Understanding Postpartum Depression -- Diagnosis and Treatment
Medications for Postpartum Depression
The first step in treatment is to resolve immediate problems such as sleep and appetite changes. Antidepressants are usually quite effective for this. You and your doctor will need to make a careful decision about the use and choice of antidepressants if you are breastfeeding. Some antidepressants are secreted in small amounts in breast milk. Other medications, such as lithium, are more controversial in breastfeeding because of concerns that they may cause infant toxicity, although there is debate if lithium poses a real risk. Talk to your health care provider to determine if the benefits of antidepressant therapy outweigh the risk. If you take an antidepressant, you will probably be advised to take it for at least six months to a year to avoid a relapse and then either taper it off or continue it longer depending on your symptoms and history.
Also, if you have had a previous episode of postpartum depression, your health care provider may suggest you take preventive medicine shortly after the baby is born or during pregnancy. Most antidepressants do not pose any major risks to a developing fetus, although all medications have potential risks. Some antidepressants including the selective serotonin reuptake inhibitors Paxil, Zoloft, and Prozac have rarely been associated with persistent pulmonary hypertension of the newborn and cardiac septal defects when taken during the last half of the pregnancy. Older reports that some tricyclic antidepressants may cause limb deformities have not been confirmed in larger, more modern studies.
Many women who have given birth do not want to become pregnant again right away. However, if you are being treated for postpartum depression, you may want to choose a contraception method other than birth control pills, which may sometimes aggravate the symptoms of depression. Talk with your health care provider to decide which contraception method is best for you.
Psychotherapy and Postpartum Depression
Psychotherapy, or talk therapy, is commonly prescribed alone or with antidepressants to treat PPD. Your health care provider can refer you to a qualified mental health professional who specializes in treating postpartum depression. A therapist can give emotional support and help you understand your feelings and develop realistic goals, which are critical to overcoming postpartum depression.