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Depression After Pregnancy

What Treatments Are Available For Depression After Pregnancy?

Wednesday, March 21, 2012 - 15:54

Although a mild case of the baby blues may pass without the need for professional intervention, women who continue to feel depressed after three weeks should seek professional help from an obstetrician or other health professional.

The most appropriate treatment plans for depression after pregnancy usually consist of a combination of treatments including:

Types of Therapy

Even after the decision to enter therapy is made, it can be confusing to choose from among the many types of therapy. Remember that there is no one best type of therapy for everyone.

One general guideline: Experts recommend that women suffering from postpartum depression choose a therapeutic approach that helps them to focus on problem-solving in the present rather than trying to work through childhood issues.

Two therapeutic approaches are most often used to treat depression and anxiety:

Cognitive Therapy

Cognitive therapy is based on the theory that the way we think and perceive the world affects our mood and daily functioning. Cognitive therapists work on the premise that negative perceptions can quickly lower self-esteem, decrease energy and motivation, and increase stress levels.

In cognitive therapy, the client learns to respond in new ways to events or occurrences. For example, if you have a difficult time soothing your baby, you may believe you are not a good mother. A cognitive therapist will help you to see that the baby may simply be reacting to some physical discomfort, like gas, that no mother can do anything about.

Cognitive therapy is a collaborative process between the therapist and client. Expect interactive sessions, feedback from the therapist, and homework assignments

Interpersonal Psychotherapy

A therapist who specializes in interpersonal psychotherapy establishes a relationship with the patient. Interpersonal psychotherapy is based on the idea that there is a link between your mood disorder and interpersonal relationships, such as those with your spouse or new baby. This therapeutic approach may help you to balance the role of mother with that of partner, worker, or friend.

Need To Know:

Choosing A Therapist:

Family practitioners, psychologists, social workers, marriage and family counselors, and psychiatrists are all potentially qualified to help you overcome postpartum depression. Your obstetrician or family doctor may be able to recommend someone who specializes in depression after pregnancy.

There are several questions to ask when choosing a therapist.

  • What type of therapy does he practice? Are you comfortable with the approach? Ask the prospective therapist about his approach to treating depression and how long treatment is expected to last.
  • What are the therapist's credentials, and is she familiar with postpartum depression?
  • Is it likely that medications will be needed? Only medical physicians, psychiatrists, and some psychiatric nurse clinicians are licensed to prescribe medications. However, many therapists provide medications to their patients through arrangements with a psychiatrist or other M.D.
  • Do you feel comfortable with the therapist?
  • How much does the therapist charge, and does your insurance cover the costs of therapy?
  • For how many weeks does the therapist expect treatment to last, and how often will sessions be scheduled? A good general expectation is for weekly sessions for 12 to 24 weeks.

AntiDepressant Medications

Antidepressant medications offer an additional option for women with postpartum depression. Antidepressants are not tranquilizers, pep pills, nerve pills, or drugs that cause addiction. Antidepressants help lift your mood and increase energy so that you can cope with life again. The combination of therapy and antidepressants appears to be the most effective treatment for many women who suffer depression after pregnancy, partly because it may make them more responsive to therapy.

Many effective antidepressants are available today, and no single drug is best for everyone. Older antidepressant drugs, referred to as "tricyclics," are considered safe and effective, although they may cause side effects such as dry mouth or tremors. Newer antidepressants are called Serotonin Re-uptake Inhibitors (SRIs). The most famous and popular of these is fluoxetine, known by its brand name Prozac.

Nice To Know:

How Antidepressants Work

Each nerve cell in your brain is separated by microscopic gaps, called synapses. Naturally occurring messenger chemicals called neurotransmitters carry information across these synapses to a receptor on the other side. The neurotransmitter fits into the receptor like a key into a lock.

There are more than 50 known neurotransmitters, many of which work in concert with each other to regulate thinking, emotions, and behaviors. Mood-regulating neurotransmitters include serotonin, acetylcholine, dopamine, norepinephrine, and epinephrine (also called adrenaline).

People who are depressed or anxious usually have too little of one or more of the neurotransmitters. In some cases, the neurotransmitters can't fit into the receptors. This means that message can't be transferred between nerve cells, and communication in the brain slows down. Antidepressant medications alleviate symptoms of depression by helping the body maintain normal levels of neurotransmitters.

Antidepressant medications are not the best choice for all women suffering from depression after pregnancy. But if symptoms are severe enough, or have continued for long enough, your doctor may recommend that that you add medication to your treatment.

Here are some important facts about antidepressants:

  • Antidepressants are effective in about 60 - 80 percent of those who use them as directed.
  • The effects of antidepressant medications are often not apparent until a month to six weeks after treatment starts.
  • Antidepressant dosage has nothing to do with the severity of depression. Some antidepressants work at lower doses than other antidepressants.
  • Since some antidepressants work better for different combinations of symptoms than others, your physician needs an accurate description of your feelings.
  • Although many antidepressants are safe for mothers and babies and can even be taken while breastfeeding, the prescribing physician should always be informed if a woman is pregnant or breastfeeding.
  • Women with histories of depression who have been on medication should generally continue medication throughout pregnancy and after delivery.
  • Drugs such as lithium carbonate may be used for women with a history of bipolar disorder. Lithium is often discontinued during pregnancy because of possible harm to the developing fetus. Mothers who are breastfeeding should not take lithium.

Nice To Know:

Researchers have recently begun experimenting with hormonal replacement therapies for women with postpartum depression. By artificially increasing women's levels of the female hormones estrogen and progesterone, researchers hope to alleviate the emotional difficulties that are associated with rapid changes in hormone levels. The work is preliminary and remains controversial.

Peer Support Groups

Peer support groups form the third leg of support for women suffering from depression after pregnancy. Women who are experiencing the baby blues can benefit from peer support groups, as well as those who are getting professional help. Peer support can be an important addition to therapy and medication, and should be an important part of your postpartum plan. Many of these groups are organized and led by women who have experienced various degrees of postpartum depression.

The benefits of peer support groups include:

  • Talking with other new mothers creates opportunities to share or trade ideas for handling problems.
  • Although talk therapy can't change your hormones, it can help you ride out a hormonal imbalance without feelings of despair.
  • They offer a place to share your frustrations with other new mothers who may have similar feelings, and may have found other ways to cope.

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