[4][2] The exact cause of PPD is unclear, however, it is believed to be due to a combination of physical, emotional, genetic, and social factors such as hormone imbalances and sleep deprivation.

[33] Additionally, preliminary research has shown that childbearing individuals who are part of the LGBTQ community may be more susceptible to prenatal depression and anxiety than cisgender and heterosexual people.

[34] According to two other studies, LGBTQ people were discouraged from accessing postpartum mental health services due to societal stigma adding a social barrier that heteronormative mothers do not have.

[39] Aberrant steroid hormone-dependent regulation of neuronal calcium influx via extracellular matrix proteins and membrane receptors involved in responding to the cell's microenvironment might be important in conferring biological risk.

Chronic illnesses caused by neuroendocrine irregularities including irritable bowel syndrome and fibromyalgia typically put individuals at risk for further health complications.

[52] The psychosocial risk factors for postpartum depression include severe life events, some forms of chronic strain, relationship quality, and support from partner and mother.

[66] Low-income women are frequently trapped in a cycle of poverty, unable to advance, affecting their ability to access and receive quality healthcare to diagnose and treat postpartum depression.

[83][84][88][89] The percentage of individuals with childbirth-related PTSD is approximately 15-18% in high-risk samples (women who experience severe birth complications, have a history of sexual/physical violence, or have other risk factors).

[91] Aside from culture, it is also important to consider one's social context, as women with low socioeconomic status may have additional stressors that affect their postpartum depression screening scores.

In simple terms, cognitive behavioral therapy is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders.

[123] Some studies show that hormone therapy may be effective in women with PPD, supported by the idea that the drop in estrogen and progesterone levels post-delivery contributes to depressive symptoms.

[134] Electroconvulsive therapy (ECT) has shown efficacy in women with severe PPD who have either failed multiple trials of medication-based treatment or cannot tolerate the available antidepressants.

[144] Other initiatives include the Substance Abuse and Mental Health Services Administration (SAMHSA) whose disaster relief program provides medical assistance at both the national and local level.

[145] The Infant and Early Childhood Mental Health Consultation (IECMH) center is a related technical assistance program that utilizes evidence-based treatment services to address issues of PPD.

Research surveys have revealed a paucity of professional, and emotional support for women struggling in the weeks following delivery despite there being a heightened risk for PPD for new mothers during this transitional period.

[150] The National Alliance on Mental Illness lists a virtual support group titled "The Shades of Blue Project," which is available to all women via the submission of a name and email address.

A history of mistrust within the United States healthcare system or negative health experiences can influence one's willingness and adherence to seek postpartum depression treatment.

[163] Different ethnic groups may believe that healthcare providers will not respect their cultural values or religious practices, which influences their willingness to use mental health services or be prescribed antidepressant medications.

[164] The highest prevalence in the US is found among women who are American Indian/Alaska Natives or Asian/Pacific Islanders, possess less than 12 years of education, are unmarried, smoke during pregnancy, experience over two stressful life events, or have full-term infant is low-birthweight or was admitted to a NICU.

An itemized research analysis put a mean prevalence at 10-15% percent but explicitly stated that cultural factors such as perception of mental health and stigma could be preventing accurate reporting.

[171] From a selected group of studies found from a literature search, researchers discovered many demographic factors of Asian populations that showed significant association with PPD.

[172] Specifically for Japanese women who were born and raised in Japan but who gave birth to their child in Hawaii, USA, about 50% of them experienced emotional dysfunction during their pregnancy.

This is because, in some Asian cultures, married couples are expected by the family to have at least one son to maintain the continuity of the bloodline which might lead a woman to experience PPD if she cannot give birth to a baby boy.

The high prevalence of postpartum depression in the region may be attributed to socio-economic and cultural factors involving social and partner support, poverty, and prevailing societal views on pregnancy and motherhood.

[72] For example, a study in Kom Ombo, Egypt, reported a rate of 73.7% for PPD, but the small sample size of 57 mothers and the broad measurement timeframe spanning from two weeks to one year postpartum contributes to the challenge of making definitive prevalence conclusions (2).

[182] Based on her descriptions of visions of demons and conversations she wrote about that she had with religious figures like God and the Virgin Mary, historians have identified what Margery Kempe was experiencing as "postnatal psychosis" and not postpartum depression.

A 16th-century physician, Castello Branco, documented a case of postpartum depression without the formal title as a relatively healthy woman with melancholy after childbirth, remained insane for a month, and recovered with treatment.

[192] Specifically regarding PPD, it is often left untreated as women frequently report feeling ashamed about seeking help and are concerned about being labeled as a "bad mother" if they acknowledge that they are experiencing depression.

[193] When this spirit is unsatisfied and venting resentment, it causes the mother to experience frequent crying, loss of appetite, and trouble sleeping, known collectively as "sakit meroyan".

[103] Some Chinese women participate in a ritual that is known as "doing the month" (confinement) in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare.