Getting a postpartum depression (PPD) diagnosis is the first step toward treatment that will help you feel better. Knowing how PPD is screened can help empower you to seek out the best healthcare for yourself or your loved one.

Left undiagnosed and untreated, PPD doesn’t go away on its own. PPD can make it hard to care for your baby and cause problems in their development. It’s important for you to be fully honest with your healthcare provider during appointments so that you can get the best care as quickly as possible.

Here, we’ll cover what to expect when receiving a PPD diagnosis.

How Is PPD Diagnosed?

A healthcare provider can diagnose postpartum depression by asking interview questions, ruling out other causes, and performing a physical examination. Healthcare providers use a self-report questionnaire as a screening test at the beginning of appointments. Screening tests can detect a health condition like PPD and determine if symptoms are getting better or worse.

If you or a loved one has recently given birth, it’s good to be on the lookout for signs of PPD. Fathers, non-birthing parents, and trans and nonbinary parents can also experience PPD.

The symptoms of postpartum depression mirror those of major depression, but they happen within the first year of giving birth. Some of the symptoms of depression include:

• Loss of interest in activities
• A depressed mood
• Tiredness
• Weight changes
• Feelings of worthlessness
• Inability to concentrate
• Feeling slowed down
• Sleep problems
• Thoughts of hurting yourself or your baby

Like in a screening for major depression, healthcare providers use the Diagnostic and Statistical Manual (DSM) as a guide for diagnosis. The DSM says that at least five of nine depression symptoms must be present before someone is diagnosed with depression.

You may be wondering who will screen you for PPD. Many different healthcare providers can help you get diagnosed, including:

• An obstetric gynecologist (OB-GYN)
• A midwife
• Your primary care doctor
• Your child’s pediatrician

While PPD screening usually takes place at a medical appointment, it can also occur through web-based platforms or text messages with a healthcare provider. These methods may be more accessible for some new parents. Your provider will give you screening questionnaires and ask about your risk factors. They will ask about your drug and alcohol use and any prescription or over-the-counter medications you have taken.

Screening Tools

Three healthcare societies have come together to make recommendations about screening for PPD. They are:

• The American College of Obstetricians and Gynecologists (ACOG)
• The American Academy of Pediatrics (AAP)
• The American Academy of Family Physicians (AAFP)

These health experts recommend regular PPD screening and screening for other perinatal mood disorders (mood disorders that occur during pregnancy and the first year after giving birth). The AAP recommends getting screened at your baby’s one-, two-, four-, and six-month checkups.

Questionnaires

There are several screening tools that your provider can use to detect PPD. Your doctor will give you a questionnaire to assess how you are feeling. The most common screening questionnaire is the Edinburgh Postnatal Depression Scale (EPDS), which has 10 questions. Some providers may also use the Patient Health Questionnaire 9 (PHQ-9), which has nine questions. Even though the EPDS and PHQ-9 have slightly different diagnostic criteria, they do a similar job of identifying PPD.

Each question on the EPDS has four possible answers. For example, one of the questions asks: “In the past seven days, have you felt anxious or worried for no good reason?” Each answer is scored from 0 ("No, not at all") to 3 ("Yes, very often"). You will get a final score between 0 and 30. A higher score means you are more likely to have PPD.

An EPDS score greater than 10 generally means that there is some probability of PPD. A score between 14 and 24 indicates a high probability, and a score of 25 or above suggests a very high probability.

How Effective Is a Questionnaire at Diagnosing PPD?

Researchers can look at sensitivity and specificity measures to see how well a test can diagnose a condition. Sensitivity measures how well a test finds people with a condition. On the other hand, specificity measures how well a test excludes people without a condition.

A systematic review found that an EPDS cutoff score of 11 has a sensitivity of 81 percent and specificity of 88 percent. This means that a score of 11 or higher accurately identifies 81 percent of people with PPD. Simultaneously, 88 percent of the people who score lower than 11 do not have PPD. Overall, this 10-question questionnaire is effective at diagnosing people with PPD.

How Can My Provider Determine If I’m Experiencing PPD or Normal Postpartum Changes?

New parents may confuse PPD with the “baby blues,” feelings of sadness and being overwhelmed that sometimes happen in the first two weeks after birth. These feelings don’t last longer than two weeks. To be diagnosed with PPD, on the other hand, you must experience symptoms for at least two weeks. Your healthcare provider will take into consideration how long you have been experiencing depression symptoms and the severity of the symptoms.

Your healthcare provider may also test for other health conditions to see if something else is affecting your mood, such as a thyroid issue. Thyroid problems can sometimes develop during or after pregnancy. Your doctor might test your thyroid hormone levels to rule out thyroid disorders.

Next Steps

If you are experiencing PPD symptoms, there are several steps you can take.

Contact Your Health Provider

As soon as you suspect you may be experiencing PPD, reach out for medical support. Being proactive is especially important if you have not had many PPD screenings during pregnancy or since giving birth. You can ask your provider to give you the EPDS if they haven’t already. Be as honest as you can with your provider so they can properly evaluate your mental health. You can make a list of all the medications you take and your health conditions to share with your provider. Write down any questions beforehand so you don’t forget them at the appointment.

Seek Treatment

Your provider may give you a referral to a mental health specialist for treatment. Common treatments include antidepressant medication and psychotherapy. Be proactive about your treatment plan by taking medications and attending therapy as prescribed.

You Are Not Alone

According to March of Dimes, around 15 percent of new mothers experience PPD. However, only about 50 percent of PPD cases are ever diagnosed. Many new mothers and new parents are afraid to share their symptoms due to feelings of shame and stigma.

Take Care of Yourself

It may be hard to put yourself first when caring for a new life and dealing with changing family dynamics at home. During your PPD recovery, it’s more important than ever to take care of your mental health. Lean on your social support, like your family and friends, and ask them for help with the baby. Take time to rest, and give yourself permission to take breaks during this transitional time.

Find Your Team

MyDepressionTeam is the social network for people living with all types of depression, including postpartum depression, and their loved ones. Members come together to ask questions, offer support and advice, and share their stories with others who understand life with PPD.

Did you know about the risk factors for postpartum depression before your baby was born? Do you have any advice for others managing these risks? Share your experience, or start a conversation by posting on your Activities page.