Postpartum depression: Help is at hand

By Joene Hendry

Symptoms of postpartum depression appear to be reduced by any psychosocial therapy, with women opting for this treatment doing better than those who try to struggle through with no treatment at all, findings of a study review suggest.

Many women experience mild, short-term depressive symptoms, or "baby blues," shortly after delivery, while others - about 13 percent - develop more serious postpartum depression, according to lead author Dr. Cindy-Lee Dennis of the University of Toronto. Although antidepressant drugs can be effective in treating depression, about 50 percent of new mothers want to avoid taking drugs.

"Effective treatment other than medication is available, especially for those with moderate or minor depression or those who are breastfeeding," Dennis told Reuters Health.

Dennis and colleagues reviewed the results of nine studies, including 956 women, to assess the efficacy of different types of non-pharmaceutical treatments on postpartum depression.

They found that any psychosocial or psychological counselling for postpartum depression, compared with the "usual" postpartum care (which meant different things in different studies) or no care, was associated with a reduced likelihood of continued depression for the first year after childbirth.

Their review is published in The Cochrane Library, a journal of medical research.

"Postpartum depression is most likely to develop within the first 12 weeks," Dennis said, particularly in mothers without support from the baby's father, a partner, family members, or other women with children.

New mothers experiencing more than two weeks of uncontrolled moods or emotions, tearfulness, anxiety, altered appetite or sleep independent of the infant's schedule, diminished interest or pleasure in most activities, loss of concentration, or feelings of worthlessness or excessive guilt, should seek counselling, Dennis notes.

All interventions in this review, except for one telephone-based intervention, were directed by health professionals, the investigators note. The various interventions involved face-to-face counselling such as counsellor directed problem solving, cognitive behavioural therapy, outpatient mental health counselling and peer support.

Nonetheless, the investigators urge caution when interpreting the pooled data from their review due to the small number of trials involved and the lack of well-designed interventions.

In addition, the efficacy of these treatments over the long-term are unknown.

It is unlikely that a single treatment will be equally effective for all new mothers, the investigators conclude, and clear conclusions regarding specific interventions for postpartum depression requires further research.