Postpartum depression is a fairly common condition that affects up to 10-15% of women who give birth.
It’s also considered one of the most serious mental disorders, with symptoms including fatigue, mood changes, loss of interest in activities previously enjoyed and feelings like helplessness or guilt.
Several studies have been conducted over the years on postpartum depression. But is postpartum depression genetic?
This article will answer this question for you and more.
What is Postpartum Depression?
Postpartum depression is a type of depression that can affect mothers after giving birth. It is a serious mental health condition that typically occurs due to hormonal changes, fatigue, and psychological adjustment to motherhood.
Symptoms of postpartum depression include feeling sad or empty, loss of interest in daily activities, problems with concentration, low self-esteem and guilt.
Postpartum depression can begin anytime from the start of pregnancy to six months after childbirth, but usually begins around three months in.
Moreover, women with postpartum depression (PPD) tend to suffer from postpartum anxiety too.
Is Postpartum Depression Genetic?
Postpartum depression can be genetic according to a study led by Zachary Kaminsky, Ph.D., an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.
Researchers discovered specific chemical alterations in two genes that, when present during pregnancy, reliably predict whether a woman will develop postpartum depression.
The two genes, TTC9B and HP1BP3, were highly correlated with the development of postpartum depression. This means that if someone in your family has suffered from postpartum depression, you are more likely to experience it yourself.
However, it is important to note that not everyone who carries these genes will develop postpartum depression and there are many other factors that contribute to its development.
What Puts a Woman at Higher Risk for PPD?
A meta-analysis looked at thirteen variables which may be used to identify women at risk for postpartum depression either during pregnancy or soon after delivery.
Ten of those thirteen have been shown to be reliable predictors, in many cases, of postpartum depression:
Prenatal depression is a significant predictor for postpartum depression. In fact, it is the strongest predictor of PPD. This means that if a woman suffers from prenatal depression, she is more likely to experience postpartum depression.
Other variable that put women at higher risk to develop postpartum depression are:
- Prenatal anxiety
- Maternity blues
- History of previous depression
- Recent stressful life events
- Poor marital relationship
- Inadequate social supports
- Childcare stress
- Difficult infant temperament
- Low self-esteem
Furthermore, there are three other possible reasons why some women are at higher risk of PPD:
- Unplanned or unwanted pregnancy
- Single marital status
- Lower socioeconomic status
What Part of The Brain Does PPD Affect?
A study looked at the role of glutamate in postpartum depression and found that women with PPD had higher levels of glutamate in the prefrontal cortex than those without PPD.
Glutamate is a neurotransmitter that has been shown to play an important role in the symptoms of depression. It helps regulate mood, emotion and memory.
The prefrontal cortex is responsible for complex thought and decision making, as well as emotion.
Postpartum Depression Causes
Postpartum depression is caused by a combination of genetic, environmental, and hormonal factors.
Some people may be more predisposed to developing postpartum depression due to their genes, while others may develop it as a result of stressful life events or changes in their hormone levels after giving birth.
Physical Causes of Postpartum Depression
The physical causes of postnatal depression are linked to hormonal changes in a woman’s body:
- A dramatic drop in progesterone and estrogen
- Thyroid gland’s hormonal production decrease
Emotional Causes of Postpartum Depression
A lack of sleep can lead to difficulties in handling certain emotions.
For example, postpartum women may feel anxious about their ability to care for their baby.
In addition, they may feel less attractive, or feel like they no longer have control over their lives.
Biological Predictors and Biomarkers for PPD
Recently, there has been more development in identifying the biological predictors for postpartum depression. This includes studying biomarkers, as well as genetic markers.
Research on genetic markers for postpartum depression
There is a growing body of evidence that suggests that PPD is more heritable than non-perinatal depression.
Studies on the genetic and epigenetic underpinnings of PPD are still in their infancy, but they suggest that there are biological predictors for PPD, including genes associated with the HPA axis and stress response on the prefrontal cortex.
Reproductive hormones
There is conflicting evidence surrounding the role of reproductive hormones in the development of postpartum depression.
Bloch and Klier’s study suggests that reproductive hormones may play a role, while Serati’s study reviews 200 studies which do not support this hypothesis.
The focus on estrogen and progesterone is an interesting area of study when it comes to predicting postpartum depression.
Stress Hormones
Stress hormones such as cortisol are implicated in a range of mental health conditions, including non-puerperal depression.
The HPA axis plays an important role in perinatal depression and the stress of giving birth.
The levels of stress hormones peak in the first and third trimester, with a drop after childbirth.
Immunological/Inflammatory Studies
The immune system is constantly working to protect the body from outside invaders. However, during pregnancy, this becomes much more challenging as the goal is to maintain balance between proinflammatory and anti-inflammatory cytokines.
If this balance is disrupted, it can lead to a number of problems, including depression. Inflammatory cytokines play a role in the pathophysiology of depression and may be associated with perinatal episodes in PPD cases.
The “proinflammatory state” during the late pregnancy and early postpartum period is an important factor in the development of PPD.
Biomarkers From Biochemical Studies
In a study of biochemical biomarkers, it was found that lower serum zinc levels and higher CRP levels predicted the development of postnatal depression.
Additionally, physio-somatic symptoms were a strong predictor of postnatal depression.
Interestingly, vitamin D has been found to be a predictor for postpartum depression too. In one study, it was found that a decreased vitamin D level during pregnancy can lead to PPD or preeclampsia.
However, another study found that there was a significant relationship between low levels of 25-hydroxyvitamin D (25(OH)D) and high EPDS scores over time.
Postpartum Depression Treatment
A few treatment options are available, regardless of whether a woman’s postpartum depression is genetic or not.
Treatment Goals and Considerations
The main goal of treatment for postpartum depression (PPD) and major depressive disorder (MDD) is the reduction of symptoms, with an ultimate goal of symptom remission.
The treatments should also be feasible- meaning that they are both acceptable to the patient and practical to administer- and aim to minimize side effects and adverse outcomes.
Traditional Antidepressants
Monoaminergic-based antidepressants are a type of medication that work to increase the amount of serotonin in the brain.
Selective Serotonin Reuptake Inhibitors (SSRIs) are a type of monoaminergic-based antidepressant and are considered the first-line treatment for major depressive disorder and postpartum depression.
Psychotherapy
Psychotherapy is a type of talk therapy that is often recommended for postpartum depression.
It can help to identify and address the underlying causes of the depression and to develop coping mechanisms.
Conclusions
Postpartum Depression (PPD) can have negative consequences on both the mother and child if left untreated. So, it is important to detect PPD early in order to treat it successfully.
If you think you or someone you know is experiencing postpartum depression, make sure you contact a doctor ASAP.
