Talk therapy works for postpartum depression

A couple of months ago I wrote a piece on light therapy for postpartum depression (PPD). A study released this month shows that talk therapy - with a professional or a mom peer - can help also. This is an important finding, because many women prefer not to take antidepressants when they are breastfeeding.

In this study, the investigators reviewed 10 clinical trials that included nearly 1,000 women. The trials tested psychological and social interventions that included cognitive behavioral therapy (CBT), counseling, and peer support groups facilitated by a health care professional. They found that women who received any of the psychological or social therapies were 30% less likely to have depressive symptoms within one year after giving birth compared to women who received postpartum care as usual. Additionally, peer support groups appeared to be just as effective as formal psychological care, such as CBT, which is great news for moms who can't afford a weekly trip to a therapist.

The study authors additionally noted two key take-home points. First, PPD is treatable, and a wide variety of treatment options is available. Second, social support is critical for moms who are experiencing PPD. Sometimes there is a tendency for new moms to try to pretend all is well, because they're "supposed" to be happy about their new addition. But having support from other women who've experienced PPD can help to normalize the experience and reduce the stigma associated with having a postpartum mood disorder.

So if you or someone you know is experiencing PPD, know there is help. Postpartum Support International is a great resource to find a peer support group in your area. Additionally, Postpartum Progress is a blog written by mom and advocate Katherine Stone, who experienced postpartum obsessive compulsive disorder. She provides a broad array of information on postpartum depression and other mood disorders that readers will find helpful.

What you think about your depression affects how you cope

When you are diagnosed with a mental health problem such as depression, one issue you have to face is how to deal with the diagnosis. Research suggests that women generally use what's called "emotion-focused coping," which includes crying, dwelling on the causes and implications of their depression (aka ruminating), and seeking support from others. (Versus men who cope by distracting themselves with hobbies, sports, alcohol, and drugs.)

A study published this month shows that people's emotional reactions to their depression diagnosis affect how they cope. Researchers interviewed 189 patients (133 women) in a primary care clinic who were taking antidepressants. They found women who believed their depression would have a greater negative impact on their lives used more maladaptive coping strategies, such as blaming themselves, ruminating about their illness, and disengaging from others. On the other hand, women who perceived they had some control over their depression and who believed their depression was caused by an identifiable stressor (such as relationship or job difficulties) used more active coping strategies, such as planning, acceptance, problem-solving, reframing the illness positively, and religious/spiritual supports.

Why do coping strategies matter? The researchers suggest that maladaptive coping may actually worsen depressive symptoms, while active coping may help to lessen them. Further, women in particular may benefit from strategies that increase their active coping skills and improve their sense of control over their disorder.

If you have been diagnosed with depression, it may be helpful to talk to your mental health care provider about how the diagnosis has affected you emotionally. You also may ask your provider to give you more detailed information about your depression, such as: how long you can expect to have symptoms, whether the symptoms will wax and wane or decrease gradually over time, how the symptoms will affect you in the short- and long-term, how the treatment will affect you short-term and over time, and how long your provider expects you will need treatment. The answers to these questions will vary for different people, and also can vary for the same person for different depressive episodes, depending on the severity of the episode. Having open and clear communication with your provider can assist you in developing a sense of control over your depression and help you to manage your illness constructively as you heal.