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Treatments and drugs
By Mayo Clinic staffTreatment and recovery time vary, depending on the severity of your depression and your individual needs.
Baby blues
The baby blues usually fade on their own within a few days to weeks. In the meantime, get as much rest as you can. Accept help from family and friends. Connect with other new moms. Avoid alcohol, which can make mood swings worse. If you have an underactive thyroid, your doctor may prescribe thyroid medication.
Postpartum depression
Postpartum depression is often treated with counseling and medication.
- Counseling. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional. Through counseling, you can find better ways to cope with your feelings, solve problems and set realistic goals. Sometimes, family or relationship therapy also is helpful.
- Antidepressants. Antidepressants are a proven treatment for postpartum depression. If you're breast-feeding, it's important to know that any medication you take will enter your breast milk. However, some antidepressants can be used during breast-feeding with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants.
- Hormone therapy. Estrogen replacement may help counteract the rapid drop in estrogen that accompanies childbirth, which may ease the signs and symptoms of postpartum depression in some women. Research on the effectiveness of hormone therapy for postpartum depression is limited, however. As with antidepressants, weigh the potential risks and benefits of hormone therapy with your doctor.
With appropriate treatment, postpartum depression usually goes away within a few months. In some cases, postpartum depression lasts up to a year. It's important to continue treatment after you begin to feel better, however. Stopping treatment too early may only lead to a relapse.
Postpartum psychosis
Postpartum psychosis requires immediate treatment, often in the hospital.
When your safety is assured, a combination of medications — such as antidepressants, antipsychotic medications and mood stabilizers — may be used to control your signs and symptoms. Sometimes electroconvulsive therapy (ECT) is recommended as well. During ECT, a small amount of electrical current is applied to your brain to produce brain waves similar to those that occur during a seizure. The chemical changes triggered by the electrical currents can reduce the symptoms of depression, especially when other treatments have failed or when you need immediate results.
Treatment for postpartum psychosis can challenge a mother's ability to breast-feed. Separation from the baby makes breast-feeding difficult, and some medications used to treat postpartum psychosis aren't recommended for women who are breast-feeding. If you're experiencing postpartum psychosis, a team of health care providers will help you work through these challenges.
- Pregnancy Risk Assessment Monitoring System (PRAMS): PRAMS and postpartum depression. Centers for Disease Control and Prevention. http://www.cdc.gov/prams/PPD.htm. Accessed March 10, 2010.
- Depression during and after pregnancy. National Institutes of Health. http://www.womenshealth.gov/faq/depression-pregnancy.cfm. Accessed March 10, 2010.
- Pearlstein T, et al. Postpartum depression. American Journal of Obstetrics & Gynecology. 2009;4:357.
- Lusskin SI, et al. Postpartum blues and depression. http://www.uptodate.com/home/index.html. Accessed March 10, 2010.
- Wisner KL, et al. Psychiatric disorders. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Churchill Livingstone; Maryland Heights, Mo.: 2007. http://www.mdconsult.com/das/book/body/187831438-3/0/1528/496.html#4-u1.0-B978-0-443-06930-7..50052-9--cesec15_2201. Accessed March 10, 2010.
- Depression. National Institutes of Mental Health. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml. Accessed March 10, 2010.
- Mischoulon D. Update and critique of natural remedies as antidepressant treatments. Obstetric and Gynecologic Clinics of North America. 2009;36:789.
- Shyn SI, et al. The genetics of major depression: Moving beyond the monoamine hypothesis. Psychiatric Clinics of North America. 2010;33:125.
- Major depressive episode. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 10, 2010.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. April 7, 2010.
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