Postpartum Depression (PPD) Treatment

Psychotherapy (aka talk therapy) is the first line of treatment for mild cases of PPD, says Nancy Byatt, DO, a perinatal psychiatrist and physician-scientist at the University of Massachusetts Chan Medical School in Worcester, where she focuses on women’s mental health, specifically in pregnancy and postpartum. Byatt is also the founding medical director of Massachusetts Child Psychiatry Access Program for Moms (MCPAP), an initiative she developed and launched to train physicians, midwives, and obstetrics nurses in identifying symptoms of depression in new moms.

Individual Therapy

In individual therapy, you’ll meet with a mental health professional weekly or at a similar cadence, Dr. Byatt says. Some people may attend therapy for a short time, such as three to six weeks, but others may continue to see their therapist for several months or more. Some types of therapy that can help people with PPD, says Byatt, include:

• Cognitive Behavioral Therapy (CBT) CBT helps people learn to identify inaccurate or negative thinking in order to view difficult situations more clearly and cope with them in a more constructive way.

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   “With therapy like CBT, you’re changing your thought processes, becoming aware of them, and challenging them so they no longer make us anxious,” Byatt says.
• Interpersonal Therapy (IPT) IPT focuses on helping people improve their interpersonal relationships to relieve mental health symptoms. Researchers have found that four to eight sessions of IPT may help reduce symptoms of postpartum depression and improve satisfaction with family relationships and support, too.

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Family and Couples Therapy

Group Therapy

Medication used to treat PPD is similar to that for major depression, with a focus on antidepressants and anti-anxiety medication depending on symptoms and severity, says Nona Nichols, MD, a consultation-liaison psychiatrist at the Center for Adult Behavioral Health at Cleveland Clinic in Ohio.

“For women with mild-to-moderate depression, we would typically consider antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), as the first-line medications. Fortunately, these medications are considered safe in breastfeeding as well,” Dr. Nichols says.

Standard Antidepressants

• Selective serotonin reuptake inhibitors (SSRIs), like sertraline (Zoloft) and fluoxetine (Prozac)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs), like duloxetine (Cymbalta) and desvenlafaxine (Pristiq)
• Tricyclic antidepressants (TCAs), like amitriptyline (Elavil) and imipramine (Tofranil)
• Other antidepressants, such as bupropion (Wellbutrin, Zyban)

Brexanolone

Zuranolone

• Cold-like symptoms
• Dizziness
• Drowsiness
• Diarrhea
• Fatigue
• Urinary tract infections
• Sedation
• Confusion

Some new parents may believe they need to ignore their needs to tend to their baby first, but this is a misconception, Byatt says. “The best way to take care of our children is to take care of ourselves,” she says. Nichols uses the acronym NESTS to explain the importance of self-care for PPD. It includes:

Nutrition

Try to focus on eating a diet rich in whole foods, such as fruits, vegetables, lean proteins, and healthy fats to support your energy levels and brain function and regulate mood, Byatt says.

Exercise

Sleep

Time for Yourself

Whether you’re taking time out each day for a shower or to catch up on your favorite show, it’s crucial for new parents to have moments for themselves, Nichols says. Byatt also recommends using this time for meditation, yoga, or any activity that allows you to pause and destress.

Support

It’s okay to ask for help, Byatt says. Consider joining a maternal support group to make friends, lean on your loved ones to batch cook and deliver some meals, or hire a professional cleaning service once a week if you can afford it. “I always ask my patients about their support systems and encourage them to ask for help and tag-team childcare as much as possible so that women have time to take care of themselves,” Nichols says.

National Maternal Mental Health Hotline

If you’re struggling with your mental health while pregnant or after giving birth, call or text 833-TLC-MAMA (833-852-6262), which is a free, confidential hotline for pregnant and new moms in English and Spanish, 24/7.

Postpartum Support International

Call 800-944-4PPD (4773) to connect with trained volunteers who provide support, encouragement, information and resources by phone, text, or email and connect pregnant, postpartum and post-loss families with local healthcare providers who treat perinatal mood and anxiety disorders.

American Academy of Family Physicians (AAFP)

AAFP is an organization representing family physicians in the United States. It provides information on PPD and a Postpartum Depression Toolkit with resources for PPD screening, diagnosis, treatment, and patient self-help.

• Having a baby is a life-changing experience. New parents can feel overwhelmed, anxious, sad, or fearful. Postpartum depression is a common experience for women, with symptoms ranging from loneliness and crying spells to severe mood swings and disinterest in tending to yourself and your baby.
• Treatment options are effective and range from medication to therapy.
• Self-care is an important part of treatment — this includes making sure you’re eating healthy meals, getting adequate sleep and taking care of your mind and body.