Theories about what causes PPD are very controversial. Most experts agree, however, that it involves a combination of hormonal, biochemical, psychosocial, and environmental influences. It is understood that no single factor is ever totally responsible for the emergence of PPD. For instance, although it is suspected that hormones play a large part in the development of PPD, we also know that fathers and adoptive mothers have suffered with PPD, which tells us that it is not strictly hormonal.

Many things can put a woman at risk for PPD. Some of these risk factors are:

• previous PPD
• family history of anxiety/depression (genetic predisposition)
• unplanned pregnancy
• unsupportive spouse
• recent separation or divorce
• major loss in past two years (death of loved one, move, job)
• obstetric complications
• environmental stressors

These risk factors do not cause PPD. Many women can have a number of these risk factors and never get depressed. We don't always know why. Other women can have one or even no risk factors and end up with a full blown major depression. What we do know is that these risk factors make a woman more vulnerable and if she knows she is at risk, she can begin to take preventative measures, such as mobilizing a support network.

The impact of PPD and the factors that play the largest part in any particular case is quite variable and is best determined by a complete diagnostic assessment. Researchers have concluded that women are most vulnerable to emotional illness following the birth of a child. This, coupled with the fact that the postpartum period is perhaps the most demanding time in any woman's life, combine to set the stage for emotional fatigue and stress.

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