Editing Postpartum depression (section)

== Signs and symptoms ==
Symptoms of PPD can occur at any time in the first year postpartum.<ref name="OBOS">The Boston Women's Health Book Collective: Our Bodies Ourselves, pages 489–491, New York: Touchstone Book, 2005</ref> Typically, a diagnosis of postpartum depression is considered after signs and symptoms persist for at least two weeks.<ref name=WebMD />

=== Emotional ===
* Persistent sadness, anxiousness, or "empty" mood<ref name="OBOS" />
* Severe mood swings<ref name="WebMD">WebMD: Understanding Post Partum Depression {{cite web |url=http://www.webmd.com/depression/postpartum-depression/understanding-postpartum-depression-basics |title=The Basics of Postpartum Depression |access-date=2015-04-09 |url-status=live |archive-url=https://web.archive.org/web/20150415013254/http://www.webmd.com/depression/postpartum-depression/understanding-postpartum-depression-basics |archive-date=2015-04-15 }}</ref>
* Frustration, irritability, restlessness, anger<ref name="OBOS" /><ref name="CDC">{{Cite web|url=https://www.cdc.gov/reproductivehealth/depression/|title=Depression Among Women {{!}} Depression {{!}} Reproductive Health {{!}} CDC|website=www.cdc.gov|access-date=2017-04-15|url-status=live|archive-url=https://web.archive.org/web/20170416130236/https://www.cdc.gov/reproductivehealth/depression/|archive-date=2017-04-16}}</ref>
* Feelings of hopelessness or helplessness<ref name="OBOS" />
* Guilt, shame, worthlessness<ref name="OBOS" /><ref name=CDC/>
* Low self-esteem<ref name="OBOS" />
* [[Hypoesthesia|Numbness]], emptiness<ref name="OBOS" />
* Exhaustion<ref name="OBOS" />
* Inability to be comforted<ref name="OBOS" />
* Trouble bonding with the baby<ref name=WebMD />
* Feeling inadequate in taking care of the baby<ref name="OBOS" /><ref name=CDC />
* Thoughts of self-harm or suicide<ref>{{cite journal | vauthors = Wisner KL, Sit DK, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, Eng HF, Luther JF, Wisniewski SR, Costantino ML, Confer AL, Moses-Kolko EL, Famy CS, Hanusa BH | title = Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings | journal = JAMA Psychiatry | volume = 70 | issue = 5 | pages = 490–498 | date = May 2013 | pmid = 23487258 | pmc = 4440326 | doi = 10.1001/jamapsychiatry.2013.87 }}</ref>

=== Behavioral ===
* Lack of interest or pleasure in usual activities<ref name="OBOS" /><ref name=CDC/><ref name=WebMD />
* Low libido<ref>{{cite journal | vauthors = Morof D, Barrett G, Peacock J, Victor CR, Manyonda I | title = Postnatal depression and sexual health after childbirth | journal = Obstetrics and Gynecology | volume = 102 | issue = 6 | pages = 1318–1325 | date = December 2003 | pmid = 14662221 | doi = 10.1016/j.obstetgynecol.2003.08.020 | s2cid = 39467608 }}</ref>
* Changes in appetite<ref name="OBOS" /><ref name=CDC/>
* Fatigue, decreased energy<ref name="OBOS" /><ref name=CDC/> and motivation<ref name="CDC" />
* Poor self-care<ref name=WebMD />
* Social withdrawal<ref name="OBOS" /><ref name=WebMD/>
* Insomnia or excessive sleep<ref name="OBOS" /><ref name=WebMD/>
* Worry about harming self, baby, or partner<ref name=WebMD/><ref name=CDC />

=== Neurobiology ===
[[Functional magnetic resonance imaging|fMRI]] studies indicate differences in brain activity between mothers with postpartum depression and those without. Mothers diagnosed with PPD tend to have less activity in the left [[frontal lobe]] and increased activity in the right frontal lobe when compared with healthy controls. They also exhibit decreased connectivity between vital brain structures, including the [[anterior cingulate cortex]], dorsal lateral [[prefrontal cortex]], [[amygdala]], and [[hippocampus]]. Brain activation differences between depressed and nondepressed mothers are more pronounced when stimulated by non-infant emotional cues. Depressed mothers show greater neural activity in the right amygdala toward non-infant emotional cues as well as reduced connectivity between the amygdala and right insular cortex. Recent findings have also identified blunted activity in the anterior cingulate cortex, [[striatum]], [[orbitofrontal cortex]], and [[Insular cortex|insula]] in mothers with PPD when viewing images of their infants.<ref name="Pawluski_2017">{{cite journal | vauthors = Pawluski JL, Lonstein JS, Fleming AS | title = The Neurobiology of Postpartum Anxiety and Depression | journal = Trends in Neurosciences | volume = 40 | issue = 2 | pages = 106–120 | date = February 2017 | pmid = 28129895 | doi = 10.1016/j.tins.2016.11.009 | s2cid = 28613743 | url = https://hal-univ-rennes1.archives-ouvertes.fr/hal-01452985/file/The%20Neurobiology%20of%20Postpartum-Tins%20Manscript%20REVISED%20clean%201.pdf }}</ref>

More robust studies on neural activation regarding PPD have been conducted with rodents than humans. These studies have allowed for greater isolation of specific brain regions, [[neurotransmitter]]s, [[hormone]]s, and [[steroid]]s.<ref name="Pawluski_2017" /><ref>{{cite journal | vauthors = Workman JL, Barha CK, Galea LA | title = Endocrine substrates of cognitive and affective changes during pregnancy and postpartum | journal = Behavioral Neuroscience | volume = 126 | issue = 1 | pages = 54–72 | date = February 2012 | pmid = 21967374 | doi = 10.1037/a0025538 | hdl-access = free | s2cid = 207642327 | hdl = 2429/66579 }}</ref>