Perinatal Depression Therapy

What is Postpartum Depression?

Postpartum depression, clinically known as perinatal depression (PND), is a major depressive episode during pregnancy or within 4 weeks after childbirth up to a year. Studies now show it is relatively common among new parents, and mothers without a good support system in place. The condition itself is a form of clinical depression that affects as many as 15 percent of women after childbirth, and sometimes during pregnancy. Unlike The “Baby Blues,” perinatal depression doesn’t typically go away without treatment. 

The Signs of Perinatal Depression

Here are some common symptoms of postpartum depression. 

• A loss of interest in pleasurable activities or little interest in things that you used to enjoy. 
• Sadness or crying. This might include frequent crying, or putting yourself down often. 
• Extreme fatigue or a loss of energy. You may feel exhausted and have little energy to care for yourself or the baby. 
• Difficulty concentrating. It may be hard to focus on simple things. You might also feel overwhelmed and have trouble making decisions. 
• Sleep issues. Insomnia or sleeping too much can both occur in postpartum depression. 
• Changes in appetite. You may have little appetite or not feel like eating. 
• Difficulty bonding with your baby. You may feel like you don’t want or have no connection with your baby. 
• Thoughts of harming yourself. Thoughts of hurting yourself or your baby can occur with postpartum depression. If you are experiencing these, it’s important to call your doctor or 988 for the Suicide and Crisis Lifeline. 

If you have experienced the above symptoms for more than two weeks, it’s important to call your doctor or make an appointment with a therapist for an evaluation.

What Causes Perinatal Depression? 

While the causes of perinatal (postpartum) depression aren’t well-understood, evidence strongly suggests that hormonal changes are the most likely culprit. Studies have found that having elevated corticotropin releasing hormone (CRH) levels during pregnancy increase the risk of perinatal depression. 

Genetics and major life events may also be contributing factors. Many new moms experience sleep deprivation and exhaustion after giving birth, and these factors may also contribute to postpartum depression.

Postpartum Depression in New Fathers 

Some would be surprised to learn that postpartum depression doesn’t just affect mothers. Fathers also suffer from postpartum depression, and the instances seem to be on-par with the rate at which women suffer from the condition – an estimated 1 to 25.5-percent of the time. Methodological differences make accurate estimates very difficult, however we do know that this condition affects both men and women, and at roughly the same rate of prevalence.

Treatment for Perinatal Depression

The first step toward treating perinatal depression is an accurate diagnosis. Since there are many irregularities between cases of perinatal depression, accurate diagnosis is often difficult. In fact, the term “postpartum depression” no longer exists in the DSM-5. In the DSM-5, postpartum depression is diagnosed as perinatal depression. Perinatal depression includes depression that occurs during pregnancy (prenatal depression) and in the weeks after childbirth (postpartum depression).

After an accurate diagnosis is achieved, there are a variety of effective treatments for perinatal depression. 

• Medication – Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, may be helpful in treating perinatal depression. Specifically, the FDA has recently approved Zurzuvae (zuranolone), the first oral medication indicated to treat postpartum depression (PPD) in adults. One big advantage of this medication is that you only have to take it for 14 days to see results.
• Cognitive behavioral therapy (CBT) – Studies have found that women who participate in CBT for postpartum depression experience a greater reduction of postpartum symptoms than women who just take medication alone. 
• Interpersonal therapy (IPT) – IPT is another treatment option that focuses on a person’s social functioning and interpersonal relationships with the aim of improving mood and well-being. IPT is an attractive option for many people, due to it being a time-limited treatment (usually 12-16 weeks). 
• Holistic therapies – Hypnosis, acupuncture, massage and other alternative medicinal practices have proven to be effective in relieving some of the symptoms involved with the condition. 
• Support groups – A great way to get help is to talk to other moms and dads who are going through the same thing as you! Support groups for postpartum are a key component of lasting recovery from the hold of any serious depression disorder. 

The best treatment for perinatal depression (PND) is often a combination treatment prescribed by a mental health professional that may consist of cognitive behavioral therapy, interpersonal therapy, medication, and/or alternative medicine such as hypnosis, light therapy, acupuncture, or dietary changes that feature increased levels of omega-3 fatty acids.

Why Hire a Therapist?

Perinatal depression can limit your daily life and make it hard to care for yourself and your baby. However, with treatment, symptoms usually improve. Your therapist will teach you how to cope with the symptoms of postpartum depression and how to change sleep and other habits to help yourself feel better. There are many types of therapists who can treat postpartum depression. Therapists that have experience in dealing with postpartum depression, or even a more generalized depression-based specialization are often well-equipped at providing you with treatment for the condition.

Getting Help For Perinatal Depression

Perinatal depression is a common medical condition that can get better with treatment. So, if you or someone you love is having symptoms of perinatal depression, use our directory to find a therapist that specializes in the latest treatment options. Search therapytribe for a qualified expert in your area or an online therapist licensed in your state. The sooner you get help, the sooner you’ll be able to cope with the depression and enjoy this critical time of bonding with your new baby.

CASE STUDY

Post-Pandemic Impact on New Moms

According to research conducted by the University of Michigan, more than a third of new moms experience postpartum depression early in the pandemic. This is triple the pre-pandemic levels of postpartum depression. Having a baby during a worldwide pandemic is an extremely isolating experience —especially for new moms. They had to skip things like traditional baby showers and visits from family and friends. Many new moms also experienced increased anxiety due to worry about COVID transmission. 

One of the surprising benefits of the pandemic on new moms was that it lead to increased quiet time, which was really helpful for mothers who had just given birth. Many new parents saw this as a benefit. University of Michigan researchers say that a more personalized approach to maternal care, one that allows new parents more quiet time may be very helpful.

References

1. A third of new moms had postpartum depression during early COVID. (n.d.). University of Michigan. https://labblog.uofmhealth.org/rounds/a-third-of-new-moms-had-postpartum-depression-during-early-covid 
2. Belluck, P. (2019, March 19). F.D.A. Approves First Drug for Postpartum Depression. The New York Times. https://www.nytimes.com/2019/03/19/health/postpartum-depression-drug.html 
3. Buck, K., Zekri, S., Nguyen, L., & Ogar, U. J. (2019). Cognitive Behavior Therapy for Postpartum Depression. American Family Physician, 100(4), 244–245. https://www.aafp.org/pubs/afp/issues/2019/0815/p244.html 
4. Dørheim, S. K., Bondevik, G. T., Eberhard-Gran, M., & Bjorvatn, B. (2009). Sleep and Depression in Postpartum Women: A Population-Based Study. Sleep, 32(7), 847–855. https://doi.org/10.1093/sleep/32.7.847 
5. Meltzer-Brody, S., Stuebe, A., Dole, N., Savitz, D., Rubinow, D., & Thorp, J. (2011). Elevated Corticotropin Releasing Hormone (CRH) during Pregnancy and Risk of Postpartum Depression (PPD). The Journal of Clinical Endocrinology & Metabolism, 96(1), E40–E47. https://doi.org/10.1210/jc.2010-0978 
6. Nguyen, J. (2017). A Literature Review of Alternative Therapies for Postpartum Depression. Nursing for Women’s Health, 21(5), 348–359. https://doi.org/10.1016/j.nwh.2017.07.003
7. Pedersen, S. C., Maindal, H. T., & Ryom, K. (2021). “I Wanted to Be There as a Father, but I Couldn’t”: A Qualitative Study of Fathers’ Experiences of Postpartum Depression and Their Help-Seeking Behavior. American Journal of Men’s Health, 15(3), 155798832110243. https://doi.org/10.1177/15579883211024375 
8. PostpartumDepression.org – Helping Women with Postpartum Depression. (2016). PostpartumDepression.org. https://www.postpartumdepression.org/ 
9. The Lifeline and 988. (n.d.). 988lifeline.org. https://988lifeline.org/current-events/the-lifeline-and-988/ 
10. Dagher RK, Bruckheim HE, Colpe LJ, Edwards E, White DB. Perinatal Depression: Challenges and Opportunities. J Womens Health (Larchmt). 2021 Feb;30(2):154-159. doi: 10.1089/jwh.2020.8862. Epub 2020 Nov 6. PMID: 33156730; PMCID: PMC7891219.