The causes of postpartum depression are not very clear, but it is easy to see several potential causes operating in this case.

The time around childbirth is clearly one of immense biological upheaval, including rapid and sustained alteration in the endocrine environment (sudden increases in prolactin and decreases in oestrogens and progestagens - hormones associated with reproduction), culminating in a period of physical ordeal not unlike a major illness, with the threat of illness and even death for mother and child.

The arrival of a child, particularly the first, is not only a major change in a woman's lifestyle, in terms of altered roles and social networks, but also may bring to the surface dormant conflicts related to her own childhood so many years ago and is therefore a potent symbolic event.