Treatment for postnatal depression
If you are experiencing postnatal depression, practical and emotional support can be very helpful, to help give you some time, space and energy to devote to yourself. But often this is not enough to help you to recover, so accessing effective treatment for postnatal depression early, is an important step towards recovery.
Below is a range of effective treatment for postnatal depression. The type of treatment and time required will depend on a range of factors including your personal situation, the severity of your symptoms, and how you respond to treatment. Try and be aware that treatment can take time, energy and patience.
The best thing anyone said to me was ‘this will end, and you will get through it. But there is no quick fix.
If you are experiencing mild depression, having the opportunity to talk through how you are feeling and thinking with someone who can understand and listen to you in a non-judgemental way can be very helpful. It can not only give you an opportunity to share experiences which can help you feel understood and not alone, but this may also help you develop effective ways to deal with challenges.
I used the group (support) to cry and talk about my feelings of anger, sadness and anxiety. It was the only place I could talk about these things because I was afraid to tell anyone else that I was depressed. I thought they would think I was weird or, worse, that I didn’t love my child.”
Psychological treatments, sometime referred to as ‘talking therapies’, can be very effective for the treatment of mild to moderate postnatal depression. These treatments use a variety of techniques to help you identify and manage negative thoughts, feelings and behaviours that are part of postnatal depression – so that you can begin to bring your symptoms under control.
Cognitive behaviour therapy (CBT)
This type of treatment helps you to identify negative thoughts and/or ways of thinking that commonly occur when someone is experiencing postnatal depression. If you are depressed, it is likely that you may view everyday events and opportunities in a negative way – as this is likely to reflect the way that you are feeling. Over time this negative thinking becomes automatic and can maintain not only your negative (depressed feelings) towards yourself, others and/or life in general, but it can also affect your behaviours. For example, you may have negative thoughts about how you look after having your baby, the value of your life, and/or your ability as a new parent. In turn this will affect your feelings towards yourself, others, your interest to engage with others – for fear that they too will have a negative view of you. This then may stop you from interacting with others and becoming more isolated. This negative cycle of thinking, feeling and behaviour is likely to make you feel worse over time.
The role of CBT is to teach you how to identify, rationalise and manage your negative thinking and challenge these thoughts and beliefs you may hold. This then gives you greater opportunity to become more objective and positive in your thinking, which will have a positive flow on effect for the way you feel and what you do. Cognitive behaviour therapy also typically involves setting some goals and activities to also provide you with an opportunity for some positive influences and experiences in your life.
Interpersonal therapy (IPT)
As postnatal depression can be associated with previous losses and/or may be affecting your relationships with others, interpersonal therapy can provide you with helpful strategies to help you resolve these issues which, if present, are likely to be affecting your postnatal depression.
These two types of therapy can be provided either in groups or individually.
If however your symptoms are moderate to severe, then you may require medication to help provide you with relief from some of the symptoms of postnatal depression.
When I understood about medication, got all the information, I was willing to accept it…before that I was scared of the thought of taking depression medication.”
Antidepressants are an effective treatment for postnatal depression. Research and guidelines recommend that there are certain types of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) that can be safely used when breastfeeding, as these medications pass into breast milk at very low levels.
If you are prescribed antidepressant medication, it is important that you take your medication regularly, and as prescribed – so that is has the chance to work effectively. It is likely that it will take up to three to four weeks to feel a positive effect on your mood, and up to six weeks for the antidepressants to have their full effect.
When I took the medication, after a while my mood lifted. I wish that I had know that it took time – it would have made the waiting easier. I was afraid that they were not going to work for me.
Whilst during this time you may experience some mild side-effects, these medications can certainly provide you with relief from the symptoms of postnatal depression. On some occasions you may need to try more than one type of antidepressant, as people respond in different ways and it is important to find the treatment that is best for you, and causes the least amount of side-effects.
The length of time that you may need to take medication also varies from person to person and is likely to be affected by your personal history, the severity of your postnatal depression, other stressors and available supports.
Once you feel that you are at a point of recovery, it is important that you don’t stop taking your medication suddenly, but rather discuss this with your doctor and work out a plan. Usually antidepressant treatment should continue for between six months to two years after a full recovery has been achieved. It can also be valuable to be aware of your initial symptoms of depression to help you identify any signs possible of relapse when coming off medication – or further down the track. This can enable you to get onto this early and potentially prevent the condition becoming severe again.
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy or ECT, is a specialist treatment that involves activating electro-currents to the brain, and can relieve a range of severe symptoms of postnatal depression. ECT is generally prescribed if your postnatal depression is severe and medications are not having a positive effect on your symptoms.
My pnd spiralled downwards extremely quickly. I became suicidal and had ECT because the medications weren’t working fast enough.”
The number of ECT treatments will vary depending on the severity of your postnatal depression and how rapidly you respond to the treatment.
For many parents, whilst ECT may be considered a last resort, it can certainly be a life-saver as it can effectively provide relief from the symptoms of postnatal depression. There can be side-effects such as short-term memory loss, however this is weighed up by you and your health professional when considering the benefits of ECT for you.
I suffered memory loss from this treatment, and about 6 months are just gone, including the 3 months I spent in hospital in the Mother/Baby unit. It’s quite possible that I received more help and information than I can recall. In the end though, it is what got me through.”