Strategies for managing depression in pregnancy and the postpartum period

Every person’s experience with depression is unique, and so their depression treatment options should be as well. Below are some strategies for managing depression during pregnancy.

Therapy

You probably know about therapy as a form of treatment for depression. It’s often the first step for someone who’s just starting to try to tackle their depression. There are different types of therapy, and which type a person uses depends on individual factors, but it most commonly involves a patient and a licensed professional talking together. Psychotherapy teaches people of all ages and from all walks of life to think and cope in healthier ways.

Psychotherapy is helpful for many people with depression, but there are still many other people who need additional forms of treatment. Here are some of the other strategies to try in addition to psychotherapy.

Medication

Many people take medications to treat depression. Medication is an extremely effective tool, often especially when combined with counseling. There are generally three categories of medication for depression.

  • Selective serotonin reuptake inhibitors (SSRI) antidepressants: Serotonin is a neurotransmitter that helps regulate mood, social behavior, appetite and digestion, and libido, among other things. SSRIs are commonly prescribed for depression because they increase serotonin levels in the brain. Examples of SSRIs include Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft), and Vilazodone (Vibryd). SSRIs are the most commonly prescribed depression medication during pregnancy and postpartum, and many SSRIs are safe during breastfeeding.
  • Non-SSRI antidepressants: Some people don’t react well to SSRIs, or have circumstances that lead them to try a different medication. Some non-SSRIs don’t increase serotonin, while others affect serotonin as well as a different neurotransmitter, while others don’t impact serotonin at all. Two types of these could be serotonin-norepinephrine reuptake inhibitors (SNRIs), like Cymbalta, or norepinephrine-dopamine reuptake inhibitors (NDRIs), like Wellbutrin.
  • Other medications: It’s not uncommon for a provider to combine medications or even add a medication to balance out the effects of an antidepressant. Some examples of medications that can be used this way are mood stabilizers and antipsychotic medication. Anti-anxiety medications might be prescribed, but these aren’t usually used long-term.

Hospital and residential treatment

Sometimes, in more severe cases of depression, people check into a hospital or a facility, especially if they’re at risk of harming themselves or others. Inpatient programs help people get focused treatment in safe and supportive environments. In hospitals or residential treatment facilities, people are prescribed medication and see a therapist; family members can also be included in the treatment process.

There’s also the option of an outpatient program. With this sort of program, a person visits the facility for a period of time to use the services it provides, but is not admitted to the hospital.

Brain stimulation therapies

Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and vagus nerve stimulation (VNS) are forms of brain stimulation therapy that are used.

Alternative therapies

Because depression has so many different causes, there are also a lot of different ways that people with depression cope and find relief.  Some lifestyle options that can be used in conjunction with therapy or medication are meditation, self-help materials like books or articles, and regular exercise, like yoga.

A final note on treatment

It’s common for people who are afraid to seek treatment, or who are already on medication but don’t yet feel their best, to seek out alternative therapies like supplements or off-label or non-prescription drugs to treat their depression. But this can be dangerous, particularly for individuals who are currently taking depression medication. It’s important to speak with a healthcare provider before starting any new kind of treatment. This is even more true for individuals who are already on depression medication, as the medication can have side effects and interactions with different supplements, drugs, and even herbal treatments. Make sure to take the precaution of speaking with your provider before you make any changes to your lifestyle.

Depression is complex, so it makes sense that treatment for depression is too. Some people will find that one medication is enough for them to function and feel better, while others need to try a variety of treatments and strategies before they find something that works for them. The most important thing you can do when considering options for depression treatment is to keep an open mind and be willing to try a number of treatments if you can’t find one that works for you and your family, to figure out what combination of treatments will help you feel better.


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Sources
  • “Depression: Treatment.” ADAA. Anxiety and Depression Association of America, 2016. Web.
  • “Depression: Care and Treatment.” ClevelandClinic. The Cleveland Clinic Foundation, 2014. Web.
  • Mayo Clinic Staff. “Treatments and Drugs.” MayoClinic. Mayo Foundation for Medical Education and Research, Jul 7 2016. Web.
  • Mayo Clinic Staff. “Selective serotonin reuptake inhibitors (SSRIs).” MayoClinic. Mayo Foundation for Medical Education and Research, Jun 24 2016. Web.
  • Lauren Hardy. “Depression Treatment: Outpatient vs. Inpatient.” HealthyPlace. HealthyPlace.com, Feb 26 2014. Web.
  • “Depression Treatment & Management.” Medscape. WebMD LLC., Apr 29 2016. Web.  
  • Mayo Clinic Staff. “Electroconvulsive therapy (ECT)” MayoClinic. Mayo Foundation for Medical Education and Research, Sep 19 2015. Web.
  • “Brain Stimulation Therapies.” NIMH. US Department of Health and Human Services, Jun 2016. Web.
  • Melinda Smith, Jeanne Segal. “Types of Antidepressants and Their Side Effects.” HelpGuide. Helpguide.org, May 2016. Web.
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