Treatment for Postpartum Depression

person holding a baby

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Pregnancy and childbirth are incredibly stressful times, and the body undergoes major changes and hormone fluctuations before, during, and after the birth. Additionally, caring for an infant while recovering from either vaginal birth or cesarean section is challenging and exhausting.

It is natural to experience stress and emotions during this adjustment time, but approximately 3% to 6% of people experience clinically significant, debilitating mood symptoms that meet criteria for postpartum depression (PPD).

Individuals struggling with PPD might experience depressive symptoms or significant anxiety. Although these symptoms can be scary, effective treatment options are available. With appropriate support and treatment, you can cope with and recover from PPD symptoms.

Psychotherapy for Postpartum Depression

As with other types of depression, PPD can be treated using psychotherapy. There are several evidence-based treatment approaches specifically designed to treat the symptoms that occur with PPD.

Extensive research has been conducted surrounding Cognitive Behavioral Therapy with postpartum parents. Research has consistently shown that these treatment protocols can reduce depressive symptoms and foster healthy attachment between the parent and child, both with and without additional medication intervention.

Additionally, attachment-based therapies involving both the parent and baby can treat PPD and improve parenting outcomes. In addition to treating the mood symptoms of PPD, these types of therapies emphasize healthy bonding with the child, mitigating attachment issues that can occur when the parent is struggling with their mental health.

Medication for Postpartum Depression

Some new parents are hesitant to use medication to treat PPD due to concerns related to chestfeeding. There can be a lot of pressure to chestfeed, with groups promoting the slogan, “Breast is Best.” However, chestfeeding when it is not the healthiest choice for the parent and baby can exacerbate the symptoms of PPD.

Talk to your providers about your concerns, and make the choice that is best for you and your baby.

Should you and your treatment team decide that medication is the right choice for you, there are different options available. Many people struggling with PPD benefit from antidepressant medication, which can be safe to take during pregnancy or while chestfeeding (ask your prescriber what is appropriate and safe in your situation).

If you are experiencing manic symptoms and/or psychosis as well as depression, you may be experiencing postpartum psychosis. For postpartum psychosis as well as for more severe cases of PPD, your provider might recommend mood stabilizers to treat your symptoms.

Additionally, if you are experiencing difficulty with reality testing, the urge to hurt yourself or your child, or delusional beliefs, you might benefit from antipsychotic medication to address these symptoms.

Always ask your provider any questions you have about side effects, safety concerns, or anything you need to know about any medications prescribed to you.

Hospitalization for Postpartum Depression

In the event that you or your provider believe you might be a danger to yourself or others, they may recommend hospitalization for your symptoms. This is to help stabilize you and your symptoms as well as keep both you and your baby safe.

If you require hospitalization for your PPD symptoms, this does not mean you are an ineffective parent or have done something wrong. It means you are taking all steps necessary to ensure your baby’s safety. Hospitalization can be scary, but this brave step can be an important component of your treatment.

Electroconvulsive Therapy for Postpartum Depression

For individuals experiencing severe PPD, particularly those with psychotic symptoms related to their disorder, some providers have recommended Electroconvulsive Therapy (ECT). Research has shown that this can help alleviate psychotic and depressive symptoms of PPD, especially in the early postpartum period.

It's advisable that you talk to a provider about the possible risks and benefits of ECT for postpartum symptoms.

Other Resources for Treating Postpartum Depression

In addition to the treatments listed, support groups can be a great resource for individuals with PPD. The experience of working through symptoms in a safe environment with others going through something similar can foster a sense of community and connection, helping address depression, isolation, and negative thought patterns.

Although not a replacement for traditional therapy, research has shown that an AI-based bot can implement certain cognitive behavioral techniques in a way that alleviates symptoms of PPD.

The app can provide education about mental health and PPD specifically while addressing negative thoughts and emotions associated with PPD.

How to Make Your Treatment Most Effective

Going to therapy can be scary and intimidating. You are being vulnerable with someone about your struggles, and this is difficult to do. You might not click with the first therapist you see, and it is OK to try out multiple therapists in order to find someone with whom you have good therapeutic fit and a strong, trusting relationship. If you feel comfortable, you can tell a therapist that you do not feel like the relationship is a good fit and ask for referrals to other therapists with whom you might “click” better.

Therapy tends to be most effective if clients feel like they can be open and honest with their therapists. However, it can be particularly challenging to attend therapy for PPD if you are experiencing intrusive thoughts of hurting yourself or your baby. Intrusive thoughts are often distressing, and most people do not want to act on them, but even the thought that you could hurt your baby can be terrifying.

Many struggling with these intrusive thoughts might be hesitant to share the thoughts with their therapist, even though addressing them is an important part of treating PPD.

If you are upset by intrusive thoughts of hurting your baby, talk to a therapist. While you might be nervous to tell anyone about your thoughts, remember that providers trained in maternal mental healthcare are experienced in this area. They'll show you ways to cope with your thoughts and teach you that having intrusive thoughts does not mean you will take any action to harm your baby.

On the other hand, if you are experiencing postpartum psychosis and worry that you will hurt your baby, tell a therapist right away. They must then follow proper protocol and admit you for psychiatric help. Though it can be scary, being honest with a therapist is a necessary step in keeping yourself and others safe.

Communication and trust are ongoing in therapy. As questions come up, know that you can ask your therapist about your diagnosis, treatment, and progress. Therapy is collaborative, and your therapist should honor your voice in the process. They are the expert on therapy, you are the expert on yourself, and together you can work through your symptoms.

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Amy Marschall, PsyD
Dr. Amy Marschall is a clinical psychologist who works with children and adolescents. She is certified in TF-CBT and telemental health.