June 20, 2024

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Postpartum Depression Treatment: Medications, Counseling

Postpartum depression (PPD) refers to depression that develops soon after having a baby, often within a few weeks, but sometimes up to a year after giving birth. It’s crucial to seek treatment for PPD, as it can lead to long-term depression or even potential danger to yourself or your baby if left untreated. PPD is usually treated through medication and/or therapy. 

This article will go over the available treatment options for PPD, as well as self-care tips and how to find support and resources.

Risk Factors for PPD

Potential risk factors for PPD include:

  • Being under the age of 25
  • Unplanned pregnancy
  • A history of mental health condition(s), such as depression, anxiety, or mood disorders
  • A stressful or complicated pregnancy or labor (i.e., experiencing health complications, birth defects, or premature labor)
  • Relationship conflicts
  • Financial stress
  • Substance abuse

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Postpartum Depression Treatment

Postpartum depression is typically treated with medication(s), talk therapy (psychotherapy), or both. The following are some of the available treatment options for PPD.

Medication

The following two medications are approved by the Food and Drug Administration (FDA) for the treatment of postpartum depression:

  • Zulresso (brexanolone): Zulresso is the first-ever drug approved by the FDA specifically to treat postpartum depression. Brexanolone, or allopregnanolone, is a neuroactive steroid that has to be delivered intravenously (via IV infusion). It works quickly to resolve postpartum depression symptoms. Common side effects include excessive sleepiness, dry mouth, and facial flushing.
  • Zurzuvae (zuranolone): In 2023, Zurzuvae (zuranolone), another neuroactive steroid, became the second FDA-approved postpartum depression treatment. Zurzuvae is taken orally twice a day for 14 days. Clinical trials found that it continued to provide relief over a month after the last dose. Potential side effects of Zurzuvae include fatigue, lightheadedness, cold symptoms, and urinary tract infections (UTIs).

Antidepressants are also sometimes prescribed to treat postpartum depression. Common classes of antidepressants that treat postpartum depression symptoms include:

Therapy and Counseling

Talk therapy, either in combination with medication or on its own, has been shown to be effective in treating PPD. Types of therapy that may be helpful include:

  • Cognitive-behavioral therapy (CBT): CBT improves problem-solving and coping skills, aids decision-making, and identifies negative thinking and behavioral patterns. Studies show that this form of therapy can significantly reduce postpartum depression symptoms and prevent them from progressing.
  • Interpersonal psychotherapy (IBT): Designed to be completed in just three to four months, interpersonal psychotherapy targets current challenges rather than looking deeply into childhood issues. It also helps to improve relationships. IPT can be delivered individually or in a group or family setting.
  • Couples therapy: Research suggests that couples therapy may be particularly effective in treating postpartum depression, possibly due to the crucial role of partner support in postpartum health and wellness.

A Word From Verywell

Postpartum depression can cause intense feelings of sadness, worry, and anxiety that last longer than two weeks, which impacts your quality of life. Baby blues is a milder version of sadness that happens soon after birth. However, it will improve within two weeks.

Renita White, MD

Self-Care in Addition to Treatment

In addition to seeking clinical treatment, it’s important to take care of yourself to manage the symptoms of postpartum depression and prevent them from getting worse. During the postpartum period, it may help to:

  • Exercise regularly.
  • Spend time with family and friends and on enjoyable hobbies.
  • Take time out to relax by yourself and with a friend, partner, or family member.
  • Limit caffeine intake.
  • Prioritize sleep, whether by napping during the day or getting help with the baby at night.
  • Avoid drugs and alcohol.
  • Practice mindfulness and relaxation techniques, such as meditation and deep breathing exercises.

Medication Alternatives for Postpartum Depression

There is some evidence to suggest that the following alternatives to prescription medication may help manage postpartum depression symptoms:

  • Omega-3 fatty acids: Both human and animal studies indicate that taking omega-3 fatty acids, or fish oil, as a daily supplement may help to treat symptoms of postpartum depression.
  • Repetitive transcranial magnetic stimulation (rTMS): Repetitive transcranial magnetic stimulation is a noninvasive therapy that utilizes magnetic fields to regulate mood and stimulate the brain. Some studies have found it to help treat postpartum depression both alone and alongside medication. 
  • Light therapy: Light therapy may be helpful due to the role of disrupted sleep in the development of postpartum depression.

Antidepressant Safety in Postpartum

Many people wonder if it’s safe to take antidepressants after giving birth. Typically, it’s not any less safe to take antidepressants during the postpartum period than at any other time. If you are breastfeeding, the answer may be more complicated. 

In any case, it’s important to talk to your healthcare provider about your particular needs, symptoms, medical history, and any other drugs or supplements you’re taking. You can also ask them about potential side effects and how they may affect you after giving birth. Most side effects from antidepressants are temporary and resolve on their own. 

Common side effects of antidepressants include:

  • Fatigue
  • Weight gain
  • Appetite changes
  • Diarrhea
  • Low libido
  • Nausea
  • Vomiting

While Breastfeeding

It’s possible for antidepressants, like other medications, to pass on to your baby when you’re breastfeeding. However, research suggests that the amounts found in breast milk are typically too low to harm an infant. Zoloft (sertraline) is often prescribed to people who breastfeed and is generally considered to be safe. 

If you’re planning to breastfeed, talk to your healthcare provider before starting an antidepressant or any other medication. They can advise you on the safest possible treatment for you and your baby.

Postpartum and Mental Health Support

If you think you may have postpartum depression, the first step is to reach out for support. Fortunately, many resources are available to help, from healthcare providers and peer support groups to emergency hotlines if needed.

Ask for Help

People who are experiencing depression that persists for two weeks or more should reach out to a healthcare provider, such as:

  • An ob-gyn (obstetrician-gynecologist)
  • A primary care provider
  • A mental health specialist, such as a psychologist or psychiatrist
  • A social worker at a community health clinic or family planning center

Tapping into your support system, such as your partner, friends, family, and community, is also important for help after having a baby. This may involve:

  • Accepting and asking for help with baby care and day-to-day chores, such as cooking and cleaning
  • Spending quality time with your loved ones and friends
  • Opening up to trusted people in your life about how you feel
  • Hiring outside help for babysitting or housework if possible and necessary

Utilize Resources

In addition to seeking help from your healthcare provider(s) and loved ones, you can find valuable postpartum depression resources through:

Seek Emergency Help

If you’re experiencing thoughts of self-harm or suicide due to PPD or for any other reason, text or call 988 to get in touch with the 988 Suicide & Crisis Lifeline at 988. TTY users can dial 711, followed by 988. Deaf and hard-of-hearing (HoH) users can also use the 988 ASL Videophone to reach out. Call 911 if you or someone else is in immediate danger.

Summary

The first-line treatment for postpartum depression (PPD) is a combination of medication and therapy. Brexanolone and zuranolone are the two medications approved by the FDA for the treatment of postpartum depression. Antidepressants may also be prescribed. Talk therapy, such as cognitive behavioral therapy, can help prevent postpartum depression symptoms from getting worse. 

If you think you have postpartum depression, reach out to your healthcare provider. They can answer questions about your available treatment options and potential side effects and safety risks when breastfeeding. While postpartum depression can be difficult to manage, you’re far from alone. Help is available, and treatment is highly effective.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Laura Dorwart

By Laura Dorwart

Dr. Dorwart has a Ph.D. from UC San Diego and is a health journalist interested in mental health, pregnancy, and disability rights.

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