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Treatment for Post Natal Depression
Treatment for Post
Natal Depression can involve a number of approaches.
Some people,
particularly those with milder symptoms may not want or need
antidepressants. I can understand this, but when talking with your G.P.
about the best treatment for you, it is useful to have a basic
understanding of the treatment options. I have therefore given details
of the main types of drug treatment below.
Antidepressants
Antidepressants work
by regulating the levels of brain chemicals which affect your mood.
There are various types of antidepressant drug treatment available. The
Medic8 Drug Search engine will give details of specific drugs if you
type in the name of the drug you have been prescribed.
The four main groups of anti
depressants are:-
Tricyclic Antidepressants (TCAs)
First prescribed in the 1950s, TCAs are still commonly used to treat
depression. They take about two weeks to work. Some tricyclic
antidepressants are also sedatives – so if you feel anxious and
agitated you may be prescribed these. However, if you feel tired then
you will probably be prescribed a non-sedative drug. Some patients have
adverse effects with tricyclic antidepressants.
Selective Serotonin Re-uptake
Inhibitors (SSRIs)
Introduced in the 1980s, SSRIs are the other major type of
antidepressant. Generally they cause fewer side effects, and are less
sedative than other antidepressant drugs. Many people find that they
are easier to take than other types of antidepressant.
Monamine Oxidase Inhibitors
(MAOIs)
MAOIs are usually used in patients who have not responded well to other
drug treatments. They are not often used as a first time treatment due
to the special diet that patients are required to follow whilst taking
them.
Reversible Inhibitors of
Monoamine Oxidase (RIMAs)
RIMAs are a similar antidepressant drug to MAOIs. They are usually
prescribed in higher doses to patients who have not responded to other
treatments.
There are a number of other antidepressants that don’t belong to these
four main antidepressant drug classes.
Most side effects from antidepressant drugs usually pass after the
first month. Do not stop taking your medication without discussing it
with your doctor. There are a number of different antidepressant
medications available. If you are experiencing unpleasant side effects
then your GP will be probably be able to prescribe a different
medication.
It is important that you talk to your GP before stopping or changing
your medication in any way. Even when you feel better, your doctor may
ask you to continue taking your medication for a period – this is just
to help ensure that your depression does not return.
Counselling
Although medication can improve your mood, Counselling can help to
explore what may have contributed to your depression in the first
place, and issues that might be keeping you depressed.
Counselling offers people the opportunity to talk through issues in
their everyday lives contributing towards their depression.
Counselling can also
be helpful for a partner who may be finding it difficult to understand
what their wife or girlfriend is going through. The difficulties of
coping with a new child sometimes mean that men can experience a form
of Post Natal Depression as well as women.
Progesterone
and Hormonal Treatments
Some earlier studies,
in particular by Katrina Dalton seemed to show that progesterone,
administered immediately after childbirth could reduce the possibility
of PND. Indeed, having experienced
Puerperal Psychosis after my first child, I
had a course of Progesterone immediately after giving birth to my
second child and experienced no symptoms of PND.
However, this was
nearly 10 years ago and whilst there continues to be some anecdotal
evidence that Progesterone may be able to help, recent medical studies
have shown that "there is no convincing evidence for the use of
progestogens for the treatment / prevention of Post Natal Depression"
and "The use of hormonal therapies in the routine management of
patients with PND is NOT advised". The latest NICE guidelines now
make no reference to hormonal treatments for PND but refer to medical
(generally anti - depressant) and psychological (such as counselling
and group therapy treatments).
Whilst it is
recognised that hormonal changes are involved in mood changes (PMT /
PMS), this is not now a recommended treatment for Post Natal
Depression. However, I am aware that some obstetrician's are willing to
offer this as a form of treatment.
Advice on the Royal
College of Psychiatrists website states "Levels of oestrogen,
progesterone (and other hormones to do with conception and birth) drop
suddenly after the baby is born. How exactly they affect your mood and
emotions is not clear. No real differences have been found in the
hormone changes of women who do and do not get PND and research does
not suggest that this is a major reason for depression. Hormone changes
may be more important in the ‘baby blues’ and puerperal psychosis".
Self Help
Take regular
exercise.
Make sure you get regular meals.
Go to post -natal classes.
Make friends with other women who are pregnant or have just had a baby
– a recent survey showed that of women with PND, 66 per cent
experienced feelings of isolation (compared to 32 per cent of all
mothers questioned) and 48 per cent were afraid of being isolated from
their social circle or friends (compared to 24 per cent of all mothers
questioned).
Keep in touch with your GP and Health Visitor.
The support and
understanding of a partner can make an enormous difference and it is
important to ensure that they get adequate help and support as Post
Natal Depression (in common with any depressive illness) can put a
strain on any relationship.
Click Here to open a printable version of this page.
To find out more, or to make an appointment, telephone
me on 01483 429567 or 07714 203500
e-mail me at angela.rhydderch@clara.co.uk
Counselling Godalming,
Guildford ,Farnham, Cranleigh and Haslemere Surrey ~ A Professional
Qualified and Caring Counsellor ~ Specialising in Anger
Management, Post Natal Depression, Depression, School Counselling,
Youth, Young People, Teenagers, Parenting, Stress and Special
Educational Needs ~ Based in Guildford and Godalming Surrey (U.K.) .
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