Postpartum depression is sometimes described as the "baby blues" but it is a real condition that requires treatment. The baby blues affect many women and are usually short-term directly following the birth of the baby. Sleep-deprivation, overwhelming emotions and hormonal changes can contribute to baby blues, making a new mother feel sad, cry often and feel as if her depressed feelings have no source.
Postpartum depression can be similar but the symptoms don’t go away and often get worse. In serious cases a mother may neglect herself, neglect her baby and even try to harm the baby. Recognizing the condition and seeking help is the first step toward effective treatment. When postpartum depression is severe the treatment consists of professional counseling and the prescribing of one of the many effective antidepressant medications.
SSRIs: Selective Serotonin Reuptake Inhibitors
Selective Serotonin Reuptake Inhibitors, or SSRIs, are one of the effective antidepressants for postpartum depression treatment. They may enter the mother’s breast milk and be ingested by the baby but the amounts are usually small, even undetectable. Regardless, a mother must discuss with her physician the potential risks and benefits associated with any antidepressant use when breastfeeding.
SSRIs are able to improve depression by helping to balance the chemicals in the brain that affect mood. Specifically how an SSRI works is not fully understood but it is able to block the reabsorption, or reuptake of serotonin as it is produced in the brain. The drug can function differently for each woman and may not improve depression for every patient. Some SSRIs used to treat postpartum depression include Lexapro, Prozac and Paxil.
A Serotonin-Norepinephrine Reuptake Inhibitor, or SNRI, works in much the same way as the SSRI. It improves the balance of naturally occurring chemicals in the brain which positively affects certain mood disorders like postpartum depression. Specifically, the SNRI blocks the reuptake of serotonin and norepinephrine. Effexor and Cymbalta are two of the common SNRIs used to treat postpartum depression.
Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
A Serotonin-Norepinephrine Reuptake Inhibitor, or SNRI, works in much the same way as the SSRI. It improves the balance of naturally occurring chemicals in the brain which positively effects certain mood disorders like postpartum depression. Specifically, the SNRI blocks the reuptake of serotonin and norepinephrine. Effexor and Cymbalta are two of the common SNRIs used to treat postpartum depression.
Another group of antidepressant drugs often used to treat postpartum depression is the tricyclic antidepressant family. This drug also works like SSRIs and SNRIs by increasing chemicals in the brain that boost mood. This drug can also restore chemical balance to decrease depression. Several different brands or generic forms of this drug are available. Nortriptyline, a generic tricyclic antidepressant is a common postpartum depression medication.
There are other families and unclassified types of antidepressants for postpartum depression treatment that work well but are not typically used to treat postpartum depression. For example, Monoamine Oxidase Inhibitors, or MAOIs are avoided unless absolutely necessary for postpartum treatment. This is partly due to the lack of research on the potential risks to the baby if the mother is breastfeeding. When a mother is not breastfeeding the MAOI is less likely to be avoided.
American Family Physician: Postpartum Major Depression: Detection and Treatment https://www.aafp.org/afp/990415ap/2247.html
Drugs.com: Paxil CR Controlled-Release Tablets https://www.drugs.com/cdi/paxil-cr-controlled-release-tablets.html
Drugs.com: Drugs Associated with Postpartum Depression https://www.drugs.com/condition/postpartum-depression.html
Field, T. (2008). "Breastfeeding and Antidepressants." Infant Behavior Development. Sept 31(3): 481-7.
HelpGuide: Postpartum Depression and the Baby Blues https://www.helpguide.org/mental/postpartum_depression.htm
Mayo Clinic: Depression (major depression) https://www.mayoclinic.com/health/ssris/MH00066
PubMed Health: Nortriptyline https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000732