Mood disorders Quiz: Ace Your Exams

A 34-year-old woman, gravida 2 para 2, is brought to the office by her partner for evaluation of low energy and persistent fatigue. She recently gave birth via vaginal delivery three weeks ago; the prenatal period and birth were uneventful, and the neonate has been doing well. She is currently breastfeeding. The patient has been feeling hopeless for two weeks and states, “I don’t know if I can do this anymore.” She has had several episodes of crying “for no reason,” and she attributes it to feeling overwhelmed with her newborn. She sleeps 4-6 hours per day. She used to enjoy attending book club meetings with her friends, but she no longer has an interest in this activity. She has no suicidal or homicidal ideation and has not experienced visual hallucinations or hearing voices. The patient has a history of postpartum blues following her first pregnancy five years ago. She takes no medications. Vitals are within normal limits. Examination reveals a visibly tired woman. Which of the following is the most likely diagnosis?