or shame.
- Excessive crying.
- A feeling of numbness or emptiness.
Postpartum depression is common. According to the Centers for Disease Control and Prevention, about 1 in 8 mothers (12.5%) in the U.S. reported postpartum depression symptoms between 2016 and 2020. However, a recent meta-analysis of 565 studies from 80 different countries or regions suggested that between 1 in 6 and 1 in 5 mothers (17.2%) develop postpartum depression worldwide. And these numbers might be underestimated, as they depend on women reporting their symptoms or seeking help.
How much of postpartum depression is genetic?
Postpartum depression does have a large genetic component. One analysis of studies on twins suggested that 37% of postpartum depression can be explained by genetics. In another study on 120 pairs of sisters, 42% of women whose sister had experienced postpartum depression developed it themselves after their first delivery. In contrast, only 15% of women without a family history developed postpartum depression. (Of course, it’s also important to consider the “nurture” factor, as those growing up in the same household are exposed to many of the same environmental factors.)
The identities of all of the genes or mutations that might contribute to postpartum depression aren’t clear. However, mutations in the genes 5-HTT, COMT and MAOA are known to be involved. These genes encode proteins that help produce, break down or transport mood-related molecules in the brain.
Aside from gene sequences, changes in the way certain genes are “read” may play a role. A small study on 52 pregnant women at Johns Hopkins University identified chemical modifications in two genes, HP1BP3 and TTC9B, that were very accurate in predicting whether a woman would develop postpartum depression. Such chemical alterations, called “epigenetic modifications,” can potentially be passed down to someone’s children, even though the gene sequence itself isn’t altered. This provides another way that the risk of postpartum depression can be inherited.
What are other risk factors for postpartum depression besides genetics?
Beyond having a family history, your risk of developing postpartum depression may increase if you:
- Had depression before or during your pregnancy.
- Are under the age of 20.
- Are experiencing stressful life events like financial problems or relationship issues.
- Did not plan to get pregnant.
- Had a difficult birth.
- Had a premature baby.
- Have a baby with special health needs.
- Have/had difficulty breastfeeding.
- Were previously or are currently a victim of domestic violence.
- Were abused as a child.
- Have minimal social support.
- Had a difficult pregnancy or childbirth in the past.
If my postpartum depression is genetic, can it be treated?
Postpartum depression is treatable, even if it has a genetic component. Most women who are treated will achieve a full recovery. Common treatments for this condition include psychotherapy (talk therapy) and antidepressant medications. The same types of antidepressants used for major depressive disorder are often used for postpartum depression. These include SSRIs, SNRIs, bupropion, and tricyclic antidepressants. In addition, within the last few years, two medications have been approved by the U.S. Food and Drug Administration specifically for postpartum depression: brexanolone (an IV treatment delivered in a clinic) and zuranolone (an oral drug).
For harder-to-treat cases, there are also alternative therapies.One is transcranial magnetic stimulation, a noninvasive technique in which pulses of magnetic energy are delivered to the brain to stimulate brain cells.
Active Path Mental Health can help treat postpartum depression
If you have postpartum depression and are seeking relief, Active Path Mental Health may be able to help. Contact our team today for more information about how we can help you with your postpartum depression or to schedule an initial appointment.
