Postpartum Depression Treatment
Female psychiatrist specializing in postpartum depression offers immediate help, including postpartum depression medication and treatment. Contact +1(833)312-4222 for assistance.
Postpartum depression (PPD) can be defined as a type of depression that occurs within the first year of childbirth and lasts for more than two weeks, with or without treatment. It coincides with the period when mothers are ‘expected’ to be overjoyed about the baby’s arrival, often causing an overwhelming, confusing, and guilt-ridden emotional experience.
If feelings of sadness, anger, irritability, guilt, numbness, detachment, fatigue, or anhedonia last longer than two weeks after childbirth, they can be an indication of postpartum depression and not just ‘baby blues’.
Seeking treatment is not something to be embarrassed or ashamed of; instead, new mothers should be encouraged to undergo screening and diagnosis for PPD if symptoms persist.
Treatment for Postpartum Depression
Optimum postpartum depression treatment involves the following steps:
- Thorough history check and examination
- Screening for exacerbating medical causes, such as thyroid imbalance
- Screening for nutritional deficiencies
- Screening for undiagnosed psychiatric illnesses, such as bipolar disorder
- Evaluating environmental stressors, such as work stress and relationship discord
- Screening for insomnia and chronic fatigue
- Evaluating psychotherapy modalities
- Evaluating the need for medication or reasons for prior treatment failure
- Collaborating with the patient and formulating a treatment plan
- Considering alternative therapies such as meditation and hypnosis
Thorough History Check and Examination
The first step towards getting treated for postpartum depression is a thorough medical history check and examinations to evaluate the possibility of PPD occurrence. Certain groups of women are at a higher risk of developing this condition; for example, women with a history of depression, women with nutritional deficiencies, women with underlying medical conditions, and women who are exposed to environmental stressors.
A history of depression or anxiety has been identified as a major psychological risk factor for postpartum depression. A study of approximately 70,000 births in Sweden between 1997 and 2008 found that women with a history of depression are twenty times more likely to develop postpartum depression than those without a prior depression diagnosis.
It is therefore important for new mothers to collaborate with their health practitioners to identify the possibility of PPD through appropriate screening procedures and begin treatment.
Screening for Excaberating Medical Causes
Exacerbating medical causes, such as anemia, thyroid imbalance, Sheehan’s Syndrome, PCOS, etc., can worsen PPD symptoms. Screening for such health conditions is necessary for the effective treatment of postpartum depression. Some of these are explained below.
Anemia and Postpartum Depression
Anemia is when the body lacks red blood cells (hemoglobin), which transport oxygen to the tissues. A pregnant woman is more likely to develop four types of anemia: iron deficiency anemia, pregnancy anemia, folate deficiency, and vitamin B-12 deficiency.
Iron deficiency anemia is the most common type in pregnant women, accounting for roughly 80% of all cases. It is critical to monitor women’s nutritional status, as anemia is a major contributor to postpartum depression.
Sheehan’s Syndrome and Postpartum Depression
Sheehan’s syndrome is postpartum hypopituitarism caused by shock or hypotension as a result of massive hemorrhage or blood loss during or after childbirth. It can appear during or after the postpartum period as lactation failure, generalized weakness and debility, cessation of menstrual periods, premature wrinkling of the face and forehead, body hair loss, and dry, coarse skin.
Sheehan’s syndrome is projected to affect one in every 1,000,000 births worldwide. Women in developing and underdeveloped countries have limited access to sophisticated medical care, skilled healthcare professionals, and medical resources, resulting in higher rates of postpartum hemorrhage, which now accounts for five out of every 1,000 births.
PCOS and Postpartum Depression
Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine metabolic disorders in women of reproductive age all over the world. As per research, women suffering from PCOS have a greater susceptibility to depression and anxiety. They are also more likely to experience multiple pregnancy complications like gestational diabetes, hypertensive disorders, and preterm births.
Thyroid and Postpartum Depression
Thyroid disorders are the endocrine diseases that have been most studied to identify a link with postpartum depression. The maternal immune system goes through many changes to accommodate the growth of the fetus during pregnancy. In the postpartum period, it tries to return to its pre-pregnancy state.
Postpartum depression can emerge from thyroid dysfunction because of hormonal shifts during pregnancy and childbirth. New mothers with persistent mood changes should monitor thyroid function, as it can aid in postpartum depression management.
Screening for Nutritional Deficiencies
Malnutrition, defined as a lack of specific nutrients such as B and D vitamins, n-3 polyunsaturated fatty acids (PUFA), folate, trace minerals, iron, antioxidants, and so on, can increase the risk of developing postpartum depression. Lactation and pregnancy put additional strain on a new mother’s body, making nutritional deficiencies more common and increasing the risk of depression symptoms.
Some specific nutrients play a very specific role in ensuring psychiatric wellness. For example, vitamin D plays an important role in the functioning of the nervous system. It regulates neurotransmitters such as adrenaline, dopamine, serotonin, and norepinephrine. A vitamin D deficiency can cause disturbances in these neurotransmitters and hormones, triggering the development of depressive symptoms.
Omega-3 fatty acids have also been linked to postpartum depression. Apart from aiding heart health, omega-3 fatty acids like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are well-known to support the development of the brain and neurotransmitter regulation.
Many people in the United States are deficient in omega-3 fatty acids due to a lack of these nutrients found in their diet. The American diet often includes fast food, which is deficient in nutrients and does not meet recommended nutritional standards.
Pregnant women are especially vulnerable to the harmful effects of low omega-3 fatty acids. This is because the increased blood supply required for fetal oxygen causes a natural decrease in DHA and EPA levels. Also, the body prioritizes the fetus’s growth and development by redirecting blood and nutrients, increasing pregnant women’s risk of developing nutritional deficiencies and, as a result, postpartum depression.
Screening for Undiagnosed Psychiatric Illnesses
The prevalence of psychiatric disorders such as bipolar disorders, anxiety, and depression increases the chances of developing postpartum depression by 30 to 35 percent. According to a study published on PubMed, 54 percent of all the women diagnosed with postpartum depression met the diagnostic criteria for bipolar disorder, while 10 percent also had a previous diagnosis.
Postpartum is considered a high-risk period for the appearance as well as the recurrence of psychiatric illnesses. Screening for undiagnosed psychiatric illnesses is an important step towards receiving the right treatment for postpartum depression.
Postpartum Depression Psychiatrist
Dr. Valeria Serban
Postpartum Depression Specialist
Dr Valeria Serban is an experienced neuropsychiatrist. She is passionate about helping young mothers overcome psychiatric symptoms during the pregnancy and postpartum period.
Dr. Serban uses a combination of medication and therapy to help patients through the Postpartum period. Her goal is to help allieviate symptoms, of depression, anxiety, insomnia, panic attacks and help mothers regain control of their lives.
Dr. Serban understands that navigating relationships, career and motherhood is not easy. As well as prescribing medication she also uses psychotherapy and lifestyle management to ensure that new mothers get the support they need during the postpartum period.
Medical School
Neurology Residency Training
Master of Philosophy (M.Ph.) - Neuroscience
Internal Medicine Residency
Neurology Residency
Doctor of Philosophy (Ph.D.) - Neuroscience
Clinical Neurophysiology Fellowship
Board Certification
Dr. Tony Issac
Board Certified Psychiatrist in New York & New Jersey (MD)
Dr. Tony Isaac is a double-board-certified Psychiatrist with nine years of psychiatry experience. He provides compassionate and discreet psychiatric evaluations, including postpartum depression screening and treatment that includes postpartum psychotherapy and sensitive medication titration.
Apart from treating a wide range of psychiatric conditions, which include insomnia, panic attacks, depression, anxiety, OCD, bipolar disorder, and schizophrenia, Dr. Tony Issac is also a postpartum depression specialist who works closely with mothers suffering from addiction, and postpartum depression to achieve a collaborative treatment plan and work towards recovery and healing.
Postpartum depression has an adverse effect on a mother’s ability to bond with her child. Dr. Issac provides high-quality and consistent care to those suffering from postpartum depression and utilizes his expertise to improve symptoms as well as social and occupational functioning.
Dr. Issac also conducts suicide assessments, and acute stabilization and works with the family and employer to provide the required support.
Please schedule online or call +1 (833) 312-4222 to schedule an appointment with Dr. Tony Issac.
Dr. Gundu Reddy
Postpartum Depression Specialist
Dr. Gundu Reddy, a board-certified urgent psychiatrist with fifteen years of experience in clinical psychiatry and ten years of experience in forensic psychiatry, is also an expert postpartum depression psychiatrist. She has trained in Medication Management, psychodynamic psychotherapy, and cognitive behavioral therapy and is interested in integrative psychiatry.
Postpartum depression or maternal depression is linked to grave morbidity for the mother, and must not be left untreated. Timely intervention from an expert postpartum depression psychiatrist is extremely critical.
According to Dr. Reddy, the decision to take postpartum depression medication must be taken seriously and must be prescribed with utmost care. She believes that the goal of medication management, which includes postpartum depression medication management, is to achieve maximum efficacy with minimum side effects and gentle titration.
Please schedule online or call +1(833)312-4222 to schedule an appointment with Dr. Reddy.
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Evaluating Environmental Stressors
The environment in which women lead their lives during the postpartum period can have a huge impact on their mental health. An effective treatment plan should consider environmental stressors like high workloads and relationship discord.
Work Stress and Postpartum Depression
Postpartum depression symptoms can worsen if the mother is going through higher psychological work demands, low control over work, and low schedule autonomy. Workplace stress and household responsibilities in an unsupported environment create a daunting effect on women.
When working women struggle with managing multiple work commitments, they develop the unwanted guilt of not being good mothers. Some measures to fix this environmental stressor include social support from colleagues, support from partners during household chores, maternity leaves, reduced workload, and constant encouragement.
Relationship Discord and Postpartum Depression
Parental frustration can take the form of relationship discord between the partners after childbirth. Even fathers may develop postpartum depression symptoms if there is mutual discord. It affects the bonding between the parents and the newborn and can even lead to mistreatment.
Sometimes, the division of the mother’s attention also affects the older children. Such instances of relationship discord should be evaluated for curating an appropriate treatment plan for postpartum depression. It is important to eliminate such stressors to improve the psychiatric conditions of new mothers.
Screening for Insomnia and Chronic Fatigue
The presence of sleep disturbances, or insomnia, is a risk factor for postpartum depression. Insomnia occurs when someone is unable to fall asleep or struggles with staying asleep.
Evidence suggests that chronic fatigue from sleep deprivation raises a woman’s risk of postpartum depression. Sleep deprivation reduces sleep quality, making it difficult for a mother to regain physical energy and agility. Poor sleep can exacerbate the symptoms of depression and anxiety.
As an important step towards treating postpartum depression, mothers should practice good Sleep Hygiene to prevent chronic fatigue.
Postpartum Depression Treatment Plan
Sometimes, postpartum depression may go away on its own within three months of childbirth. However, if it interferes with regular life or if ‘baby blues’ lasts longer than two weeks, seeking treatment is important.
PPD is treatable with medication, or a combination of medication and psychotherapy, and many alternate treatments that are easily integrated into the daily routine. Depending on the severity of symptoms and underlying conditions, the treatment plans and expected recovery duration may vary. Close collaboration with a mental health professional is essential to develop the best treatment plan.
Postpartum Depression Medication
Postpartum depression medication typically consists of:
- Antidepressants,
- Mood stabilizers,
- Anxiolytics,
- Insomnia medications (anxiety medications), and
- Antipsychotic medication in severe cases
Postpartum depression medication can cause rapid resolution of symptoms and is typically indicated if symptoms are severe or not resolving spontaneously. By stabilizing the mood, medication can enable the mother to better engage with her baby, bond with her partner, and resume daily activities.
This can have a positive impact on the overall family dynamic, as it creates a more nurturing environment for the baby’s development and allows the partner to offer much-needed support.
Mothers with postpartum depression may be afraid to take psychiatric medication for the first time. Therefore, close collaboration with the psychiatrist is required to discuss the pros and cons and ensure that the patient feels comfortable with the treatment plan.
Another aspect to consider with postpartum depression medication is the potential for breastfeeding. Many new mothers may be concerned about the safety of taking medication while breastfeeding. However, research has shown that most SSRIs are safe for breastfeeding, as only trace amounts are transferred to breast milk. One option is to combine breastfeeding with formula milk, so the baby is only exposed to trace amounts of medication.
In most cases, the risks associated with untreated PPD may outweigh any potential concerns about medication and breastfeeding. Mothers must discuss this matter with their healthcare providers, who can help weigh the benefits and risks and determine the most suitable option.
Postpartum depression medication is an effective treatment modality for managing PPD. By addressing the chemical imbalances in the brain, medication can help alleviate the symptoms of depression and enable new mothers to navigate the challenges of parenting with greater ease.
It is a personal choice whether to take medication for postpartum depression. Medication is typically recommended if:
- Symptoms appear severe or persistent
- Symptoms interfere with the ability to care for the child
- Symptoms interfere with the ability to bond with the child
- Symptoms interfere with the ability to care for family
- Symptoms Interfere with the ability to communicate with the partner
- Symptoms harm personal and professional relationships
- Symptoms interfere with the ability to function at work
- Natural treatments and alternatives have not proven effective
However, it is important to remember that medication is just one component of a comprehensive treatment plan. Support from healthcare professionals, therapy, and self-care practices also play a vital role in overcoming PPD and promoting the well-being of both the mother and her baby.
Antidepressants While Breastfeeding
Many antidepressants are classified as ‘Schedule C’, which means they are safe during pregnancy and breastfeeding. Psychiatric medications that are considered safe while breastfeeding are:
- Confirmed to be safe by clinical studies
- Primarily metabolized and only found in trace amounts in breast milk
Ultimately, it is a personal decision, and a mother should consult with her psychiatrist to weigh the potential risks and benefits. Depending on the severity of the symptoms and the level of impairment, a mother may choose to continue breastfeeding or bottle-feed if medication is necessary.
Breast milk is thought to be better than formula milk because it has an appropriate chemical composition of nutrients and electrolytes, as well as trace amounts of antibodies and bacteria virus particles that stimulate the baby’s immune system.
Formula milk has come a long way since the ‘breast is best’ commercials of the 1980s and 1990s, and its chemical composition is much closer to that of breast milk. Most people consider it an acceptable alternative to breast-feeding.
In the case of severe postpartum depression, the benefits of treating the mother over the baby are thought to outweigh the loss of benefit from breastfeeding. However, formula milk contains no hormones or maternal antibodies.
Therapy for Postpartum Depression
Psychotherapy or talk therapy is aimed at helping women cope with and recover from the emotional and psychological effects of postpartum depression. It involves meeting with a trained mental health professional, such as an Online Psychiatrist (link to page), who specializes in treating postpartum depression.
Here is an explanation of the various types of therapy commonly used for postpartum depression:
1. Cognitive Behavioral Therapy for Postpartum Depression
CBT is a widely used therapy for treating postpartum depression. It focuses on identifying and changing negative thought patterns and behaviors that contribute to depression. The therapist helps the woman develop healthier coping mechanisms, improve her self-esteem, and redefine her self-image as a mother.
2. Interpersonal Therapy for Postpartum Depression
This therapy focuses on improving the quality of a woman’s relationships and communication skills, which may have been affected by postpartum depression. It helps address issues related to role changes, loss of identity, marital conflicts, and social isolation experienced during the postpartum period.
3. Supportive Therapy for Postpartum Depression
This therapy primarily focuses on providing emotional support, empathy, and validation for the woman’s feelings and experiences. The therapist establishes a non-judgmental and safe environment to encourage the woman to express her emotions and talk about her struggles.
4. Psychoeducation for Postpartum Depression
Psychoeducation involves providing information and education about postpartum depression, its symptoms, risk factors, and available treatment options. It helps the woman understand that her condition is treatable and normalizes her feelings, reducing stigma and shame.
5. Couple or Family Therapy for Postpartum Depression
This form of therapy involves the woman’s partner or family members, as it aims to improve communication, understanding, and support within the family unit. It helps partners and family members develop strategies to assist the woman in her recovery and creates a supportive environment for her.
Therapy sessions typically occur regularly, often weekly, in a private setting. The duration of therapy may vary depending on the severity of postpartum depression and individual progress. Treatment is personalized to address the specific needs, circumstances, and symptoms of the woman and may include a combination of different therapeutic approaches.
Therapy for postpartum depression provides a safe space for women to share their feelings, explore challenges, develop coping strategies, and gain insight into their condition. With consistent therapy sessions, women can learn new skills, improve their emotional well-being, and develop a healthier and more fulfilling postpartum experience.
In some cases, therapy may also be supplemented by medication or other forms of treatment, depending on the woman’s needs and the recommendation of her healthcare provider.
One option is a combination of breast and bottle feeding, which gives the baby some of the benefits of breast milk, such as exposure to antibodies, while also providing the nutritional benefits of formula. This combination also minimizes the risk of exposure to medication, as the majority of its feed is formula milk.
Alternative Treatments for Postpartum Depression
While traditional treatments such as therapy and medication are often recommended for postpartum depression, alternative treatments can also be beneficial in treating postpartum depression.
Yoga for Postpartum Depression
Yoga is an alternative treatment that can help alleviate postpartum depression symptoms. Engaging in gentle yoga exercises can promote relaxation, reduce stress, and improve mood.
Yoga involves deep breathing, stretching, and focusing on body movements, which can help release tension and increase feelings of well-being. Additionally, yoga may provide a supportive community where women can connect with others experiencing similar challenges, thus reducing feelings of isolation.
Meditation for Postpartum Depression
Meditation is another alternative treatment that can be effective in managing postpartum depression. Meditation involves training the mind to focus on the present moment, cultivating a sense of calm and mental clarity.
It can help reduce anxiety, stress, and negative thoughts commonly associated with postpartum depression. Practicing mindfulness meditation regularly can also promote self-acceptance, self-compassion, and emotional resilience.
Other alternative treatments that may be helpful for postpartum depression include acupuncture, massage therapy, herbal remedies, and aromatherapy.
- Acupuncture involves the insertion of thin needles into specific points on the body to rebalance energy flow and promote overall well-being.
- Massage therapy can reduce muscle tension, improve sleep, and enhance relaxation.
- Certain herbs, such as St. John’s Wort and lavender, have been studied for their potential mood-enhancing properties.
- Aromatherapy involves using essential oils to promote relaxation and uplift mood.
It is important to know that alternative treatments should not replace or be solely relied upon as a substitute for professional medical advice. It is always recommended to consult with a healthcare professional before starting any alternative treatment for postpartum depression, especially if the patient is already receiving traditional medical treatments. The appropriate combination of therapies can lead to a comprehensive and effective approach to managing postpartum depression.
Hormone Therapy for Postpartum Depression
Hormone therapy can be a promising way to help with postpartum depression. It uses estrogen and progesterone to balance hormone levels after childbirth. Estrogen, often given with progesterone, helps stabilize mood by affecting brain chemicals. Progesterone supplements can ease symptoms by replacing what’s lost after birth.
Contraceptives with both hormones can also help prevent PPD by regulating hormones throughout the menstrual cycle. While more research is needed, hormone therapy shows potential for helping new moms cope with the challenges of postpartum depression by addressing the body’s hormonal changes.
Why do many mothers fail to seek postpartum depression treatment?
About 80 percent of new mothers go through a period of low mood, anxiety, and irritability after childbirth. This condition, called ‘Baby Blues’, is caused by hormone shifts, especially drops in estrogen, progesterone, and growth hormone levels. However, baby blues usually resolves itself within two weeks.
If symptoms do not resolve within a fortnight, it is important to consider the possibility of postpartum depression and seek advice from a mental health professional. The consequences of untreated postpartum depression can be detrimental to the child, mother, and people surrounding them. The most common reasons mothers fail to seek treatment for postpartum depression are:
- Lack of Diagnosis
- Thinking they should ‘suck it up’
- Not knowing if treatment is available
- Lack of access to resources
- Feelings of guilt and inadequacy
- Feeling too depressed or anxious to even seek treatment
Consequences of Postpartum Depression
Apart from a disruption in the mother-child relationship, the child may also go through anxiety, failure to thrive, developmental delay, long-term difficulty with relationships, long-term cognitive impairment, failure to achieve expected milestones, and problems with social or occupational functioning.
Mothers experiencing PPD are prone to experiencing negative impacts on their personal and professional lives. It may affect them by altering the following:
- Energy levels
- Attention
- Motivation levels
- Irritability
- Reasoning and problem-solving abilities
- Engagement with colleagues
- Productivity
- Frustration tolerance
Such difficulties may lead to conflicts with colleagues and supervisors, increasing the chances of being passed over for promotion or even terminated from their current position.
Postpartum Depression and Relationship Problems
Untreated postpartum depression poses a high chance of marital or relationship difficulty, especially when the partner is absent or unsupportive. The depressive state sometimes creates a lack of emotional and physical intimacy, leading to a serious disconnection that increases the chances of marital discord, separation, and even divorce.
The problems extend to the equation shared between the mother and her elder children, as their relationship with each other might change because of the arrival of a new family member. Elder children may misunderstand their mother’s despair and think that she doesn’t love them anymore. The truth, however, is that she is depressed and burnt out.
Postpartum Depression and Physical Illness
Besides affecting mental health, PPD also creates a harsh impact on the mother’s physical health, disrupting her energy levels, causing feelings of restlessness, changing her food habits (leaning towards comfort eating, binging on junk food, and experiencing increased sugar cravings), disturbing her sleep cycles, inducing chronic stomach problems, headaches, and body pains, etc.
Postpartum depression and Addiction
Women going through postpartum depression are at a higher risk for developing destructive habits such as smoking, substance abuse, and alcoholism, and are more likely to experience emotional, physical, or sexual abuse.
Postpartum Depression and Suicidal Thoughts
It may also lead to self-inflicted injuries and suicidal ideations. PPD is one of the most prominent causes of maternal mortality in high-income countries like the United States.
The most effective solution for overcoming postpartum depression while saving important relationships, restoring work-life balance, and improving physical health is receiving timely treatment from a board-certified psychiatrist.