How is postpartum depression treated?

If you’ve been diagnosed with postpartum depression, it’s important to know that the vast majority of women with this condition can be treated successfully. But without treatment, postpartum depression can last for a long time. The sooner you begin treatment, the sooner you’ll feel better again. A treatment plan may include prescription drug and/or non-drug options recommended by your health care provider.

Drug treatment options

Antidepressant medication, alone or in combination with other therapies, can be used for postpartum depression. Most antidepressants are compatible with breastfeeding, and the amount of medication a baby gets through breast milk is usually small. But some medications are safer than others, so be sure to let your health care provider know that you’re are breastfeeding.

Sometimes a well-meaning but misinformed health care provider may tell a mother to stop breastfeeding and use formula “just to be safe” while she’ is taking certain medications. However, in almost all cases, it’s healthier for your baby to breastfeed even while you’re taking medication than to formula-feed.

To ensure that a medication is safe to take while breastfeeding, contact the InfantRisk Center’s MommyMeds site or visit LactMed, an online database.

Non-drug treatment options

Nondrug options for treating postpartum depression include…:

  • Psychotherapy. Two types of psychotherapy work well in treating postpartum depression: cognitive behavioral therapy (CBT) and interpersonal therapy. CBT focuses on present thinking, behavior, and communication rather than on past experiences; interpersonal therapy focuses on relationships with peers and family members. In its recommendation statement for Screening for Depression in adults, the U.S. Preventive Services Task Force “encourage[s] clinicians to consider CBT or other evidence-based counseling interventions” for depression in pregnant or breastfeeding women.
  • Exercise. Exercise is helpful even for mothers with severe depression. Two randomized clinical trials at Duke University Medical Center comparing Zoloft (an antidepressant medication) and exercise found that exercise was as effective as Zoloft for treating severe depression.
  • Omega-3s. The omega-3 fatty acids EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid), found in fish or in fish-oil supplements, can both treat and help prevent depression.
  • St. John’s wort. This over-the-counter herbal antidepressant is widely used and is compatible with breastfeeding. However, it can interact with other prescription drugs, such as birth control pills or antidepressant medications, so be sure to talk with your health care provider before taking St. John’s wort. It may be useful in treating mild depression, but data are inconsistent with regard to its effectiveness in treating severe depression.
  • Breastfeeding! Breastfeeding can be an important part of a woman’s recovery. It lowers stress, helps you sleep longer and better, and aids in building a positive relationship with your one’s baby. (However, do get help if you’re having breastfeeding problems: Ii, if left untreated, nursing issues can actually lead to depression.) Research shows that mothers who supplement with formula or exclusively formula-feed are at higher risk for depression than mothers who breastfeed. Although breastfeeding mothers can suffer from depression, switching to formula can make the symptoms worse.

Postpartum depression is an illness, not a weakness. It can have serious consequences if left untreated. Regardless of which treatment option you choose, know that all mothers (those who suffer from postpartum depression and those who don’t) are challenged to balance parenting, home, and oftentimes work. When you return home from the hospital, be sure to ask for help and to accept that without help, some things just won’t get done. Tomorrow is another day. The laundry can wait. And visits with friends can be delayed. It’s more important to try to do something for yourself each day, such as walking, reading, or listening to music, even if it’s only for only 15 minutes. A little bit of “me” time can go a long way toward helping you find the balance you need.

Last updated November 27, 2017

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