Postpartum / Postnatal Treatment

By Dr. Ananya Mandal, MDReviewed by Sally Robertson, B.Sc.

Postpartum depression (Postnatal depression) is a severely distressing but treatable condition. Postpartum depression needs to be identified in good time so that professional help can be sought. Recovery may take time and it is vital for both mother and baby that family are supportive during this time. Some of the approaches to treating postpartum depression include:

Psychotherapy and counselling

These techniques are usually the first line of approach in treating mild-to-moderate postpartum depression, especially in women who have never suffered from any mental health problems before. This type of therapy may take the form of:

• Self- help advice offered in counselling sessions
• Interpersonal psychotherapy which helps an individual to understand how they are communicating and interacting with others. If a problematic behaviour in relating to others is identified, the therapist can help the mother address and change the behaviour.
• Cognitive behavioural therapy is an approach that can help a woman change her behaviour by altering the way she thinks about a problem. Therapy does not focus on past events but on day-to-day obstacles that are causing negative thought patterns and attitudes and giving rise to negative behaviour.

Medications

Cases of mild depression that do not resolve with psychotherapy or counselling are termed moderate-to-severe and are usually treated with antidepressants. Selective serotonin reuptake inhibitors such as fluoxetine, citalpram and paroxetine are considered safe for treating breastfeeding women and may be prescribed over a four to six week period.

For severe cases of depression where psychosis is also manifesting, mood stabilizers such as lithium or antipsychotic agents and tranquilizers may be prescribed. However, breastfeeding can pass these medications onto the baby so the baby needs to be transferred to formula milk before this medication is started.

Support

Adequate support is one of the most vital aspects of therapy for postnatal depression. As well as professional support, support provided by family and friends can significantly reduce the severity of postnatal depression. Support can also be found in the form of support groups which other mothers with similar problems may attend.

Regular physical exercise

Studies have shown that regular physical exercise helps to reduce the severity of postpartum depression.

Electroconvulsive therapy

Electroconvulsive therapy is recommended only in very severe cases of postpartum depression where mothers have not been responsive to psychotherapy and medication. The procedure is usually performed under general anesthesia and involves an electric shock being applied to the brain by means of electrodes placed over the head. The procedure is usually performed twice a week for 6 to 12 weeks.

Further Reading

• All Postpartum Depression Content
• What is Postpartum / Postnatal Depression?
• Postpartum / Postnatal Depression Causes
• Postpartum / Postnatal Symptoms
• Intrusive Thoughts and Postpartum Depression