Treatment options
The treatment a woman receives should depend on her score on the Edinburgh Scale, but all too often there is no follow-up care, either because adequate mental health resources aren’t available or because she can’t access them.
It’s hard to make it to an appointment when you’re overwhelmed, exhausted and depressed, especially if you don’t have easy transportation or childcare, Dr. Frolov said. “When I see someone make it to an appointment with me, I am overjoyed, honestly, to see them in my office, because I know that often there’s a lot that went into it.”
Therapy
If a woman is found to have mild to moderate depression, she should quickly be referred to some sort of therapy.
Group therapy is often recommended for new moms who are struggling, and it can be one of the most powerful interventions, said Paige Bellenbaum, a licensed clinical social worker and the founding director of The Motherhood Center, a clinic in New York City that offers intensive outpatient care for women with postpartum depression. “It’s the support that women provide to one another,” she said, “that helps them to feel so much less alone in this really, really challenging journey.”
In one-on-one therapy, counselors often use approaches like cognitive behavioral therapy, dialectical behavioral therapy and interpersonal therapy, which provide women with skills to help them manage their emotions, avoid or reframe negative thoughts and improve communication with their partner.
Medication
For women who have moderate to severe postpartum depression, experts often recommend medication — most commonly selective serotonin reuptake inhibitors, or S.S.R.I.s. There is limited research specifically testing S.S.R.I.s for postpartum depression, but one meta-analysis assessing six studies indicated that a little less than half of the women who take them see an improvement.
Traditionally, doctors have worried that these medications are unsafe for women who are pregnant or breastfeeding, but Dr. Frolov said the risks are small, especially compared to those associated with postpartum depression. She said Zoloft, in particular, is frequently prescribed because less medication is secreted into breast milk than with other S.S.R.I.s.
