Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 6/8/2022
Given the sensitive state of a mother and baby during pregnancy or right after birth, it’s natural to be concerned about depression symptoms and their effects on mother and child. You may also be considering what treatment options mean if you’re breastfeeding and what — if any — impact your medications may have on breastmilk.
As you read along, just remember that postpartum and perinatal depression is a common experience, that you are not alone and there are different treatment options available.
However, depressive symptoms during pregnancy or after birth should be taken seriously and be addressed.
Postpartum depression is depression that occurs in pregnant or recently pregnant women and is actually onset from pregnancy or after birth.
Although it's often referred to as postpartum, it doesn’t necessarily mean it only happens after a baby is born.
Some women show symptoms of depression during pregnancy — known as perinatal depression — while other women might just show symptoms after birth, whether that's weeks after delivery or up to six months. This is known as postnatal depression.
It is often referred to as peripartum depression to encompass both time periods that occur during pregnancy and postpartum.
A common misconception is that postnatal depression is the baby blues. However, unlike what many women know as the baby blues (a feeling of being down after birth within the first two weeks) postpartum depression lasts for a longer period of time, affects daily tasks, is draining both emotionally and physically and is considered a mood disorder.
Most women show several of the symptoms listed below, although which exact symptoms show up and how they evolve vary from person to person.
Aches and pains
Loss of appetite or overeating
Feelings of anxiousness or hopelessness
Feelings of guilt, worthlessness or general pessimism
Loss of interest in activities
Fear of hurting the baby
Feelings of disconnection from the baby
Crying more often than usual
Withdrawing from others
If you’re concerned about perinatal depression, postpartum depression or are experiencing general signs of depression, please contact your healthcare provider to determine what the best plan of action is for your health.
Postpartum depression affects both you and your baby, so it’s really important to seek medical attention if you’re concerned.
Potential risks for postpartum depression can be broad, meaning that any woman who is currently pregnant or recently gave birth is at risk.
However, if you’re going through anything specifically stressful or have less support while going through such events (in addition to being pregnant or giving birth), you might be at a greater risk of postpartum depression.
Sometimes, a family history of mood disorders, a history of mental health disorders or a history of depression may also increase your chances of experiencing postnatal depression.
Left untreated, postpartum depression can be detrimental for both mother and child. It can impact the development of the child, and in severe cases for women, lead to suicidal ideation or suicide attempts.
That’s why treating it as quickly as possible is so critical.
One treatment option is medication. Medication has been found to be an effective option for women with postpartum depression. Specifically, for women experiencing moderate to severe cases, antidepressant medications are often recommended, given their effectiveness.
A common concern you may have about any type of medication treatment, but specifically when using medication while experiencing postpartum depression, is if it will allow you to continue to breastfeed or if medication will affect your breast milk.
While each medication is different and comes with specific usage and prescription guidelines from the Food and Drug Administration (FDA), generally speaking, healthcare providers will recommend against breastfeeding if using antidepressant medications.
However, exceptions are sometimes made, depending on the type of medication you’re prescribed. That said, this is a conversation best had between you and your healthcare provider.
There are a variety of medications that have been found to be effective in the treatment of postpartum depression. Part of the consideration for treatment will depend on your medical history, the severity of the depression symptoms and whether or not you’re breastfeeding.
Paroxetine, sold under the brand name Paxil®, is another common medication choice depending on patient history and if you’re currently breastfeeding.
Nortriptyline is considered a tricyclic antidepressant that works similarly to SSRIs (selective serotonin reuptake inhibitors) and SNRIs (selective norepinephrine reuptake inhibitors), and is sometimes also considered by healthcare professionals if more traditional antidepressant medications aren’t effective.
In one study, researchers found that nortriptyline performed similarly to sertraline for treating postpartum depression.
According to the FDA, citalopram was found in clinical studies to be present in breast milk, and did lead to mild adverse effects in breastfed infants. However, it’s not prohibited outright from being prescribed, but should be taken into consideration by a provider before prescribing citalopram to new mothers.
Some women may have a history of not responding well to SSRIs or not responding well during treatment. In that case, bupropion may sometimes be used.
However, like other antidepressants, bupropion has been shown in studies to enter breastmilk. While there are no definitive studies on whether or not it may affect an infant, be sure to speak with your healthcare provider if you are or are intending to breastfeed while taking bupropion.
Aside from medication, a common treatment option for postpartum depression you may choose to try is therapy.
Interpersonal therapy is a short-term effective therapy method that supports new mothers or women showing symptoms of depression during pregnancy. Interpersonal therapy helps patients recognize stressors, and then talk through role changes, relationships and more.
Although not as common as the baby blues (a feeling of sadness after giving birth) peripartum depression (a more severe and longer-lasting depressive state) is a relatively common experience among pregnant women who’ve just given birth.
However, just because it’s relatively common doesn’t mean it should be left untreated or not taken seriously. In fact not treating peripartum depression can impact the overall health and wellbeing of mothers and children alike.
Talk with a healthcare provider to determine the best method of treatment for you and your current situation, whether that's psychotherapy, medication, or a combination of both.
Both psychotherapy and medication for depression have been found to be effective treatments for women, ultimately improving the health and wellbeing of mother and child as symptoms improve!
If you are concerned about depressive symptoms, contact your healthcare provider, or seek treatment online.