Nursing mothers and fathers too
suffering from postpartum depression are commonly treated in three major ways.
But the physician best determines what steps to follow.
Here are the basic ways:
1. Educational
programs and support groups
Treatment
of postpartum depression in men and women is similar. Both mothers and fathers
with this condition have been found to greatly benefit from being educated
about the illness, as well as from the support of other parents who have been
in this position.
2. Psychotherapies
Psychotherapy
("talk therapy") involves working with a trained therapist to figure
out ways to solve problems and cope with all forms of depression, including
postpartum depression. It can be a powerful intervention, even producing
positive biochemical changes in the brain. This is particularly important as an
alternative to medication treatment while women are breastfeeding.
In
general, these therapies take weeks to months to complete. More intense
psychotherapy may be needed for longer when treating very severe depression or
for depression with other psychiatric symptoms.
Interpersonal
therapy (IPT): This helps to alleviate depressive
symptoms and helps the person with PPD develop more effective skills for coping
with social and interpersonal relationships. IPT employs two strategies to
achieve these goals.
- The first is education about the nature of depression. The therapist will emphasize that depression is a common illness and that most people can expect to get better with treatment.
- The second is defining specific problems (such as child care pressures or interpersonal conflicts). After the problems are defined, the therapist is able to help set realistic goals for solving these problems. Together, the individual with PPD and his or her therapist will use various treatment techniques to reach these goals.
Cognitive
behavioral therapy (CBT): This
helps to alleviate depression and reduce the likelihood it will come back by
helping the PPD sufferer change his or her way of thinking. In CBT, the
therapist uses three techniques to accomplish these goals.
- Didactic component: This phase helps to set up positive expectations for therapy and promote cooperation.
- Cognitive component: This helps to identify the thoughts and assumptions that influence behaviors, particularly those that may predispose the person with PPD to being depressed.
- Behavioral component: This employs behavior-modification techniques to teach the individual with PPD more effective strategies for dealing with problems.
3. Medications
Medication
therapy for postpartum depression usually involves the use of antidepressant
medication. The major types of antidepressant medication are the selective
serotonin reuptake inhibitors (SSRIs), seritonin/norepinephrine/dopamine
reuptake inhibitors (NSRIs), the tricyclic antidepressants (TCAs), and the
monoamine oxidase inhibitors (MAOIs). SSRI medications affect levels of
serotonin in the brain.
For
many prescribing doctors, these medications are the first choice because of the
high level of effectiveness and general safety of this group of medicines.
Examples of antidepressants are listed here. The generic name is first, with
the brand name in parentheses.
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Fluvoxamine (Luvox)
- Citalopram (Celexa)
- Escitalopram (Lexapro)
Approximately
two-thirds of people who take antidepressant medications get better. It may
take anywhere from one to six weeks of taking medication at its effective dose
to start feeling better.
It
is, therefore, important not to give up taking the medication because benefits
are not felt right away.
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