Postpartum

Treatment Of Postpartum Depression

Postpartum depression (PPD) can affect most new mothers within the three days after delivery and may last for up to two weeks. Postpartum depression treatment can help mothers cope with difficult emotions and take better care of their baby and themselves.

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Importance Of Postpartum Depression Treatment

According to research 1 , about 1 in 7 women are affected by PPD. Although the condition may have negative effects on both the mother and the baby, around 1 in 5 women 2 refuse to seek help and treatment for their condition. Postpartum depression is more severe and intense than baby blues and may last for several weeks after childbirth, if left untreated. A 2010 study 3 found that when left untreated, maternal depression can lead to a number of different “potential negative effects on maternal-infant attachment and child development.” This is why it is crucial that the patient seek medical help as postpartum depression treatment can help the sufferer overcome the symptoms and look after their child.

According to a 2018 study 4 , “Careful assessment of risk factors for postpartum depression during pregnancy and monitoring depressive symptoms during pregnancy and the postpartum period will lead to better outcomes for women and their families.”

Treatment Of Postpartum Depression

If you or a loved one has the symptoms of PPD, then you should immediately seek professional help. Treatment generally includes psychotherapy, medications or a combination of both. However, treatment may vary depending on the patient and the severity of the condition. Moreover, certain lifestyle changes and support from family & friends are also important for successful treatment and recovery.

Here are some of the most effective postpartum depression treatment options available for people suffering from this condition:

1. Psychotherapy

A psychiatrist, psychologist, therapist, or any other mental health professional can provide therapy and counselling that can help the sufferer greatly. Therapy can help the patient to recognize their negative thoughts, develop new strategies to cope with depression and change how they think, feel, behave and act. By talking with the therapist, a new mother learns to respond to stressful situations in a positive way, instead of engaging in intrusive negative thoughts.

Some of the most common types of therapies used for the treatment of postpartum depression include:

A. Cognitive Behavioral Therapy (CBT)

CBT is a form of psychotherapy that can be especially effective in helping people struggling with anxiety and depression. It enables depressed patients to change distorted patterns of negative thoughts and behaviors and learn new ways to cope with and reduce stress. “People learn to challenge and change unhelpful patterns of thinking and behavior as a way of improving their depressive and anxious feelings and emotions,” explains NIMH.

Research shows that cognitive behavioral therapy (CBT) can significantly help as a successful postpartum depression treatment option. However, for people with severe PPD, a combination of CBT and medication can yield the best results.

B. Interpersonal Therapy (IPT)

An evidence-based therapy technique, IPT is also an effective treatment option of women with this condition. As interpersonal experiences and life events greatly influence our thoughts, moods and behavior, IPT helps focus on developing communication skills, set realistic expectations and develop social support networks for better interpersonal relationships. It also empowers the patients to better deal with various issues adding to their depression.

According to a 2012 study 5 , “Interpersonal psychotherapy is the best validated treatment for postpartum depression and should be considered first-line treatment, especially for depressed breastfeeding women.”

2. Medications

The doctor or mental health professional may prescribe antidepressants for the treatment of severe PPD. Antidepressants help to balance the chemicals in the brain which regulate mood. However, it may take around 3-4 weeks for antidepressants to show any results and make patients feel better. These medicines can also help with hopelessness, irritability, sleeplessness etc. Moreover, it can also improve the mother-child bond over time. However, chemicals from antidepressants may be passed on to breast milk and affect the child.

This is why, “women who are pregnant or breastfeeding should notify their doctor before starting antidepressants so their doctor can work to minimize the baby’s exposure to the medication during pregnancy or breastfeeding,” explains NIMH. Most side effects from antidepressants are usually short lived and resolve naturally after some time. Some common side effects of antidepressants as postpartum depression treatment include:

  • Anxiety
  • Memory loss
  • Drowsiness & nausea
  • Lightheadedness & dizziness
  • Loss of balance
  • Confusion
  • Headaches
  • Insomnia
  • Dry mouth
  • Weight gain
  • Sweating and tremors
  • Reduced sex drive
  • Constipation or diarrhea
  • Restlessness or fatigue


If the side effects are severe or affect the mother’s ability to perform daily activities, then they should contact their doctor immediately. According to a 2010 study 6 , tricyclic antidepressants (TCAs), like Amoxapine, Nortriptyline and Imipramine, are usually safe for mothers who are breast-feeding. However, TCAs are usually not recommended for individuals with a history of severe depression, suicidal tendencies, epilepsy or heart disease. In such cases, selective serotonin reuptake inhibitors (SSRIs), like sertraline or paroxetine may be prescribed. Apart from these, brexanolone may also be used for the treatment of PPD in adult women.

According to a report 7 , the U.S. Food and Drug Administration (FDA) “approved Zulresso (brexanolone) injection for intravenous (IV) use for the treatment of postpartum depression (PPD) in adult women. This is the first drug approved by the FDA specifically for PPD.” Regardless, mothers with postpartum depression must talk about feeding options with their doctor so that the most effective and safest treatment options can be provided for her and for the infant. The NIMH, however, warns “Do not stop taking antidepressants without the help of a doctor or other health care provider.”

3. Electroconvulsive therapy (ECT)

When other therapy techniques or postpartum depression treatment options don’t prove effective due to the severity of the condition, the doctor may recommend ECT. It can be very effective in treating severe depression, but the benefits may not last for a long period of time. One 2015 study 8 found that ECT, when combined with “joint mother-baby hospitalization,” can be a highly valuable treatment option for relieving maternal depressive symptoms and improving mother-infant relationships.

Another 2018 study 9 found that electroconvulsive therapy can help to improve postpartum depression and postpartum psychosis. It states “The response rate of those with postpartum depression and/or psychosis to ECT was high. The response rate of patients with psychosis or depression was higher during the postpartum period than outside it.”

4. Hormone therapy

Research 10 indicates that hormone therapy can also be helpful in postpartum depression treatment as maternal levels of estrogen & progesterone reduce dramatically during delivery. It believed that this change can lead to the development of PPD in women. One 2000 study 11 revealed that hormonal changes during childbirth can lead to mood-destabilizing symptoms, especially in women with a history of PPD. The researchers believe that hormone therapy as a preventative intervention or treatment can substantially help patients. However, hormonal interventions may include certain side effects, such as:

  • Nausea & vomiting
  • Breast pain or tenderness
  • Changes in weight
  • Risk of developing cancers


If the mother is at risk of harming the child or herself, then the doctor may recommend immediate hospitalization in a mental health clinic.

Treatment Of Postpartum Psychosis

Postpartum psychosis is one the most damaging perinatal psychiatric disorders. As it is a psychiatric emergency, it is crucial that this condition is identified in time. Although it is a limited and brief illness, psychosis can start suddenly. However, it responds strongly to treatment. Presently, there are no established guidelines for coping with or managing this mental disorder as treatment primarily depends on the cause of onset. If the mother is at risk of harming the child or themselves, then they should be hospitalized immediately.

There are several medications for postpartum depression treatment that can help to manage acute psychosis. Hence, it is important to consult a doctor for safe and effective treatment. According to a recent 2020 scientific analysis 12 , certain medications control acute psychosis effectively, such as “mood stabilizers, atypical antipsychotics, and antiepileptic drugs. Common drugs from these classes include lithium, sodium valproate, lamotrigine, carbamazepine, benzodiazepines, quetiapine, olanzapine, etc.”

Another 2018 study 13 found that a combination of “antipsychotics, mood stabilizers, hormones, propranolol, and electroconvulsive therapy (ECT),” can not only help to prevent postpartum psychosis but also treat it successfully. ECT involves the use of electrical charges for stimulating chemicals in the brain. It is generally a safe, well-tolerated and effective treatment option for treating postpartum psychosis. Once the patient becomes stable, therapy may be recommended to help the new mother sort through her thoughts and emotions.

Treatment Of Postpartum Depression In Men

As both parents can experience this mental health disorder, both parents should be encouraged to seek postpartum depression treatment. Similar to the treatment of PPD in women, fathers should also ask for professional help if they are experiencing the symptoms of this condition. Depression in new fathers can be effectively treated with therapy or medication or by a combination of both. If both the mother and father are affected by postpartum depression, then family counseling or couples counseling can be helpful.

Moreover, the father should try to bring about some lifestyle changes like exercising regularly, maintaining a nutritious diet, getting enough sleep, preparing for childcare, joining a support group and spending some time alone or with friends.

Home Remedies & Lifestyle Changes For PPD

In addition to medical postpartum depression treatment, certain lifestyle changes and home remedies can help the patient recover faster and support the treatment process. Here are some suggestions that can be implemented to overcome symptoms of PPD:

  • Get enough good-quality sleep regularly. Sleep whenever the infant is sleeping
  • Maintain a nutritious, healthy diet
  • Maintain blood sugar levels by eating habitually
  • Engage in physical activity or do regular exercise like walking with your baby
  • Avoid smoking and drinking alcohol
  • Be organized and don’t try to do everything by yourself to reduce stress
  • Seek support from partner, family, and friends
  • Spend some time alone or with your partner or go out with friends
  • Interact & share with other mothers to learn from them
  • Refrain from making any drastic life changes after childbirth as it can cause unnecessary stress
  • Arrange for someone to care of your child when you are feeling down

Prevention And Self-care For PPD

There are some effective ways to prevent the onset of PPD. The American College of Obstetricians and Gynecologists (ACOG) suggests that “If you have a history of depression at any time in your life or if you are taking an antidepressant, tell your ob-gyn (obstetrician-gynecologist) or other health care professional early in your prenatal care. Ideally, you should tell him or her before you become pregnant.” This can help your healthcare provider to start the postpartum depression treatment process immediately after delivery to prevent this condition.

Apart from this, there are some other self-care tips that can help a new mother to prevent PPD after consulting with their doctor. Here some of the most effective ways to get started:

1. Communicate openly

Talk openly with supportive loved ones about your emotions, concerns and issues. Although depression may make you feel like withdrawing from others and keeping things to yourself, it is crucial that you share your feelings with people you trust. This can be especially difficult if the patient is generally an introvert, a shy or reserved individual. However, talking to someone close to you will help you vent and release pent up frustration. There is always someone who is willing to listen.

2. Make sure to avoid isolation

Understand that you don’t have to suffer alone and it is crucial that you fight isolation. Being lonely and isolated can make you feel further depressed and affect your mental and physical health. Although it is not important for the sufferer to rebuild their social life and start attending every social event they are invited to, they should put some effort to maintain and strengthen close and intimate relationships.

Talking with your partner, family, friends or a therapist is an important part of postpartum depression treatment. Ask a trusted loved one to take a doctor’s appointment for you, if you are unable to do it yourself. Taking care of yourself is as important as taking care of your child.

3. Join local self-help and support groups

In case you are a people person and enjoy being socially active, then joining and participating in a self-help group or a depression support group can be a great idea. The patient can even choose to join a support group for new mothers or new fathers. Interacting with other people in similar situations can help you gain a new perspective, learn from their experiences, empower yourself, learn how to reduce stress, create new friendships and focus on different aspects of life.

4. Focus on the baby

Instead of being bothered by family responsibilities, errands, chores and other household tasks, keep your focus on taking care of your infant and yourself. Ask your partner, family members and friends to lend a helping hand with household tasks while you take care of the baby.

5. Make rest & relaxation a priority

Being a new parent can be mentally, physically and emotionally demanding. Adequate rest and sleep can help new parents find the mental and physical energy to cope with the daily challenges of caring for a newborn baby. In case, the infant sleeps for a short period of time, then you can ask someone to help you out and take care of the baby for a while so that you can get rest and sleep when necessary.

It is also important to introduce some relaxation practices into your daily schedule like deep breathing techniques, yoga, meditation, massage, reading a book, getting a hot bath or even spending some time in nature. These postpartum depression treatment strategies will help you relieve stress, anxiety and tension and make you feel relaxed and well rested.

How Family And Friends Can Help

It is crucial that the partner, family and friends realize that depression is a serious mental health condition that can not only affect the mother, but also the child, the father and the entire family. Hence, partners, spouses, family members, and friends should learn to identify the symptoms of postpartum depression in new mothers or even in new fathers. Moreover, they should also encourage the sufferer to seek and maintain postpartum depression treatment under the supervision of a doctor. “Family members can encourage the mother to talk with a health care provider, offer emotional support, and assist with daily tasks such as caring for the baby or the home,” explain NIMH.

Here are some helpful suggestions for partners, family and friends to help someone affected by PPD:

1. Identify the symptoms

Partners and family members must educate themselves about PPD and learn to recognize the symptoms of anxiety and depression. “If you see signs, urge her to see a health care provider,” suggests the American Psychiatric Association.

2. Listen

Family and friends should let the sufferer know that they are here to support them and listen to their worries, concerns and fears without being judgemental. If the new mother is hesitant to speak, then the partner and others should encourage and support her to open up about her feelings.

3. Be supportive

Support from loved ones is very important when it comes to overcoming depression. You should let the affected person know that you are here to support and help them. Let them understand that they are not alone. The American Psychiatric Association suggests “Try offering to help with household tasks or watching the baby while she gets some rest or visits friends.” This is a vital aspect of postpartum depression treatment.

4. Encourage them to seek help

Family and friends must always encourage the sufferer to seek professional help, if and when needed. Although the patient may not be comfortable with consulting a doctor or may feel ashamed about their condition, family and friends must always motivate them and make them feel comfortable about talking to a healthcare provider. Moreover, they can also make an appointment and accompany them as well.

Postpartum Depression Treatment Can Help

Being affected by this disorder does not mean that the parent is uncaring or doesn’t love their child. This is a serious mental disorder which can be treated effectively with medication and therapy. If you or a loved one is experiencing a low mood for over two weeks after childbirth, then make sure to consult a doctor immediately.

References:
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