A number of factors, such as your genetics, environment, and cultural background, can play a role in the development of postpartum depression.

If you’re preparing for a child to arrive, or you’ve recently given birth, you may be going through a number of changes.

Perhaps you’re experiencing the “baby blues,” or you’re having a difficult time adjusting. In the midst of these changes, you may be wondering if what you’re experiencing is more than just “sadness.”

Could what you’re feeling be postpartum depression?

If it is postpartum depression, are there factors that may have increased your chances of this condition?

While not much is known about the “why” behind postpartum depression, several contributing factors might increase an individual’s chance of developing it.

According to the U.S. Department of Health and Human Services, your chances of experiencing postpartum depression increase if you’re under the age of 20.

Having multiple births, like twins or triplets, can also make you more likely for the condition.

One study found that those living with gestational diabetes are also slightly more prone to developing postpartum depression.

Research also shows a link between postpartum depression and the presence of:

  • a short or long allele for serotonin, the happiness hormone
  • biomarkers for inflammation
  • elevated levels of stress hormones, like cortisol
  • thyroiditis

Research has shown that negative environmental factors can contribute to the development of postpartum depression. Environmental factors that might influence this condition, include:

  • history of abuse or domestic violence
  • low education level
  • financial worries

Some studies suggest that where you live might also play a role in postpartum depression.

A 2017 systematic review found that countries with higher rates of income inequality, maternal and infant mortality, or women of child-bearing age who work more than 40 hours a week, had higher rates of postpartum depression.

An older 2013 study of more than 6,000 surveyed Canadian women suggests those living in larger cities may be more likely to experience postpartum depression.

Research shows that if you have a history of a mental health condition, it’s a good idea to let your primary care physician, OB-GYN, or mental health professional know so they can better support you.

Studies suggest that having a family or personal history of mental health conditions is the strongest risk factor for developing postpartum depression.

If you have a history of depression, experts say you are 20 times more likely to develop postpartum depression than someone without a history of depression.

Some conditions that might make you more likely to experience postpartum depression include:

Not everyone who has a personal or family history of these conditions will develop postpartum depression.

Research shows that low self-esteem can be a contributing factor for postpartum depression.

Also, after birth, you may be confronted with some new realities of what it means to be a caregiver — some good and some, well, not so good.

You may feel overwhelmed by new responsibilities, like changing, feeding, and transport. You may feel trapped by the sudden loss of your freedom or just how much a little being depends on you.

Perhaps you feel unattractive to your partner as your body heals, which can strain even the best relationships. It’s also possible that you feel as if you can’t measure up to being the “perfect” parent, or you’re having negative thoughts about yourself, your partner, or your baby.

All of these emotional factors can create the perfect storm for postpartum depression to arise.

Your cultural background may play a role in your chances of developing postpartum depression.

Research shows that if you come from a background in which people place more importance on male children or don’t emphasize family support, you may have a higher chance of postpartum depression.

That same study found a connection between postpartum depression and a person’s tendency to feel more or less secure in their relationships. Those who were more anxious or uncertain in their relationships reported an increase in their symptoms.

In general, conflict in relationships and a lack of support can increase your chance of postpartum depression.

Stressful life events can also make postpartum depression more likely. Whether you have more stress at home or work, it can be difficult to balance all of the moving parts while taking care of a newborn.

Other factors that might contribute to postpartum depression include:

  • a recent death of a loved one
  • someone in your family having an illness
  • moving to a new location
  • a recent traumatic event

Substance use can also play a role. New parents who use drugs and alcohol have a greater chance of developing postpartum depression.

Sleep deprivation with a new baby is no laughing matter. With a newborn up and down every few hours, you’ll be lucky to sleep more than a few hours at a time.

Research shows this chronic state of exhaustion can make you more likely to experience postpartum depression.

When you’re feeling tired and lack energy, not only is it difficult to think and complete daily tasks, but it’s also difficult to regulate your emotions.

This could lead to panic attacks, crying spells, and angry outbursts, among other responses.

If there are complications during pregnancy or delivery, this can contribute to the onset of postpartum depression.

  • Preterm birth. Research suggests a link between preterm birth — giving birth before 37 weeks — and postpartum depression. However, a review of these studies encourages further assessment to confirm this as a contributing factor.
  • Cesarean delivery, commonly referred to as C-section. Some studies suggest that giving birth by planned C-section, as well as emergency C-section, may increase your chance of postpartum depression. However, this is still a controversial topic, and more research is needed.
  • Hospitalization. If your baby is hospitalized, this can be a contributing factor for postpartum depression, as well.
  • Baby’s health. Your baby’s health conditions may play a role, too. An older study found that having a baby with colic — inconsolable, prolonged crying — was associated with postpartum depression.

Emerging research suggests that transgender men might be more prone to postpartum depression.

For some transgender and gender-nonconforming people, there is added stress before and after the birthing process. Research shows that transgender men may experience:

  • lack of gender-affirming perinatal environments
  • inexperienced healthcare providers
  • transphobia
  • violence
  • social isolation
  • hormonal challenges

All of these factors can make you feel like you can’t reach out for support. If you can relate to this, consider visiting the Association of LGBTQ+ Psychiatrists for a referral to a healthcare or mental health professional with experience in this field.

If the pandemic feels like it’s adding extra challenges, you’re not alone.

New research shows that existing postpartum risk factors — history of depression, social tensions, low socioeconomic status — are getting worse as a result of COVID-19.

Experts also suggest that, in general, we can expect to see an increase of postnatal depression cases in the general population as a result of the pandemic.

A clinical review of existing literature shows that some racial and ethnic factors may increase your chance of developing postpartum depression.

These include:

  • delays with your visa
  • language barriers
  • racial or ethnic discrimination
  • uncertainty around your immigration status

According to the CDC, 4% of new fathers experience depression after a baby is born. The contributing factors among men include:

  • having financial difficulties
  • having a history of depression
  • being younger in age

If you’re experiencing — or have experienced — any of these contributing factors, does that mean you’ll have postpartum depression? Not necessarily.

If you think you may have a chance of developing postpartum depression, consider talking with your primary care doctor, OB-GYN, or mental health professional. They can use an inventory while you’re pregnant, or soon after you give birth, to determine how likely you are to develop the condition.

Research suggests the Postpartum Depression Predictors Inventory-Revised (PDPI-R) is considered the gold standard in detecting risk for new parents.

It measures 13 variables, known as the strongest predictors for developing postpartum depression. Those with a score of 10 or higher are considered to have a greater chance of developing the condition, but only a doctor can make that diagnosis.

The variables include:

  • added stress from recent life events
  • anxiety while pregnant
  • challenges with your baby’s temperament
  • being a single parent
  • feeling sad or having “maternity blues”
  • depression while pregnant
  • history of depression
  • lack of a support network
  • low self-esteem
  • relationship dissatisfaction
  • socioeconomic challenges
  • stress while providing childcare
  • unwanted or unplanned pregnancy

The Edinburgh Postnatal Depression Scale (EPDS) is another inventory used to assess a person’s chance of developing postpartum depression.

Not everyone who has one or more of these risk factors will develop postpartum depression.

If you’re wondering whether you may develop it, or you suspect you’re living with postpartum depression already, consider reaching out to your doctor. You might also turn to loved ones or a support group.

Overall, try to take it easy on yourself. Your body, mind, and spirit have been through a lot lately.

This doesn’t mean that you aren’t cut out for parenthood, or that you don’t love your baby. It does mean you could benefit from some extra support right now. Take good care of yourself.