Before Therapy Diagnosing Postpartum Depression
After giving birth, a woman will experience hormonal changes as her body adjusts to no longer being pregnant. Estrogen and progesterone will drop significantly, which can cause depression, anxiety, or mood swings for the first few weeks. This period is called the baby blues and is very common.
However, if these symptoms last more than a few weeks, occur alongside other symptoms, or appear within the first year after giving birth and linger, the Office of Womens Health recommends scheduling a follow-up appointment with your doctor. Your doctor will perform a postpartum depression screening, which includes questions about any current mental health conditions and family history of depression or mental illness.
In some cases, more severe symptoms might indicate the rare condition of postpartum psychosis. Severe symptoms may include intrusive thoughts about harming the new baby, hallucinations, obsession with the new babys health and well-being, or suicidal thoughts. Postpartum psychosis requires immediate medical intervention for the health and safety of the new mother and her baby.
Upon receiving a postpartum depression diagnosis, your doctor will discuss your treatment options, which often include a combination of medication and therapy. Your doctor can usually provide a referral for mental health professionals that specialize in treating PPD.
Symptoms Of Postpartum Depression
While roughly three-quarters of all new mothers experience baby blues 45 days after the birth of the baby, for mothers who had a traumatic birth experience, these feelings can come on even earlier. Mothers with baby blues often experience the symptoms of postpartum depression, such as impatience, irritability and anxiety. These feelings generally disappear within 14 days after delivery.
But when these mood swings continue past a 2-week period, it may be a sign that the woman is going through postpartum depression. According to the American Journal of Obstetrics and Gynecology, postpartum depression affects up to 15 percent of mothers.
Postpartum depression typically occurs within 4 weeks of giving birth and possibly as long as 30 weeks postpartum. Symptoms of postpartum depression include:
- Poor concentration
The diagnostic criteria for a Major Depressive Episode is no different in the postpartum period compared to other episodes of depression. To be considered depression, the patient has experienced at least two weeks of persistent low mood, as well as four of the following: increased or decreased appetite, sleep disturbance, psychomotor agitation or retardation, feeling always tired, feelings of worthlessness, low concentration and thoughts of suicide.
Conventional Treatments For Postpartum Depression
Early detection and treatment of depression after and during pregnancy is important because of the many adverse outcomes, including infant care and development. Experts have recommended screening for postpartum depression at the first postnatal obstetrical visit, which is typically 46 weeks after delivery. As a screening tool, many healthcare practitioners use a 10-item self-report that emphasizes emotional and functional factors.
1. Psychotherapy
Common forms of psychotherapy include interpersonal therapy and short-term cognitive-behavioral therapy. Family physicians are key players in the detection and treatment of postpartum depression this is because new mothers have a tendency to negate their feelings as something other than a treatable psychiatric illness. Depressed mothers also report that they dont receive the social support that they desire in this time of need. This lack of perceived support occurs in womens relationships with their parents, relatives and friends, but it most pronounced in their relationships with their partners.
Interpersonal psychotherapy is a short-term, limited focus treatment that targets the specific interpersonal disruptions experienced by women in the postpartum period. Plus, a recent systematic review found that patients with major depressive disorder in primary care actually prefer psychotherapy over antidepressant medication for treatment, especially women with postpartum depression.
2. Antidepressant Medication
3. Hormone Therapy
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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.
How Can I Help Someone With Postpartum Depression
People with postpartum depression need lots of support. Here are some ways you can help:
- Know the signs of depression and anxiety and urge your friend or partner to seek medical care.
- Be a good listener. Let them know you’re there to listen and help.
- Offer to help them with daily tasks like cleaning and running errands.
- Offer to help watch their baby while they sleep or rest.
- Encourage them to seek help from a therapist or other mental health provider. Offer to set up an appointment or go with them as a support person.
A note from Cleveland Clinic
Postpartum depression is a common mood disorder that affects 1 in 7 people after giving birth. It’s not your fault, and you did nothing to cause it. It doesn’t make you a bad parent or a bad person. The biological, physical and chemical factors that cause PPD are beyond your control. Signs of postpartum depression include feeling sad or worthless, losing interest in things you once enjoyed, excessive crying and mood swings. Talk to your healthcare provider if you think you have postpartum depression. They can figure out how to best manage your symptoms. Counseling, medication or joining a support group can help.
Last reviewed by a Cleveland Clinic medical professional on 04/12/2022.
References
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Should Breastfeeding Mothers Take Antidepressants
Nursing moms who are experiencing symptoms of depression should seek treatment immediately. If you are not already seeing a therapist or a psychiatrist, ask your OB-GYN or midwife for a referral. You dont have to go through this alone.
In some cases, your provider might recommend therapy alone as a treatment for your depression. But if she thinks you need to take an antidepressant, try not to worry.
All antidepressants are excreted into breast milk, but most are found at very low or undetectable levels in infant serum, says Dr. Rebecca Berens, assistant professor of Family and Community Medicine at Baylor College of Medicine in Houston. While infants should be monitored for behavior changes and weight gain if a mother is taking antidepressants, very few side effects in infants have been observed in studies. The risks to infant and maternal health of untreated postpartum depression are significant and far outweigh the risks of taking antidepressants while breastfeeding.
That being said, its not a one-size-fits-all approach. The best antidepressant to take is the one that best controls the mothers symptoms while also taking into consideration the infant safety profile, so this decision must be individualized, Dr. Berens says.
Natural Treatment For Postpartum Depression
1. Omega-3 Fatty Acids
According to researchers at The University of Kansas Medical Center, there is a growing body of clinical evidence that suggests that low dietary intake or tissue levels of omega-3 fatty acids are associated with postpartum depression. Omega-3 benefits are known to include relieving depression and feelings of anxiety. Low tissue levels of DHA are reported in patients with postpartum depression and the physiological demands of pregnancy and lactation put a childbearing women at particular risk of experiencing a loss of DHA. Animal studies indicate that decreased brain DHA in postpartum females leads to several depression-associated neurobiological changes that inhibits the brains ability to respond to stress appropriately.
A 2014 study involving female fats found that menhaden fish oil benefits include exerting beneficial effects on postpartum depression and decreasing the biomarkers related to depression, such as corticosterone and pro-inflammatory cytokines.
A review published in the Journal of Midwifery and Womens Health discusses the recent research on omega-3s and womens mental health, with a particular focus on the perinatal period. These studies include population studies examining fish consumption and studies testing the efficacy of EPA and DHA as treatments for depression. The majority of studies indicate that EPA is able to treat depression either alone or in combination with DHA and/or antidepressant medications.
2. Acupuncture
3. Exercise
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How Do Doctors Screen For Postpartum Depression
It can be hard to detect mild cases of postpartum depression. Healthcare providers rely heavily on your responses to their questions.
Many healthcare providers use the Edinburgh Postnatal Depression Scale to screen for postpartum depression. It consists of 10 questions related to symptoms of depression such as feeling unhappy, anxious or guilty. You’re asked to check the response that comes closest to how you’ve felt the last seven days. A higher score indicates possible postpartum depression.
If your provider feels you have signs of postpartum depression, they will recommend an appropriate treatment.
Do I Need Health Insurance To Receive This Service
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
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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.
Fda Approves First Drug For Postpartum Depression
The medication works quickly, within 48 hours. But its an expensive infusion and requires a stay in a medical center.
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By Pam Belluck
The first drug for women suffering postpartum depression received federal approval on Tuesday, a move likely to pave the way for a wave of treatments to address a debilitating condition that is the most common complication of pregnancy.
The drug works very quickly, within 48 hours a significant improvement over currently available antidepressants, which can take two to four weeks to have an effect, if they work at all.
Experts say the new treatment will provide immediate relief for mothers whose depression keeps them from providing their babies with the care, bonding and nurturing that is crucial for healthy development. As many as one in seven American women experience depression during or after pregnancy.
Postpartum depression is a serious condition that, when severe, can be life-threatening, Dr. Tiffany Farchione, acting director of the Division of Psychiatry Products at the Food and Drug Administrations Center for Drug Evaluation and Research, said in a statement.
This approval marks the first time a drug has been specifically approved to treat postpartum depression, providing an important new treatment option.
She did not stop antidepressants altogether, but switched to a low dose of Effexor.
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Postpartum Depression Is Different From The Baby Blues
Postpartum depression is depression that occurs after having a baby. Feelings of postpartum depression are more intense and last longer than those of baby blues, a term used to describe the worry, sadness, and tiredness many women experience after having a baby.
If you think you have depression, seek treatment from your health care provider as soon as possible.
Can Postpartum Depression Be Prevented
Postpartum depression isn’t entirely preventable. It helps to know warning signs of the condition and what factors increase your risk. Here are some tips that can help prevent postpartum depression:
- Be realistic about your expectations for yourself and your baby.
- Limit visitors when you first go home.
- Ask for help â let others know how they can help you.
- Sleep or rest when your baby sleeps.
- Exercise â take a walk and get out of the house for a break.
- Keep in touch with your family and friends â don’t isolate yourself.
- Foster your relationship with your partner â make time for each other.
- Expect some good days and some bad days.
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What Are The Symptoms And Signs Of Postpartum Depression
Most new mothers will experience things like the baby blues. However, if those baby blues dont go away by the second week you could be looking at postpartum depression.
The symptoms of postpartum depression is different for all moms but here are a few common factors:
As a new mom you will feel most of these things at some point. However, having postpartum depression or postpartum anxiety you will feel these things stronger and more regularly. Not all postpartum mothers will feel every symptom.
When To See A Medical Provider
Even though its common, it can take a little while to determine postpartum depression. PPD symptoms can emerge anytime during the first three months after birth, and if left untreated, it can turn into chronic depression. If you notice symptoms of PPD in yourself or a loved one, especially if it extends beyond two weeks, you should see a healthcare provider. They will be able to diagnose you and discuss the best treatment plan for you. The sooner you get help for PPD and your symptoms, the sooner youll start to feel relief.
If you have been given treatment such as antidepressants, do not stop taking the medication without first discussing with your healthcare provider, even if you find that your symptoms have subsided. If you want to stop for any reason, talk things over with your doctor they can help you stop the medication safely.
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What Are The Signs & Symptoms Of Postpartum Depression
Symptoms of postpartum depression can vary from woman to woman. But common signs include:
- feeling sad, hopeless, or overwhelmed
- feeling worried, scared, or panicked
- blaming yourself unnecessarily
- not feeling attached to the baby
- not wanting to do things that usually are enjoyable
Although it is very rare, some women have very serious symptoms such as:
- thoughts of hurting the baby or themselves
- hearing voices, seeing things that are not there, or feeling paranoid
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Advantages Of Speaking To An Online Psycho Therapist
Psycho therapists are trained to aid individuals with psychological wellness problems. Yet not every person can manage to see a psychologist, which is why its excellent that there are now on the internet psychologists that can offer the exact same service at a reduced rate.
If you want to discover a person to talk to free of cost online, you need to look into the most effective websites that use this service. You need to additionally seek testimonials of these sites and also check out endorsements from people who have actually used their services prior to.
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Types Of Postpartum Depression Therapy
Therapy, or psychotherapy, is a broad profession with many different approaches. Though there are different types of therapy, they all seek to treat postpartum depression.
Some therapies may better suit different people or forms of postpartum depression. Some mental health care professionals specialize in specific therapy types, while others offer several forms of therapy.
Here are five standard therapies for mothers and others suffering from postpartum depression.
Treatment For Postpartum Depression
PPD is generally treated with a combination of medication and therapy. Support groups may also be helpful. Doctors recommend seeking professional help if:
- Symptoms persist more than a couple of weeks
- It is not possible to function normally
- Everyday situations are beyond the persons ability to handle
- There are any thoughts of self-harm or harming the baby
- Panic, anxiety and fear are present for most of the day
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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.