Treatment

The below information was taken from The Royal College of Psychiatrists. You can visit their website here

Why is treatment important?

Most women will get better without any treatment within 3 to 6 months. 1 in 4 mothers with PND are still depressed when their child is one-year-old. However, this can mean a lot of suffering. PND can spoil the experience of new motherhood. It can strain your relationship with your baby and partner. You may not look after your baby, or yourself, as well as you would when you are well. PND can affect your child’s development and behaviour even after the depression has ended. So the shorter it lasts, the better.

Which treatments are available?

The treatment you need depends on how unwell you are. You should be told about all the likely benefits and risks of treatment so you can make the best choice for you.

Treatment includes:

  • talking treatments
  • medication.

Talking treatments

Talking about your feelings can be helpful, however depressed you are. Sometimes, it’s hard to express your feeling to someone close to you. Talking to a trained counsellor or therapist can be easier. It can be a relief to tell someone how you feel. It can also help you to understand and make sense of your difficulties.

Many general practices now have a counsellor. rained health visitors can offer counselling at home in some areas.

There are also more specialised psychological treatments. Cognitive Behavioural Therapy can help you to see how some of your ways of thinking and behaving may be making you depressed. You can learn to change these thoughts which has a positive effect on other symptoms. Other psychotherapies can help you to understand the depression in terms of your relationships or what has happened to you in the past.

Some counselling and psychotherapy services will see you more quickly if you have recently had a baby. Ask your GP or health visitor about services in your local area.

Are there problem with talking treatments?

Talking treatments are usually very safe, but they can have unwanted effects. Talking about things may bring up bad memories from the past. This can make you low or distressed. Psychotherapy can put a strain on relationships with people close to you.

Make sure that you can trust your therapist and that they have the necessary training.

Another problem with talking therapies is that they are still hard to get in some areas. National guidelines state that women with PND should be seen within a month. In reality, there are often long waiting lists. This means you may not get any treatment for quite a while.

Medication

If you have a more severe depression, or it has not improved with support or a talking therapy, an antidepressant will probably help.

There are several types of antidepressants. They all work equally well, but have different side-effects. They are not addictive. They can all be used in PND, but some are safer than others if you are breastfeeding.

Antidepressants take at least 2 weeks to start working. You will need to take them for around 6 months after your start to feel better.

Are antidepressants safe in breastfeeding?

Make sure that your doctor knows that you are breastfeeding. For many antidepressants, there is no evidence that they cause problems for breastfed babies, so breastfeeding is usually possible.

However, the decision is an individual one for each woman. Some antidepressants have been used in breastfeeding for many years. There is less information about newer medications. You doctor can provide up-to-date information and advice.

To decide whether to breastfeed when taking an antidepressant, you need to think about:

  • how severe your illness is (or has been in the past)
  • treatments which have helped you before
  • side-effects
  • up-to-date information about the safety of medication in breastfeeding
  • the benefits of breastfeeding
  • whether your baby is very premature or has any health problems
  • the impact of the untreated illness on your baby.

What about hormonal treatments?

Hormones have been suggested as a treatment for PND. However, there is little evidence that they work, and they have their own dangers, particularly if you have had thrombosis (blood clots in their veins).

Alternative remedies

St John’s Wort is a herbal remedy available from chemists. There is evidence that it is effective in mild to moderate depression. It seems to work in much the same way as some antidepressants, but some people find that it has fewer side-effects.

One problem is that St John’s Wort can interfere with the way other medications work. If you are taking other medication, you should discuss it with your doctor. This is very important if you are taking the oral contraceptive pill. St John’s Wort might stop your pill working. This can lead to an unplanned pregnancy.

There is not enough information to say that it is definitely safe in breastfeeding. Only small amounts get into breast milk, but do not assume that because it is ‘herbal’, it will be safe. Discuss the risks and benefits of treatment in breastfeeding with your doctor.

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