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Differential Diagnosis

In addition to the other Types of Postpartum Mood and Anxiety Disorders, rehabilitation counselors may want to consider ruling out medical causes of symptoms.1

Due to the physiological changes during pregnancy, the postpartum period is a time of risk for medical conditions such as thyroid disorders and anemia.2 Several symptoms of these medical conditions can mimic those of postpartum depression.2 Therefore, rehabilitation counselors may need to refer clients for evaluation by a medical professional to rule out differential diagnoses.

Postpartum Thyroid Disorders

  • More prevalent in postpartum women than in non-postpartum women,3 occurs in 7-11% of postpartum women.2, 4
  • Symptoms include depressive symptoms,2, 5 fatigue,4, 6 weight gain,6 brittle hair,6 and dry skin.6
  • Diagnostic Procedures include thyroid function tests.6
  • Treatment involves thyroid replacement therapies.2


  • More common in postpartum period than at other times due to depletion of iron from pregnancy and breastfeeding.2
  • Symptoms include fatigue,2, 5, 6 irritability,2 and tachycardia.6
  • Diagnostic Procedures include complete blood cell count.6
  • Treatment involves iron supplementation.6


  1. Cohen, L. S., Wang, B., Nonacs, R., Viguera, A. C., Lemon, E. L., & Freeman, M. P. (2010). Treatment of mood disorders during pregnancy and postpartum. Psychiatric Clinics of North America, 33(2), 273-293. Retrieved from https://auth-lib-unc-edu.libproxy.lib.unc.edu/ezproxy_auth.php?url=http://search.ebscohost.com.libproxy.lib.unc.edu/login.aspx?direct=true&db=c8h&AN=2010623522&site=ehost-live&scope=site
  2. Sit, D. K. Y., & Wisner, K. L. (2005). Decision making for postpartum depression treatment. Psychiatric Annals, 35(7), 577-585. Retrieved from https://auth-lib-unc-edu.libproxy.lib.unc.edu/ezproxy_auth.php?url=http://search.ebscohost.com.libproxy.lib.unc.edu/login.aspx?direct=true&db=hch&AN=28025801&site=ehost-live&scope=site
  3. Wisner, K. L., Parry, B. L., & Piontek, C. M. (2002). Postpartum depression. The New England Journal of Medicine, 347(3), 194-199. doi:10.1056/NEJMcp011542
  4. Lucas, A., Pizarro, E., Granada, M. L., Salinas, I., & Sanmartí, A. (2001). Postpartum thyroid dysfunction and postpartum depression: Are they two linked disorders? Clinical Endocrinology, 55(6), 809-814. doi:10.1046/j.1365-2265.2001.01421.x
  5. Hirst, K. P., & Moutier, C. Y. (2010). Postpartum major depression. American Family Physician, 82(8), 926-933. Retrieved from http://www.aafp.org/afp/990415ap/2247.html
  6. Pearson, R. L., Sudak, D., Murray, J. L., & Alici-Evciman, Y. (2007). Medical topics: Postpartum depression. Retrieved from http://www.mdconsult.com.libproxy.lib.unc.edu/das/pdxmd/body/172005763-16/0?type=med&eid=9-u1.0-_1_mt_1011044#173275266_721

 Last Updated July 13, 2011