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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 08712
239523 or
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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