Postpartum Depression Treatment: A Few Options

If you’re reading this post (or if you’ve read my post on my struggle with postpartum depression,) you know that it can be a dark and scary time. You’re probably wondering what this means for you, how to move forward, and what your postpartum depression treatment options are. First of all, please know that you are never alone.

I’ve done some research (and lived through much of it myself) and compiled it all for you below.

Medication

Hear me out: There is a huge stigma against taking medications for mental health. I totally get it. BUT, as someone who has done it, I’m here to tell you that it can be SUCH a game-changer and – for me personally – has easily been one of the most effective postpartum depression treatment options.

Full transparency: I was extremely hesitant to take any kind of antidepressant medication. As a highly anxious person, my concern was the side effects. How would I feel during the 6-8 week adjustment period? How would it feel to stop taking it? Was I going to be on it forever? Was I going to be able to wean off without the awful “brain zaps” I kept hearing about? Would I lose all of my joy in daily activities? Would it impact my ability to be a good wife, mom, and employee?

I psyched myself out and read SO many horror stories about antidepressant experiences, and continued to convince myself that my depression wasn’t that bad, that it was something else (looking at you Postpartum Thyroiditis), or that time would alleviate all of my symptoms. Finally, after a particularly bad day, exactly 5 months postpartum, I “caved.” And you know how many of my concerns actually came true? Zero. So I’m starting this list off with some postpartum depression medications.

The Cleveland Clinic has a great overview of some of the medication options available for postpartum depression, but I’ve added some notes here for you as well. While this list looks intimidating and very clinical, it’s actually quite simple if you break it all down.

• Selective serotonin reuptake inhibitors (SSRIs)
  • Help your brain by working on Serotonin, one of your happy chemicals. Instead of Serotonin getting reabsorbed (and therefore essentially going away), it hangs out in your brain for a while longer and increases your mood.
  • Usually the first class of drugs that providers try, as they are generally well tolerated and seem to have fewer side effects (though that is relative.)
  • Zoloft is considered safe to use while breastfeeding, so many providers will start with this one.
  • It tends to take about 6-8 weeks before you see significant improvement in your symptoms.
  • IF there are negative side effects when first starting this medication, they tend to be gastrointestinal symptoms (nausea or vomiting, diarrhea). Remember that a lot of people never feel any negative side effects, so don’t let that scare you!
  • One of the unfortunate reasons some people stop this medication or switch to a different class of medications is because of issues with s*x (think inability to get to your happy place.)
  • Examples: sertraline (Zoloft®) and fluoxetine (Prozac®).
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Like SSRIs, but help with energy levels too, because they impact not only your Serotonin levels but your Norepinephrine levels as well.
  • If you’re struggling with serious fatigue, this might be a good option for you.
  • Also takes about 6-8 weeks to reach its full effect.
  • Many of the same side effects, including sexual dysfunction unfortunately.
  • Examples include: duloxetine (Cymbalta®) and desvenlafaxine (Pristiq®).
• Norepinephrine and dopamine reuptake inhibitors (NDRIs)
  • Doesn’t impact Serotonin, but does work on your Norepinephrine (energy) and Dopamine (happy but a different kind) chemicals.
  • Because this impacts your energy levels, side effects are less sexual and more feeling “overactive” – ie tremors, difficulty sleeping, loss of appetite, and constipation.
  • It still takes – you guessed it – 6-8 weeks to reach it’s FULL effect, but that doesn’t mean that you don’t START feeling better sooner than that (as early as 2 weeks for some).
  • Examples: Bupropion (Wellbutrin®) and Zyban®.
  • *As a side note, Buproprion is what I was started on and have had a good experience on so far. I chose this because I also have ADHD, which Buproprion is an off-label use for. I have already noticed a difference in mood and motivation, but I will give you the full update after my 6-8 week mark. Please remember this is different for everyone. What works for me might not work well for you.
• Tricyclic antidepressants (TCAs)
  • Also allow Serotonin and Norepinephrine to hang out in your brain a little longer.
  • Sometimes less prescribed because they can have more side effects than some of the above.
  • Examples include: amitriptyline (Elavil®) and iimipramine (Tofranil®).

Some notes: This is obviously not a full list of your medication options, I’ve done my best to really simplify this, and again I am not a physician. WebMD also has a great overview (though it is a bit more clinical.) If this all sounds scary, please remember that you do not have to be on these medications forever.

As someone who has been through this, I will say this: I would highly encourage you to read up on some of the different types of medications and assess their side effect profile, how they work, and what your pros and cons are for each type. All medications have side effects, but for some, the side effects are worse than others. Work with a psychiatrist or a psychiatric nurse practitioner to find what’s right for you. Unfortunately, most of these medications need time to work, so try not to give up immediately if it’s been a few weeks and you don’t feel any better. This is a great time to combine other methods on this list with medication until you feel the full effects!

Therapy & Peer Support

I’ve found it very helpful to seek out female therapists who specialize in postpartum depression. Someone who has been through it or is well versed in it can be extremely beneficial to your recovery. As I’ve mentioned before, Psychology Today has a great tool that allows you to look up therapists based on your location, insurance, gender, the type of therapy you’re interested in, the therapist’s age, your gender preferences, and so much more. I also found several people through my insurance’s website. There are also several support groups available, so please check out my separate post for some other resources.

Partner (or friend or family) Support

I did this really silly thing in the beginning of my postpartum journey where I wanted to appear strong, resilient, and like I had everything out of control. Like a lot of postpartum moms, I felt none of those things. Don’t be like me: Tell your partner, a close friend, or a family member how you are feeling. I understand that therapy is not an option for everyone due to financial constraints, so this is especially important if that sounds like you.

This is also a great way to work with your support system to make a plan for how you are going to practice self care. I know that sounds hilarious, because your whole body is sore and you’re overwhelmed, exhausted, and hormonal. But self care doesn’t have to mean going to the spa. It can be taking a shower everyday. Getting outside at least once a day. Taking a 15 min break from your baby. Listening to your favorite song. Doing a 10 minute workout (if you’re cleared to obviously.)

Other Natural Methods That Can Help (Many taken from the NIH)

• Omega 3 fatty acids
  
  • Thought to increase mood by reducing inflammation
• Some evidence that acupuncture or massage might help
• Vitamin B6
• Exercise
  • I know this one can be hard because you have no energy, but short walks or 10 minute workouts count too!
  • Hello endorphins! I always feel better after a workout, no matter how short.
• *I can’t recommend this and haven’t done the research to see if it actually works, but I did use CBD in the evenings for racing thoughts and anxiety. Obviously, with a new baby, you can’t exactly take melatonin and knock out every night. I felt like it helped me sleep, even if just for a few hours. Talk to your provider about this one. Some holistic providers might have a discussion with you about this.

Please note that any of the above postpartum depression treatment options can be combined to ensure that your treatment plan works best for YOU.

Remember to advocate for yourself. Put on a medication and hate it (even after giving it the appropriate amount of time to work?) Talk to your provider and see if you can make a change. Not loving your therapist or not finding it helpful? Check out someone else!

I hope this list of postpartum depression treatment options provides you with a great place to start. Always remember: You are never alone, and you got this!