What are some primary triggers for PND?

Some known triggers are: working beyond 33–34 weeks’ gestation.

• The seismic hormonal changes after delivery, and their effects on neurotransmitters within the brain).
• Recent adverse life-crisis event(s) (e.g. death of family member or close friend, redundancy, shifting homes, marriage, childbirth) and the effect on inter-personal relationships.
• Being anxious, stressed, insecure or irrational; having pessimistic negative expectations of childbirth, parental burden, or fear of labour; having a ‘worrier’, unassertive and non-coping vulnerable personality; having preexisting lack of self-interest or low self-esteem.
• Personal or family history of psychiatric disturbance or illness (e.g. anxiety, depression, bipolar disorder, schizophrenia, alcoholism).
• Low-quality, deficient social-support network
• Having two or more young children; or partner who is depressed. Some other primary causes are discussed in pages 385-387.