Several treatment and management options exist to support you in your recovery.
There are known risks to the health and wellness of both you and your baby when postpartum depression is left untreated. For some of you, coming to postpartumcare.ca may be the first step in your journey to recovery. We do encourage you to get the help you need as it will make both you and your baby healthier.
None of these treatments may be perfect, and you’ll have to consider all of the pros and cons. It’s important to determine, alongside your healthcare provider, what you’re looking for in a management option and what’s the best treatment for you.
These are the most common treatments for postpartum depression:
- Psychoeducation
- Psychological Therapies
- Cognitive Behavioural Therapy (CBT)
- Interpersonal Therapy (IPT)
- Psychodynamic Therapy (PDT)
- Parent-infant Psychotherapy
- Couples and Family Therapy
- Medication
- Mindfulness
- Support Groups
- Self-care
- Other
Psychoeducation
Psychoeducation is education about a specific mental health illness or broadly about mental health. It can help you and your family better understand relevant information and symptoms, and learn about the available treatment or management options for you.
Psychotherapy
Psychotherapy, also known as “talk therapy,” is provided by professionals (such as psychologists, psychiatrists, and counsellors) trained in specific treatment methods. Psychotherapy can be done one-on-one or in groups, and can sometimes be provided online.
CBT focuses on how thoughts affect your emotions which, in turn, affect your behaviour and body responses. This type of therapy helps you identify and change patterns of negative thinking. It can help you take an active role in dealing with your depression. Typically, CBT takes longer to work compared to taking medications, but it has no side effects. Additionally, coping tools developed during CBT can be used throughout the rest of your life and beyond depression.
Interpersonal therapy is a problem-focused, short-term therapy that focuses on role transitions and your relationships with other people. There is a focus on understanding the impact of becoming a parent on your relationships, the expectations about those relationships, the balanced view of needs and whether they’re being met and the way to effectively communicate your needs to others.
Psychodynamic therapy is an insight-oriented therapy, which focuses on unconscious processes and how they show themselves in your current behaviour. It can help improve your self-awareness and understanding of your behaviour. This is often done by identifying the patterns in your emotions, thoughts, and behaviours to gain more self-awarenesss with the guidance of a therapist.
Family/marital therapy is joint therapy that helps you gain stability in your relationship with your partner or family. Stable marital and family relationships can help new parents adapt to the demands of the marriage, baby, and family. Therapy techniques often involve both behavioural components and psychoeducation.
Parent-infant psychotherapy aims to relieve the emotional stress you may be experiencing as a new parent, and/or in your interactions with your baby. Therapy techniques include psychotherapy and educational interventions.
Medication
There are several medication options that exist for PPD, which are typically prescribed based on medical guidelines and personal preferences.
Your healthcare provider will likely assess the following when deciding whether medication is an appropriate treatment to recommend:
- inability to take care of yourself (e.g. not dressing, isolating at home or skipping prenatal appointments)
- having difficulty sleeping most nights
- not making expected weight gains
- using/abusing substances
- experiencing overwhelming feelings of worry
- experiencing recurrent panic attacks
- experiencing thoughts of self-harm or suicide
- experiencing psychotic symptoms (e.g. hearing voices or believing someone is trying to harm you)
Types of Medication
How long will you have to take medication?
Antidepressants are typically used for six months or longer, first to treat PPD and then to prevent a relapse (or recurrence) of mood symptoms. Your healthcare provider may recommend up to a year or longer before gradually reducing your medication. Quitting suddenly can cause withdrawal symptoms or cause depression to return, so be sure to discuss with your healthcare provider to determine the best way to stop taking the medication, including whether it makes sense to also take part in psychological therapy.
Questions to ask to your medication prescriber
- Name and dose of medicine
- How often to take it
- How to take it (e.g. with a meal or glass of water)
- What to do if you miss a dose (i.e. should you take it when you remember, or should you wait for the next dose?)
Mindfulness
Mindfulness is a non-religious type of psychological skill-building that teaches you how to use the focus of your attention in a non-judgmental way. To start, you may listen to guided mindfulness exercises and practice along. With time, practicing mindfulness leads to fundamental changes in brain function and activity in a way that helps improve mood, reduce stress, and manage anxiety.
Mindfulness techniques can include daily practices of meditation: focused and non-judgmental attention to the present moment. Mindfulness may be used in addition to medication and/or therapy. Mindfulness-based cognitive therapy is based on using present-moment awareness to the components of cognitive behavioral therapy, such as to identify patterns of negative thinking.
Support Groups
Support groups typically provide a safe space for parents to connect and receive information. The groups vary depending on location and type of support provided (e.g. support specifically for parents with PPD).
Self-care
Self-care is making positive changes in one’s life that will promote mental, emotional, and physical well-being. In British Columbia, a common acronym used to help new parents remember the basic steps for self-care is NEST-S:
Nutrition: Make it easy to enjoy nutritious foods throughout the day by prepping snacks ahead of time (e.g. veggies and dip).
Exercise: There is considerable research on the benefits of regular exercise for improving depression.
Sleep and rest: Sleep is very important for both physical and mental health but it can be difficult with a newborn. Even sleeping or resting for a short time can improve your mood.
Time for self: This is an area that new parents often neglect and can be especially detrimental for parents who are depressed and/or experiencing other mental health concerns.
Support: Social support plays an important role in helping new parents adjust to life changes. Healthy relationships can help prevent depression and other mental health disorders, and are also an important factor in recovery.
See the self-care page for more ideas on how to take care of yourself.
Other
Other treatment options include bright light therapy, especially for winter-related depression,
parent coaching, which provides education and support for baby care and related problems, and
infant massage classes, which teach skills for physical and emotional bonding with your baby.