A 32-year-old woman comes to the office due to fatigue and loss of energy. She sleeps poorly due to multiple awakenings to feed her 3-month-old son, and it takes her a long time to fall back asleep. During the day, the patient is able to nap when the baby is sleeping but still feels tired all the time. Although the baby is healthy, she worries about him constantly. She has trouble concentrating and fears that she will neglect some aspect of his care. The patient says, "I was elated for the first few weeks after giving birth, but for the last couple of months I haven't been able to enjoy him and just feel I am a bad mother." Although still overweight, she has lost most of her baby weight and is less interested in food. The patient has a history of psoriasis and asthma treated with topical corticosteroids and as-needed beta agonists.
Blood pressure is 120/70 mm Hg and pulse is 88/min. Examination shows moist mucous membranes, clear lung fields, normal S1 and S2, no edema, and no neurological deficits. On mental status examination, the patient appears tired and anxious. She has no thoughts of suicide or harming the baby.
Which of the following is the most likely diagnosis?

Question

A 32-year-old woman comes to the office due to fatigue and loss of energy.  She sleeps poorly due to multiple awakenings to feed her 3-month-old son, and it takes her a long time to fall back asleep.  During the day, the patient is able to nap when the baby is sleeping but still feels tired all the time.  Although the baby is healthy, she worries about him constantly.  She has trouble concentrating and fears that she will neglect some aspect of his care.  The patient says, "I was elated for the first few weeks after giving birth, but for the last couple of months I haven't been able to enjoy him and just feel I am a bad mother."  Although still overweight, she has lost most of her baby weight and is less interested in food.  The patient has a history of psoriasis and asthma treated with topical corticosteroids and as-needed beta agonists.
Blood pressure is 120/70 mm Hg and pulse is 88/min.  Examination shows moist mucous membranes, clear lung fields, normal S1 and S2, no edema, and no neurological deficits.  On mental status examination, the patient appears tired and anxious.  She has no thoughts of suicide or harming the baby.
Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

The symptoms described, including fatigue, anxiety, poor sleep, loss of interest, and feelings of inadequacy, are consistent with postpartum depression, which can occur within the first few months after childbirth.

A 32-Year-Old Woman Comes to the Office Due to Fatigue