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Postpartum Depression

Evidence-Based Options for Postpartum Depression

By November 1, 2021No Comments

You probably heard about the “baby blues” before you got pregnant. It’s totally normal for new moms to feel fatigued, anxious, and even a little sad after their babies are born. It’s very common, but it’s manageable and usually resolves on its own after a few weeks.

While the symptoms may be similar, postpartum depression is much more powerful and hangs around a lot longer than the baby blues. It can cause intense feelings of exhaustion, hopelessness, and mood swings that make it difficult to perform daily tasks, much less care for your newborn.

As many as one out of seven women experience postpartum depression. It is defined as a form of major depression that begins within four weeks of childbirth. The condition is linked to chemical, social, and psychological changes that occur due to a rapid drop in hormone levels after delivery. 

But there’s more to it than that. Studies show that hearing their babies cry triggers a deeply anxious neural response in new moms. This heightened state of alert is normal in most cases, but in mothers with postpartum depression the feeling becomes overwhelming, even leading to disorientation, detachment, and apathy.

Postpartum depression is a serious condition that shouldn’t be ignored, but it can be overcome with evidence-based treatments.

Common Signs of Postpartum Depression

It’s normal to feel tired and even a little moody after having a baby, but the symptoms of postpartum depression go much further than that. They’re often so severe that normal daily tasks become challenging. Symptoms can vary from day to day, but there are some common indicators:

  • You’re exhausted, but you have trouble falling asleep.
  • You sleep too much, and often at odd times.
  • You experience sudden mood swings without reason or warning.
  • You feel angry, anxious, or irritable, but you don’t know why.
  • You feel ill and achy without reason.
  • You aren’t interested in eating or you’re eating all the time, even when you’re not hungry.
  • Your life feels out of control. Everything feels hopeless and overwhelming.
  • You can’t focus, make decisions, or remember simple things.
  • You feel sad and cry all the time, but you don’t know what you’re sad about.
  • You have no interest in your hobbies and other things you used to enjoy.
  • You just want to be alone.
  • You feel disconnected from your baby, which makes you feel guilty and worthless. But you don’t want to tell anyone because you’re afraid they’ll think you’re a bad mother.
  • You may have thoughts of harming your baby or yourself.

These symptoms generally start within a few weeks after your baby is born, but sometimes they don’t show up until months later. Sometimes they come and go. Unfortunately, the symptoms of postpartum depression often get worse if they go untreated.

Evidence-Based Treatment Options for Postpartum Depression

If you have signs of postpartum depression, you should talk to your doctor right away. The sooner you begin treatment, the sooner you’ll begin to feel better.

There are four main treatment options for postpartum depression: herbal supplements, ketamine IV infusions, TMS therapy, Zulresso,  talk therapy, and medication. Any of these options can be helpful on their own, but they could be even more effective when used in combination. Maintaining open communication with your doctor will be key to success.

Ketamine IV Infusions

Ketamine IV infusions are a relatively new treatment for postpartum depression, but the drug has been around for many years. Studies show that ketamine can reduce postpartum depression symptoms significantly, and it works much faster than most antidepressants.

Ketamine can be administered intermittently, so moms can still breastfeed safely using a “pump and dump” strategy during treatment. It has little to no side effects and is often effective for treatment-resistant depression patients who aren’t seeing results with traditional medications.

TMS Therapy

TMS therapy, or Transcranial Magnetic Stimulation, is a non-invasive procedure that uses magnetic pulses to awaken parts of the brain that are underactive in someone who is suffering from postpartum depression. Remission rates are 66-90% in open trials, so the results are very promising.

Since TMS is drug-free, there is no risk of passing chemicals to your baby during breastfeeding. The treatment also works quickly, with many patients achieving remission in three to six months. TMS requires 5 treatments per week for six weeks, but it’s a highly appealing option for breastfeeding moms.

Zulresso

Zulresso, or brexanolone, is a fairly new FDA-approved treatment for postpartum depression. Although this drug does have antidepressant effects, it works differently from traditional antidepressants. Zulresso is thought to modulate the HPA axis, which mediates the body’s response to stress.

The drug can result in complete remission within hours, rather than the weeks it takes to see results with traditional antidepressants. However, it’s important to know that Zulresso is not approved for use while breastfeeding and the treatment requires a 60-hour infusion, which can be administered in hospitals or boutique office settings. 

Herbal Supplements

Herbal supplements can be very helpful for overcoming the symptoms of postpartum depression but be sure to work with a qualified medical professional before taking any herb. Although they’re natural and seem harmless, they could transfer to your baby through your breastmilk and that may be harmful.

According to women’s health experts, certain fertility herbs can be beneficial for postpartum depression. For example, maca root is known to balance hormones while reducing stress and providing essential vitamins and minerals for women’s health.

Another example is passionflower, a nervine that can have a calming effect on the body without causing drowsiness. Ashwagandha is an adaptogenic herb known to help the body adapt to stress by modulating stress hormones.

If you’re having difficulty sleeping due to anxiety, your doctor may recommend a skullcap to help you sleep or an eleuthero to boost your energy levels. As you can see, there are lots of herbs that can be helpful in a number of ways, so be sure to talk to your doctor to see what your options are.

Talk Therapy

Talk therapy with a mental health professional can be extremely helpful for anyone suffering from postpartum depression, and it’s often recommended for use with other treatments. A therapist can help you make sense of negative and destructive thoughts and offer strategies to help you work through them.

Medication

Antidepressants are the go-to medication for postpartum depression, and they can be very effective for some people. They have a direct impact on the brain, altering certain chemicals that control mood. However, it can take several weeks for antidepressants to start working. 

Some people also experience negative side effects like agitation, dizziness, and fatigue. They can also be addictive, and in rare cases, they can promote suicidal thoughts or behavior. If this happens to you, be sure to tell your doctor right away.

Not all antidepressants are safe to take while breastfeeding, so be sure to tell your doctor if you’re nursing. If your hormone levels are low, your doctor may also recommend hormone therapy to help alleviate your symptoms.

Wrapping Up: Don’t Overlook the Importance of Self-Care

This part of treatment may sound easy, but it’s actually very challenging for new moms who are already feeling a sense of guilt for being disconnected from their newborn. It means giving yourself a break, and that’s often more difficult than it sounds.

Don’t try to take on more responsibility than you can handle right now. Tell your loved ones what you need. They want to help, but sometimes they don’t know how. A little “me time” is important, but don’t let yourself become isolated. Join a postpartum support group or a new mom’s group instead.

Don’t try to self-medicate with alcohol. It’s a depressant and will only make you feel worse. Focus on giving your body what it needs by eating a well-balanced diet, a little exercise, and lots of rest. Massage, meditation, yoga, and other mindfulness practices can also be helpful.

Most importantly, give yourself time to heal. Even with treatment, it can take six months or more before you start to feel normal again.

TMS & Brain Health is not a healthcare provider and does not render any psychiatry or other medical services, including but not limited to TMS, Ketamine, or Neurofeedback. IOP services are rendered through a separate, affiliated entity. Rather, TMS & Brain Health performs administrative services for various psychiatrists and/or psychiatry and/or medical practices.  Further, this website does not provide medical advice, diagnosis, or treatment. More information can be found at our disclaimer page.
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