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Treatment for Postpartum Depression

 If you feel that you are suffering from postpartum depression you should seek professional help. Treatment for postpartum depression will depend upon the severity of the condition and can include a combination of therapy, support groups and medication.

Individual therapy and marriage counseling can be very helpful in treating postpartum depression. Marriage counseling can help in cases of marital discord and involves both the mother and the father. Other forms of individual therapy include:

• Psychotherapy or Talk Therapy: This form of therapy involves working with a trained psychotherapist to help you cope with your problems and depression. It can be a powerful alternative to medical treatment in the case of breastfeeding mothers. Psychotherapy can continue for weeks or months depending on the severity of the symptoms and the presence of other mental illnesses.
• Interpersonal Therapy (IPT): This form of therapy helps the person with postpartum depression develop coping skills in social and interpersonal relationships. It educates the patient about the nature of depression with the therapist emphasizing the fact that most people get better with treatment. The therapist then helps the patient to identify specific problems and then set goals to resolve these problems. Various techniques are then used to achieve these goals.
• Cognitive Behavioral Therapy (CBT): This form of therapy uses three techniques to help the patient change his or her way of thinking.

The didactic component is a phase that sets up an expectation for a positive outcome and promotes cooperation.

The cognitive component helps the patient to identify thought patterns that govern behavior, particularly those that may cause depression.

The behavioral technique employs behavior modification techniques to teach the patient effective ways to deal with problems.

Educational programs and support groups can help both mothers and fathers learn about their illness. This will enable them to deal with the problem more effectively and take informed decisions. Support groups also help both parents cope more effectively by listening to and learning from the experiences of others who have also suffered from the same problem.

Medical treatment involves the use of hormone therapy or antidepressants to treat a person with postpartum depression.

Estrogen replacement therapy is often used in conjunction with antidepressants to treat postpartum depression. Hormone therapy has certain risks which you should discuss with your doctor beforehand.

Severe cases of postpartum depression may require treatment with antidepressants. The use of medication should also be accompanied by therapy and should be monitored by a doctor. Before beginning a course of antidepressants, it is important to know what effect the medication may have on the baby, as it can be passed on to the baby during breastfeeding. Make sure you discuss this with your doctor before proceeding with the treatment.

The different types of medications that can be used to treat postpartum depression include:

• Selective serotonin reuptake inhibitors (SSRIs): These medications are often the first choice of doctors due to their high levels of effectiveness and safety. They work by affecting the levels of serotonin in the brain. Examples of SSRIs are fluoxetine, sertraline and paroxetine.
• Atypical antidepressants: These medications are used in cases where SSRIs have not worked. They include bupropion, mirtazapine, trazodone and duloxetine.
• Tricyclic antidepressants: These are prescribed when SSRIs or atypical antidepressants are ineffective. Examples include amitriptyline, doxepin and nortriptyline. They work by affecting neurotransmitters or brain chemicals like adrenaline and noradrenaline.
• Monoamine oxidase inhibitors (MAOIs): These medications are seldom prescribed these days owing to the advent of SSRIs. They should not be taken with many other types of medications and foods that have high levels of tyramine like cheese, wine and cured meats. Examples include phenelzine and tranylcypromine.
  

Antidepressants can take up to six weeks before taking effect. It is important not to discontinue the medication because of a lack of improvement. Approximately 70% of people who take antidepressants for postpartum depression eventually get better.

In cases of postpartum psychosis, an atypical neuroleptic may also be prescribed along with a mood stabilizer. Examples include aripiprazole, olanzapine, quetiapine, risperidone and iloperidone. Non neuroleptic mood stabilizers may also be used along with neuroleptic medication to treat postpartum psychosis because bipolar disorder may also be an underlying factor. These include lithium, divalproex, carbamazepine and lamotrigine.



Frequently asked questions

• How To Cure Postpartum Depression?

References

1. Laura J. Miller, Elizabeth M. LaRusso, Preventing Postpartum Depression, Psychiatric Clinics of North America, Volume 34, Issue 1, March 2011, Pages 53-65, ISSN 0193-953X, 10.1016/j.psc.2010.11.010.
2. Christina Munoz, Janyce Agruss, Amy Haeger, Lynn Sivertsen, Postpartum Depression: Detection and Treatment in the Primary Care Setting, The Journal for Nurse Practitioners, Volume 2, Issue 4, April 2006, Pages 247-253, ISSN 1555-4155, 10.1016/j.nurpra.2006.02.008.