Postpartum Depression: Treatment

Postpartum depression (PPD) is a serious mood disorder. It affects many pregnant people after having a baby. You may feel very sad, angry, anxious, or tired if you have this condition. You may cry a lot. You may have trouble focusing. These feelings can make it hard for you to take care of yourself and your baby. But you can get help. Treatment includes medicine and talk therapy.

How is PPD treated?

Treatment for PPD often doesn't depend on whether you are breastfeeding your baby. The 2 main treatments are:

• Medicine. Antidepressants are the main type of medicine used for this condition. They work by balancing chemicals in the brain that control your moods. There are many different antidepressants. They work on different chemicals in the brain. You may need more than one medicine. Tell your healthcare provider if you are breastfeeding. They can help you find the medicine that’s best for you and your baby.

• Talk therapy (counseling or psychotherapy). You will talk about your feelings with a mental health provider. This could be with a therapist, counselor, psychologist, or social worker. They can give support for the emotions you are feeling. They can help you learn ways to manage stress and anxiety. This may be done in sessions with just you and the provider. Or it may be done in a group therapy session.

Medicine or talk therapy may be used alone. Or they may be used together. Talk therapy may be used alone if medicine has not worked well for you in the past. Talk with your healthcare provider about this.

Most birth parents find their condition gets better with these treatments. You can do other things at home that may help you feel better. These include:

• Talk with friends and family members about how you are feeling.

• Join a support group for parents with new babies.

• Do some light exercise. Try taking your baby for a walk in the stroller.

• Eat a healthy diet.

• Get rest whenever you can. Try sleeping when your baby sleeps.

• Ask for and accepting help with meals, shopping, and laundry.

Medicines for breastfeeding parents

Most people with PPD are treated with antidepressant medicines. These medicines must be prescribed by your healthcare provider. They are usually safe for both you and your baby. Tell your healthcare provider if you are breastfeeding. They can help you find a medicine that’s a good choice for both you and your baby.

Your provider may want you to use the same medicine while breastfeeding that you used during pregnancy if you had depression then.. Changing to another medicine can have risks for you and your baby. Talk with your healthcare provider.

Several types of medicine may be used to treat PPD in both breastfeeding and nonbreastfeeding parents. They include:

• SSRIs (selective serotonin reuptake inhibitors). These types of medicines are used most often. They are considered safe for both parent and baby.

• SNRIs (serotonin-norepinephrine reuptake inhibitors). These medicines also seem to be safe to use when breastfeeding. But some SNRIs may expose a baby to more medicine in breastmilk than other medicines.

• Atypical antidepressants. Some of these medicines are safe to take when breastfeeding.

• Benzodiazepines. These medicines are often used for severe anxiety or agitation. But some are not advised for breastfeeding parents.

Your healthcare provider will keep track of you while you are on a medicine.

These medicines may take a few weeks to start working. Call your healthcare provider if you don’t feel better in a few weeks. Together you may decide to change the medicine. Or add another medicine.

Possible medicine risks for breastfed babies

It's possible for these medicines to be passed to babies in breastmilk. This amount is very low. It's considered safe. The overall benefits of breastfeeding for both parent and baby outweigh any possible minor risk. It’s also important for a parent with PPD to get the medicine they need.

But possible risks from medicine in your breastmilk may be a concern in some cases. These include:

• If your baby is sick

• If your baby is low birthweight

• If your baby was born early (premature)

If this is the case for you, talk with your healthcare provider and your baby’s provider about treatment choices. They can tell you which are safe for you and your baby.

Breastfeeding babies who are healthy don’t often have side effects from medicine for PPD. But it is possible. Talk with your provider and your baby’s provider about what side effects to watch for.

Treatment for nonbreastfeeding parents

Treatment choices for PPD are very similar for nonbreastfeeding parents. Your healthcare provider will work with you to find a medicine that is safe for you. They will also likely advise that you try medicine and talk therapy together.

Medicines that may be used if you are not breastfeeding include:

• SSRIs (selective serotonin reuptake inhibitors)

• SNRIs (serotonin-norepinephrine reuptake inhibitors)

• Atypical antidepressants

• Seratonin modulators

Medicine side effects for birth parents

Some medicines for PPD may have side effects. These are often short-term (temporary). They will go away on their own. These may include:

• Upset stomach (nausea) or vomiting

• Trouble sleeping

• Weight gain or weight loss

• Dry mouth

• Dizziness

• Lack of interest in sex

• Diarrhea

• Headaches

Call your healthcare provider if any of these symptoms don’t go away. Call if they get in the way of your daily tasks. They may have you try a different medicine.

When to call your healthcare provider

Call your healthcare provider right away if you are being treated for PPD and:

• You have severe or abnormal side effects to medicine

• Your side effects to medicine are getting in the way of your daily tasks

Call 988

Call or text 988 right away if you are being treated for PPD and:

• Your depression gets worse

• You start thinking about hurting yourself, your baby, or others

When you call or text 988, you will be connected to trained crisis counselors. An online chat choice is also available. Lifeline is free and available 24/7.