Postpartum Depression
(continued)

Treatment of PPD:

Treatment of PPD begins with putting a name on the woman's symptoms; sometimes just identifying a "condition" that's responsible for the patient's uncontrollable feelings contributes to a sense of better well-being. Treatment must be medical and psychological; physical conditions (e.g. pituitary or thyroid disorders) must be considered and ruled out before the diagnosis of PPD can be given. The most important-although most difficult-condition to rule out is simple sleep deprivation. Test whether the symptoms persist even after mom has had a good opportunity to rest, undisturbed, for several hours. This means turning off the phones and television, having someone look after the newborn where mom can't hear the baby cry, and having someone look after any other children AWAY from mom?s earshot! If you just can't get to sleep at all, ask your doctor to recommend a sleeping pill. If the symptoms resolve or improve significantly with a good sleep, chances are that PPD or even the baby blues is not the diagnosis.

Once the diagnosis of PPD is made, group or individual psychotherapy may be helpful. Education about newborn care, providing increased social support, and non-pressured lactation counseling are often helpful. Drug therapy is highly effective and does not necessarily require women to stop nursing. Even though anti-depressant medications all get into the breast milk, it is unclear that this has any untoward effects on the baby (***discuss this issue with your physician for any prescription or over-the-counter medication you may take). There are several choices of antidepressant medication; each has different side effect profiles and length of usage experience for PPD. If antidepressant medication is prescribed, it will generally be continued for at least six months. Occasionally, women have been prescribed estrogen as part of their treatment regimen for severe PPD once their periods have resumed.

Any woman who has thought of suicide, harming herself, harming her baby or harming others needs an immediate psychiatric consultation. This must always be taken seriously.

What about women who have had PPD in a previous pregnancy? Some physicians recommend beginning antidepressant therapy immediately after delivery of a subsequent child just in case. Others request that the patient or a family member call in as soon as symptoms are noted.