Treatment Options For Postpartum Depression

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Once you receive a postpartum depression diagnosis, it might actually feel like a weight has been lifted. Now you finally know what is going on, and you can start down the road toward feeling better. Yet diagnosis is only the first step. While treatments for postpartum depression are usually quite effective, it can be easy to feel overwhelmed by all the options in front of you.

Should you go to therapy? What kind of therapy? Should you try medication? Is it safe? What else can you do to feel better? What long-term options do you need to think about?

First of all, if you are feeling stressed about these decisions, you are not alone. You are still at the beginning of your journey, and while you have received a diagnosis, you are still wading through the darkness of postpartum depression, which can make decisions like these more difficult.

Many of these decisions are best made between you and your healthcare providers—and you can certainly consult with them for information and feedback. Still, the more knowledge you acquire about your treatment options, the easier it will be to navigate this part of your journey.

We’ve broken down the treatment options for postpartum depression—psychotherapy, medication, alternative/complementary options, and lifestyle changes—in a clear and easy-to-understand way.

Psychotherapy

Psychotherapy (talk therapy) is usually the first treatment option offered to moms battling postpartum depression, especially for mild to moderate cases.

Psychotherapy has proven to be reliably effective in treating postpartum depression. For example, a large review study found that psychological treatments for postpartum depression were effective and decreased symptoms among mothers who utilized them. Moms who received therapy had a reduced likelihood of postpartum depression within the first year after birth.

Therapy Options for Postpartum Depression

There are a few therapy modalities that have shown particular promise in treating postpartum depression, including:

  • Interpersonal therapy: Interpersonal therapy explores the relationship between your interpersonal problems and experiences and your mood. It is often used to treat depression. Treatment usually lasts 12 to 20 weeks.
  • Cognitive behavioral therapy (CBT): CBT explores the relationship of your thoughts to your behavioral actions. It uses mindfulness techniques to help you become more aware of your negative thought patterns, and helps you come up with techniques for managing stress.
  • Nondirective counseling: Nondirective counseling is based on the premise that you know yourself best, and that your own path to healing is within you. Your therapist will take a more hands-off approach and will focus on listening and self-affirmation.

Postpartum Depression Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

Almost any experienced therapist can help you navigate postpartum depression and work with you on recovery. But it can be helpful to find a therapist who has experience treating postpartum mood disorders.

Remember to follow your gut when picking a therapist. You want to find someone who you feel comfortable with. Sometimes you may need to meet with more than one therapist until you find the one for you. Also keep in mind that there are now more options than ever before for therapy, including online and virtual therapists.

Medication

It’s not uncommon for mothers to need medication to help them through postpartum depression. The amount of time you need to be on medication depends on your personal situation, and may be anywhere from a few months to longer. The time course should not dictate your decision about whether or not to start treatment.

Remember that there is nothing “weak” about using medication to get through this. Making that decision might be the strongest and smartest choice for you—after all, making an active choice to prioritize your mental health is one of the best things you can do for yourself and your family.

The choice to start medication to treat your postpartum depression should be made in consultation with your doctor, who will discuss what options may work best for your particular situation.

Many mothers are concerned that starting psychotropic medication will mean they need to stop breastfeeding. But the good news is that many medications are compatible with breastfeeding. You can discuss options with your doctor, and you may consider consulting LactMed, a government-sponsored database that compiles medications and their known effects on breastfeeding.

Medications Commonly Used to Treat Postpartum Depression

  • Specific serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, fluvoxamine, and venlafaxine.
  • If SSRIs can’t be tolerated, bupropion (Wellbutrin) is a possible alternative. Speak to your physician about using Wellbutrin while nursing. It is used fairly often without any issue, but there has been a case report of infantile seizures after a breastfeeding mother starts on Wellbutrin. This is a decision to make with your doctor.
  • Some mothers might need to combine anti-depressants with anti-anxiety medication such as clonazepam or lorazepam.
  • Zulresso (brexanolone) is a drug approved specifically to treat postpartum depression. It is for women with postpartum depression that began in the last trimester or within four weeks of delivery. It is given as a one-time, intravenous infusion administered continuously over a total of 60 hours.
  • If you are battling postpartum psychosis, which is considered a medical emergency, you may be treated with a mood stabilizer and/or an anti-psychotic medication, and often with a benzodiazepine (an anti-anxiety medicine). Postpartum psychosis is not a type of postpartum depression, but a different perinatal mood disorder that is likely a bipolar variant.

Electroconvulsive Therapy

Electroconvulsive therapy is often used to treat severe cases of postpartum depression that do not respond to medication. It is also used frequently to treat postpartum psychosis. According to the International Journal of Women’s Health, although data about electroconvulsive therapy and postpartum depression is limited, “one small study of five women receiving ECT for refractory postpartum depression reported a 100% remission rate.”

Complementary Medicine and Over-the-Counter (OTC) Treatments

The two most often utilized and proven methods to treat postpartum depression are therapy and medication. However, sometimes it can help to add a little extra boost to your treatment. It’s important to note that not all alternative treatments have much proof behind them, so stocking up on a certain vitamin or food may not be all it’s chalked up to to be. You want to beware of any treatments that may do more harm than good.

Always consult with your doctor before trying any alternative medications, OTC treatments, or supplements.

Here are a few complementary treatments for postpartum depression that are supported and recommended by experts.

Bright Light Therapy

Bright light therapy is used to treat seasonal affective disorders. But as the International Journal of Women’s Health explains, there is evidence that bright light therapy can treat non-seasonal depression, and may have promise in the treatment of postpartum depression.

Omega-3 Fatty Acids

Consuming omega-3 fatty acids may help mothers who are experiencing postpartum depression, according to a study published in the International Journal of Women’s Health. “Omega-3 fatty acids have received specific attention in the treatment of perinatal depression, because of the known health benefits of these compounds for pregnant and postpartum women as well as some data showing positive effects on mood in the general population,” the researchers explain. However, research on using these fatty acids to treat postpartum depression is not conclusive.

Acupuncture and Massage

Although the research is still emerging, there is some evidence that acupuncture and massage can have a positive impact on treating mild symptoms of postpartum depression. Massage in particular has been found to significantly improve the symptoms of postpartum depression.

Lifestyle Changes

Again, nothing can fully substitute for professional mental health care. That being said, postpartum depression is triggered in part by the abrupt changes to your lifestyle that happened after the birth of your baby. So treating it may mean re-evaluating the day-to-day experiences that add stress to your life.

Of course, caring for a baby means that things like exercise and sleep may look a little different, and may seem virtually impossible to obtain! But a few small, attainable tweaks can make all the difference.

Exercise

The endorphins released during exercise can help improve your mood and lift your spirits. It can be really hard to fit exercise in when you have an infant. But it can be done with a little ingenuity. Take your baby on a walk (they will love it too!). Bounce around the house while wearing your baby in a carrier. Do a 15 minute exercise video while your baby naps. Every little bit counts and you can exercise in short spurts throughout the day.

Prioritize Sleep

The idea of prioritizing sleep may sound laughable when you have a baby. But sleep deprivation can negatively affect your mental health. “Sleep when the baby sleeps” may not work for you, but there are other ways to make sure you get the sleep you need. If you have a partner, ask them to wake up early with the baby and let you sleep in. Have a helper hold your baby during the day so you can take a solo nap. Go to sleep early and leave the chores for a rainy day.

Connect With Other Parents

When you are struggling with postpartum depression, it can be easy to feel like you are all alone. But the fact is, many other parents are struggling, too. Not everyone is dealing with a postpartum mood disorder, but parenting little ones is extremely difficult and emotionally taxing—which is why it can be so gratifying to connect to other parents who are facing similar challenges. Banding together with them can help you get through this.

Make Time for Yourself

This may also sound like an impossibility. But part of what can prompt an episode of postpartum depression is the sudden change of identity that happens when you first become a mom. It can be so helpful to remember who you are outside of your role as “mom.” Taking even an hour a week to do something you love—reading, spending time with friends, taking up a hobby—can be very helpful as you journey through your postpartum depression recovery.

A Word From Verywell

Your recovery from postpartum depression isn’t necessarily going to be a straight line. There will be days that you begin to feel better, and days when it still feels as challenging as ever. Remember that this is normal, but if you stay in touch with your doctors, therapists, and support network, you will get through this.

You deserve to feel better—to feel like yourself again—and there are so many options out there to help you get where you need to be.

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