Martha gave birth to twins two weeks ago. She finds herself weeping while she is changing the twins or feeding them. She is irritable and has had little sleep since their birth. Martha feels guilt and shame because she says a good mother would be able to take care of her children.
The subtype of major depression Martha is most likely suffering from is depression with:

A. anxious distress.
B. psychotic.
C. peripartum onset.
D. atypical.

C. peripartum onset. (postpartum onset)

Explanation:

Peripartum onset generally occurs with the major depression and is, therefore, include "postpartum depression as well. Peripartum depression is described as one of the major or big "depressive episodes" that women experience during her pregnancy as well as after delivery within the first four weeks of her delivery.

However, the postpartum depression is said to be experienced by a woman in two different forms i.e, early and late-onset.

In the question above, the given statement signifies that Martha is experiencing peripartum onset with major depression.

productive most commonly means: achieving or producing a significant amount or result.

explanation:

productive can also mean:

these depend on how the word productive is used. most likely productive will mean   achieving or producing a significant amount or result.