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Postpartum Depression: Treatment

Postpartum depression is a serious mood disorder that affects many women after having a baby. If you have this condition you may feel extremely sad, angry, anxious, and tired. You may cry a lot and have trouble focusing. Left untreated, these feelings can make it hard for you to take care of yourself and your baby. But help is available. Treatment includes medicine and talk therapy.

How is postpartum depression treated?

Treatment options for postpartum depression are generally the same, whether you are breastfeeding your baby or not. The 2 main treatments are:

  • Medicine. Antidepressants are the main type of medicine used for this condition. They work by balancing chemicals in the brain that control your moods. There are many different antidepressants. They work on different chemicals in the brain. In some cases, more than 1 medicine may be used. Tell your healthcare provider if you are breastfeeding. He or she can help you find the medicine that’s best for you and your baby.

  • Talk therapy (counseling or psychotherapy). During a therapy session, you will talk about your feelings with a mental health provider (a therapist, counselor, psychologist, or social worker). He or she can provide emotional support, and help you learn ways to manage stress and anxiety. This may be done in private sessions with just you and the provider, or it may be done in a group therapy session.

Medicine and talk therapy may be used alone or together. Talk therapy may be used alone if antidepressants have not worked well for you in the past. Talk with your healthcare provider about this.

Most women find their condition gets better with these treatments. Other things you can do at home that may also help you feel better include:

  • Talking with friends and family members about how you are feeling

  • Joining a support group for moms with new babies

  • Doing some light exercise, such as taking your baby for a walk in the stroller

  • Eating a healthy diet

  • Getting some rest whenever you can, such as sleeping when your baby sleeps

  • Asking for and accepting help with meals, shopping, and laundry

Medicines for breastfeeding moms

Most women with postpartum depression are treated with antidepressant medicines. These medicines must be prescribed by your healthcare provider. They are generally safe for both you and your baby. Tell your healthcare provider if you are breastfeeding. He or she can help you find a medicine that’s a good choice for both you and your baby.

If you were treated with antidepressants during your pregnancy, your provider may want you to keep using the same medicine while breastfeeding. Changing to another medicine can have risks for you and your baby. Talk with your healthcare provider.

The types of antidepressants that may be used to treat postpartum depression in both breastfeeding and nonbreastfeeding moms include:

  • SSRIs (selective serotonin reuptake inhibitors). These types of medicines are used most often. They are considered safe for both mom and baby.

  • SNRIs (serotonin-norepinephrine reuptake inhibitors). These medicines also seem to be safe to use when breastfeeding. But some SNRIs may expose a baby to more medicine in breastmilk than others.

  • Atypical antidepressants. Some of these medicines are safe to take when breastfeeding.

  • Benzodiazepines. These medicines are often used for severe anxiety or agitation. But some are not advised for breastfeeding women.

Your healthcare provider will monitor you while you are on a medicine.

Antidepressants may take a few weeks to start working. But if you don’t feel better in a few weeks, call your healthcare provider. Together you may decide to change the medicine, or to add another medicine.

Possible medicine risks for breastfed babies

It's possible for antidepressant medicine to be passed to babies in breastmilk. This amount is very low, and considered safe. Experts also note that the overall benefits of breastfeeding for both mom and baby outweigh any possible minor risk. It’s also vital for a mom with postpartum depression to get the medicine that she needs.

But possible risks from medicine in your breastmilk may be a concern in some cases, such as if your baby:

  • Is sick

  • Is low birthweight

  • Was born early (premature)

If this is the case for you, talk with your healthcare provider and your baby’s provider about what treatment options are safe for you and your baby.

Breastfeeding babies who are healthy don’t often have side effects from antidepressants. But it is possible. Talk with your provider and your baby’s provider about what side effects to watch for.

Treatment for nonbreastfeeding moms

Treatment options for postpartum depression are very similar for nonbreastfeeding women. Your healthcare provider will work with you to find a medicine that is safe for you. He or she will also likely advise that you try a combination of medicine and talk therapy.

Medicines that may be used if you are not breastfeeding include:

  • SSRIs (selective serotonin reuptake inhibitors)

  • SNRIs (serotonin-norepinephrine reuptake inhibitors)

  • Atypical antidepressants

  • Seratonin modulators

Medicine side effects for moms

Some antidepressants may have side effects. These are often short-term (temporary) and will go away on their own. These may include:

  • Upset stomach (nausea) or vomiting

  • Trouble sleeping

  • Weight gain or weight loss

  • Dry mouth

  • Dizziness

  • Lack of interest in sex

  • Diarrhea

  • Headaches

If any of these symptoms don’t go away, or if they get in the way of your daily tasks, call your healthcare provider. He or she may have you try a different medicine.

When to call your healthcare provider

Call your healthcare provider right away if you are being treated for postpartum depression and:

  • You have severe or abnormal side effects to medicine

  • Your side effects to medicine are getting in the way of your normal daily tasks

Call

Call right away if you are being treated for postpartum depression and:

  • Your depression gets worse

  • You start thinking about hurting yourself, your baby, or others

Online Medical Reviewer: Donna Freeborn, PhD, CNM, FNP
Online Medical Reviewer: Irina Burd, MD, PhD
Date Last Reviewed: 6/1/2020
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