Therapies for postpartum depression

CEBU, Philippines – First and foremost, it is very important to speak with the doctor, midwife or nurse as soon as possible if certain symptoms of post-partum depression are noticed. It's important for the woman and her family to remember it can take time to recover fully from the condition. There are common treatments and help for postpartum depression.

Support and advice

The most important first step in managing postpartum depression is recognizing the problem and taking action to deal with it. The support and understanding of the spouse, family and friends plays a big part in the patient's recovery.

It's important for the patient to talk to those close to her and explain how she feels. Bottling everything up can cause tension, particularly with her spouse, who may feel shut out. Social workers or counselors can also be helpful in providing support and advice.

Self-help groups can provide good advice, as well, about how to cope with the effects of postpartum depression. It can be very reassuring to meet other women who have the same problem. Again, one good source of proper guidance is a health professional.

Physical Exercise

Exercise has been proven to help depression, and it's one of the main treatments for mild depression. The doctor may refer the patient to a qualified fitness trainer who will be able to provide a suitable exercise program.

Psychological treatments

Psychological therapies are usually recommended as the first line of treatment for mild-to-moderate postnatal depression for women with no previous history of mental health conditions.

Some common ones are discussed below.

Guided Self-Help

Guided self-help is based on the principle that the doctor can only "help the patient to help herself." For example, the doctor can provide self-help manuals detailing types of issues the patient might be facing and practical advice on how to deal with them. The manuals also contain information on using cognitive behavioral techniques to help combat feelings of helplessness.

The doctor may also recommend an interactive computer program that's available on the internet, like "Beating the Blues," which also takes a cognitive behavioral approach to battling depression.

Talking therapies

Talking therapies encourage patient to talk through her problems, either one-to-one with a counselor or with a group. The patient can then discuss ways to approach problems in a more positive manner. Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) are two talking therapies widely used in the treatment of postnatal depression.

CBT is based on the idea that unhelpful and unrealistic thinking leads to negative behavior. The therapy aims to break such cycle and find new ways of thinking that can help the patient behave in a more positive way. For example, thinking there's a perfect ideal of "motherly behavior," that is both unrealistic and unhelpful. All mothers are human and humans make mistakes. It's neither necessary nor helpful to try and be "Supermom."

On the other hand, IPT aims to identify whether the patient's relationships with others may be contributing towards feelings of depression.

If the patient is unresponsive to therapies, then medication is often prescribed. Antidepressants may be resorted to if the patient has moderate postnatal depression and a previous history of depression or is experiencing severe postnatal depression.

A combination of talking therapies and an antidepressant may also be recommended.

Antidepressants work by balancing mood-altering chemicals in the patient's brain. These can help ease symptoms such as low mood, irritability, lack of concentration and sleeplessness, allowing the patient to function normally and helping her cope better with her new baby.

Contrary to popular myth, antidepressants aren't addictive. A prescription period usually lasts six to nine months.

Antidepressants take two to four weeks to start working, so it's important to keep taking them even if no improvement is noticed straight away. The patient should also continue taking her medicine for the full length of time recommended by the doctor. If she stops too early, her depression may return.

A patient who is breastfeeding her baby should inform her doctor about it, for the right antidepressant to be prescribed.  Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressants that are often recommended for breastfeeding women. But some SSRIs may have adverse side effects, like feeling sick, blurred vision, diarrhea or constipation, dizziness,  feeling agitated or shaky, insomnia (not sleeping well) or feeling very sleepy. These side effects, however, should pass once the patient gets used to the medication.

Many mothers are keen to breastfeed their babies because they feel it helps them to bond with their child and boosts their self-esteem and confidence in maternal abilities. These are important factors to consider in combating symptoms of postnatal depression.

In case of severe postnatal depression and the patient isn't responding to therapy treatment she is then referred to a mental-health team for a more intensive course of treatment. The team is usually made up of a range of specialists, including psychologists, psychiatrists, specialist nurses and occupational therapists.

A small number of women develop symptoms of psychosis after giving birth (being unable to tell the difference between reality and their imagination). This is termed puerperal psychosis, in which case the patient may be treated with a combination of: mood-stabling medications, such as lithium or an anti-epileptic medication; an antipsychotic (this helps combat the symptoms of psychosis); and a tranquilizer, such as a benzodiazepine, to help her relax.

(www.nhs.uk)