Postpartum depression comes with various challenges, but there are many things you can do to feel better. Treatment options include therapy, medications, and self-care.
After giving birth, many people feel sad, anxious, or stressed. This is sometimes called the “baby blues.” But when these feelings become more intense, it might be postpartum depression (PPD) — now called peripartum depression.
Simply put, postpartum depression is depression during pregnancy and after childbirth that can last for months or longer.
PPD affects about
If you’re looking for more information about how to diagnose and treat postpartum depression, you’ve come to the right place.
Michelle Kukla, Psy.D., clinical psychologist and founder of Healthy Living Counseling Center, says that while postpartum depression is often associated with depression after giving birth, it’s just as important to know that depression can occur during pregnancy, too.
Kukla says 30% of pregnant people “will develop depression. Early intervention is critical. I like to say intervene early and thoroughly.”
Some symptoms of postpartum depression may include changes in energy, sleep, and eating habits, as well as feelings of:
- extreme sadness
- anger and agitation
Kukla says the most widely used method to assess for PPD is the Edinburgh Postnatal Depression Scale (EPDS), which consists of 10 questions that prompt people to score how they are feeling.
Having a psychiatrist or psychologist who specializes in perinatal mental health administer and assess the test is the safest way to ensure your health.
“Postpartum depression is already underdiagnosed, but there is even more of a disparity in women of color,” says Kukla.
According to one
“The mental health field needs to continue to reach out to women, and especially women of color, to help shatter the stigma of seeking care for mental health needs, especially during postpartum depression,” Kukla says.
If you’re looking for a mental health professional who specializes in perinatal mental health, consider reaching out to your gynecologist, child’s pediatrician or searching this provider directory.
While postpartum depression can feel overwhelming, several treatment options are available.
Some options may include therapy and medication. However, for people who don’t want to “take medication, especially while pregnant or breastfeeding, know that there are effective options,” says Kukla.
Below are some treatment options.
Psychotherapy (also called talk therapy) is used to treat different types of depression. Two forms often used with postpartum depression include:
Cognitive behavioral therapy (CBT) helps you to develop the ability to recognize unhelpful thought patterns that might contribute to negative behaviors and emotions.
Interpersonal therapy (IPT) aims to improve interpersonal relationships and social functioning as a way to reduce distress.
The American Psychiatric Association recommends psychotherapy without medication for pregnant people or those who are breastfeeding who have major depressive disorder if they are experiencing mild anxiety or depression.
However, for those experiencing moderate or severe depression or anxiety, your doctor may prescribe
“Taking medications while breastfeeding and during pregnancy should be discussed with a psychiatrist who specializes in perinatal mental health,” Kukla says. Many people try non-pharmacological and behavioral interventions “to avoid [medication], and some will stop breastfeeding to start medication trial.” This varies depending on the person.
The American Psychiatric Association lists the following medications as options to treat PPD:
- Selective serotonin reuptake inhibitors (SSRIs) are used to treat depression, anxiety, and other mood disorders. However, some SSRIs have been linked to a lung condition in babies called persistent pulmonary hypertension.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) can help treat irritability and sadness, as well as anxiety.
- Bupropion (Wellbutrin) is used to treat major depressive disorder, seasonal affective disorder, and to help those trying to quit smoking.
- Tricyclic antidepressants (TCAs) are the first medications developed to treat depression and are still used.
Also, in 2019, the Food and Drug Administration (FDA) approved the first drug specifically for postpartum depression.
Zulresso (brexanolone) is administered via IV infusion over a 60-hour period. Because the treatment can cause sedation and loss of consciousness, it’s given only under medical supervision in a restricted program.
“While this might seem like an unusual form of treatment, it is very effective at relieving depression by restoring hormone levels that shifted following pregnancy. Plus, the majority of women in the clinical trial were so desperate for the relief they described the challenges surrounding the medicine’s administration as a minor inconvenience,” says Kukla.
In addition to psychotherapy and medication, Kukla says some mental health professionals might use the following to help with symptoms of postpartum depression:
- Mindfulness-based interventions, which teach strategies to live in the moment without judgment.
- Lightbox therapy or bright light therapy often used to treat seasonal affective disorder.
- Brain stimulation therapy, such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS). A doctor might recommend these methods if your symptoms are severe, or if they don’t respond to other treatments.
Kukla says that focusing on self-care — such as eating nutritious food, getting some exercise, relaxing when you can, and getting enough sleep — is essential during pregnancy and with a new baby.
Also, Kukla recommends enhancing your support system with friends, family, other parents, and support groups to decrease isolation and to feel supported.
“It’s so classic for women to put all the attention and focus on the family and new baby, and exclude themselves. That’s where the interpersonal therapy can play a role — to help women understand it’s important to take care of yourself by dedicating 20 minutes to do meditation or exercise, even if that means getting creative by doing exercises with your child,” says Kukla.
The length of time for postpartum depression can vary. According to a 2014 review of studies, many symptoms of postpartum depression improve over time and take about 3 to 6 months to resolve.
However, the review also reported that:
- about 30% to 50% of people studied experienced postpartum depression 1 year after giving birth
- less than half had symptoms of depression 3 years after giving birth
People with postpartum depression have an increased chance of postpartum depression again and should be monitored closely. “They also remain at risk for future episodes of depression,” says Kukla.
While postpartum depression is a serious and complicated condition, there are treatments and help is available.
“I strongly believe that there are so many different approaches to mental health and wellness, and that there is hope and promising treatments and interventions for healing from postpartum depression,” says Kukla.
In addition to seeking treatment from your doctor, the following organizations offer support for people with postpartum depression.
- Centre of Perinatal Excellence (COPE) offers educational information about PPD and connects moms with peer support.
- Postpartum Support International (PSI) dedicated to helping women with perinatal mood and anxiety disorders.
- Health Resources & Services Administration (HRSA) offers educational information about maternal and child health.