Depression after childbirth: Can psychosocial and psychological treatment approaches help?

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PantherMedia / Georgiy Pashin

In some women, the “baby blues” they have after childbirth develops into clinical . Non-directive counseling, cognitive behavioral therapy and interpersonal psychotherapy can help relieve postnatal in many women.

Having a newborn baby involves making major changes in your everyday life. It's normal for mothers and fathers to feel unsure about their new roles and how their lives are changing. It can be a very emotional time. Many women have already heard about this period of emotional ups and downs, often called "the baby blues." But they may still be surprised how quickly their mood can change in the first few days and weeks after childbirth.

About half of all mothers have experienced the baby blues. It's usually strongest between the third and fifth day after the birth of their child. In most cases it goes away again within two weeks at the most. Emotional support and practical help is enough to help most women through this difficult time.

Some women develop in the first few months after having their baby, though, and need treatment for it. This is known as postnatal (or postpartum) and affects about 15 out of 100 women. That is about 3 times the average rate of among women of the same age group who have not just had babies. But postnatal often isn't diagnosed.

Research has shown that psychological treatment can have long-term benefits

Antidepressants are an important treatment for some women. But women with postnatal tend to prefer treatments without medication. Talking to a supportive, non-judgmental person often really helps mothers who are depressed. Psychotherapists can offer this kind of help.

There are many different psychological treatments for people who have depression. Not all of them have been formally assessed in studies, though. Researchers from the looked for studies on psychosocial support and psychological treatments, to see if any of these approaches have been proven to help with postnatal .

The Cochrane researchers found ten studies involving almost 1,000 women who had postnatal . Various kinds of psychological treatment were used in these studies. The studies showed that psychological treatment is more effective at making postnatal go away than the usual postnatal care women receive after giving birth:

  • 57 out of 100 women who received the usual postnatal care were still depressed one year after the studies began.
  • 40 out of 100 women who had psychological treatment were still depressed after one year.

In other words, psychological treatment helped the go away in an extra 17 out of 100 women.

Types of treatment that have been shown to work

Most of the studies included in the Cochrane researchers' analysis looked at non-directive counseling, cognitive behavioral therapy or interpersonal psychotherapy. These treatments were given by trained psychologists and counselors.

Non-directive counseling involves talking, with the aim of being emotionally supportive while not giving any advice. There is not necessarily a fixed number of sessions.

Cognitive behavioral therapy (CBT) involves a series of sessions – usually about ten, although this can vary. The aim of CBT is to identify thought patterns and behaviors that might be making life unnecessarily difficult, and then change them. In postnatal , this involves things like finding out what is making it hard for the mother to cope with her emotions and the changes brought on by motherhood. For example, if she often has thoughts like, “I’m a bad mother and I will always be a bad mother,” the CBT therapist will help her work on changing that belief.

Interpersonal psychotherapy involves weekly sessions with a psychotherapist for a limited period of time. This treatment focuses on the woman’s symptoms as well as certain issues that become more important as her role in life (being a mother) and relationships with her partner and other people close to her change. That's why it is called “interpersonal psychotherapy.” The goal is to develop individual strategies to address the identified problems.

The Cochrane researchers didn't include studies on group therapy or self-help groups. There's also not much good-quality research on other types of psychological treatment, such as psychotherapy that focuses on early childhood experiences.

Dennis CL, Hodnett E. Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database Syst Rev 2007; (4): CD006116.

Howard LM, Oram S, Galley H, Trevillion K, Feder G. Domestic violence and perinatal mental disorders: a systematic review and meta-analysis. PLoS Med 2013; 10(5): e1001452.

Perveen T, Mahmood S, Gosadi I, Mehrai J, Sheikh SS. Long term effectiveness of cognitive behavior therapy for treatment of postpartum depression: a systematic review and meta-analysis. Journal of Pioneering Medical Sciences 2013; 3(4): 198-204.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Updated on September 21, 2016
Next planned update: 2020

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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