Postpartum period
During the subacute postpartum period, psychological disorders may emerge. Among these are postpartum depression, posttraumatic stress disorder, and in rare cases, puerperal psychosis. Postpartum mental illness can affect both mothers and fathers, and is not uncommon. Early detection and adequate treatment is required. Approximately 25% – 85% of postpartum women will experience the "blues" for a few days. Between 7% and 17% may experience clinical depression, with a higher risk among those women with a history of clinical depression. Prevalence of PTSD following normal childbirth (excluding stillbirth or major complications) is estimated to be between 2.8 and 5.6% at 6 weeks postpartum.
Psychoneuroendocrinology
Treatment of postpartum depression can include individual or group psychotherapy, medication, and supportive interventions. A combination of individual psychotherapy (particularly cognitive therapy) and medication has been shown to be effective. There are no standard guidelines regarding medication therapy. The potential risk of infant exposure to small amounts of antidepressants in breast milk is unclear, so in each individual woman the risk of not taking antidepressants must be balanced against the risk of either not breastfeeding or potentially exposing the infant with continued breastfeeding. There is some reassuring data on the safety of SSRI antidepressants, and infants nursed by mothers taking SSRIS typically receive low levels of medication exposure.