After giving birth, between 10 percent and 15 percent of women experience postpartum depression (PPD), though the prevalence may be 20 percent or more. Without treatment, PPD—also known as maternal depression or peripartum depression—can negatively affect mother-baby attachment, child care, and child development.
The right treatment for PPD may look different for each client. Here’s how to approach PPD treatment to achieve the best outcomes.
What is postpartum depression (PPD)?
Most women experience “baby blues” after childbirth. Having a baby is a huge change for any mother, whether it’s her first child or her tenth. The physical changes, hormone fluctuations, and increasing responsibility of pregnancy and childbirth can lead to mood swings and strong emotions.
However, if these feelings persist, it may turn into PPD. Signs of PPD include:
- Feelings of sadness or severe mood swings that last longer than a few weeks
- Persistently feeling hopeless, sad, worthless, lonely, or inadequate
- Crying often
- Lack of bonding with the baby
- Anxiety and panic attacks
- Lack of desire for self-care
Difficult pregnancy or birth, and a past history of depression or other mental health issues, may increase the risk of PPD.
Best Treatment Options for PPD
Proper screening and diagnosis of PPD is essential. Some screening tests used for PPD include:
- Edinburgh Postnatal Depression Scale (EPDS), a list of 10 short statements describing feelings in the past 7 days
- 2-Question Patient Health Questionnaire (PHQ-2), which is a good first screening for possible PPD
- 9-Question Patient Health Questionnaire (PHQ-9), which may be administered after the PHQ-2
There are many treatment options for PPD. Cognitive behavioral therapy and interpersonal therapy can help with problematic thinking or relationship difficulties, respectively. Other types of counseling, such as dialectical behavioral therapy or couples therapy, may help.
Many antidepressants are safe to take while breastfeeding. However, not all antidepressants or anti-anxiety medications are appropriate. Some women may benefit from antidepressant treatment even before they show signs of PPD, but such medications must be safe during pregnancy and breastfeeding.
Brexanolone (Zulresso), a synthetic version of the hormone allopregnanolone, is the first FDA-approved medication specifically for treating PPD. This drug is administered with an IV infusion over a 60-hour period under medical supervision.
Outside of clinical options, there are other ways to help your client:
- Recommend support outside of therapy options, which can help prevent isolation and make PPD worse. Emotional support may involve contacting a friend or close family member, reaching out to religious leadership, or joining a support group.
- Help your client manage expectations. New mothers may feel overwhelmed with responsibility and doubt their capabilities. They may feel discouraged that the postpartum stage does not look or feel the way they had hoped.
- Encourage physical self-care. More sleep and good nutrition often fall by the wayside, but can help mothers feel better. Encourage your client to let someone else care for the baby while she takes a moment for herself, such as taking a long shower or enjoying some time outside.
Childbirth can be a difficult time for any parent, however joyous the event. This can make behavioral health treatment more of a challenge for clients and caregivers.
Tracking client data and outcomes is crucial for understanding how effective treatment has been. BestNotes EHR solutions includes OutcomeTools, which helps take the work out of outcome studies. Contact us today to learn more about how we can help your practice achieve the best outcomes!