Strategies for managing postpartum depression

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

Therapy

You probably know about therapy as a form of treatment for depression. It’s 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 always involves a patient and a licensed professional talking together. Psychotherapy teaches people of all ages and from all walks of life to think in healthier ways.

Psychotherapy is helpful for many people with depression, but some may need additional forms of treatment. Here are some of the other strategies to consider:

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 of the more common alternative treatments for depression include support groups, meditation, self-help materials like books or articles, and regular exercise, like yoga. Talk to your provider about which therapies are safe, especially if you’re taking medication, since alternative therapies can have interactions with medications. One simple-sounding (but hard to achieve) supplement to therapy and treatment for depression is just making sure to get enough sleep, since sleep deprivation can make depression worse.

Medication

Many people take medication to treat depression. While medication usually isn’t the first or only form of treatment for depression, it can be an extremely effective tool 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), and Sertraline (Zoloft). Zoloft and Paxil have the lowest transmission into breast milk, but all the SSRIs are generally considered to be 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 SSRIs are considered safe during pregnancy, while others are known to carry a certain amount of risk. Two types of these could be serotonin-norepinephrine reuptake inhibitors (SNRIs), like Venlafaxine (Effexor) and Duloxetine (Cymbalta), or norepinephrine-dopamine reuptake inhibitors (NDRIs), like Bupropion (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 focus entirely on themselves in a safe and supportive environment. In hospitals or residential treatment facilities, people are prescribed medication and see a therapist; family members may also be incorporated into treatment.

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 continues to sleep at home. In the U.S., there are a few perinatal intensive outpatient programs around the country, where moms visit with their babies. There is also one inpatient unit for moms and babies at UNC-Chapel Hill.

Brain stimulation therapies

These therapies may be options, but they are typically not used unless other forms of treatment have failed. Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and vagus nerve stimulation (VNS) are among some of the forms of brain stimulation therapy used. ECT and VNS procedures take place in a medical facility under supervision by a provider who has completed special training, while TMS takes place in a doctor’s office (still one who has special training).

A final note on treatment

It’s common for people who are afraid to seek treatment, or those who are already on medication but don’t yet feel their best, to seek out alternative therapies like supplements or off-label 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. Unfortunately, because of the nature of depression, it’s also nearly impossible to guarantee that the condition won’t ever return. 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.


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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.
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