Postpartum Depression

There have been two main approaches for treating postpartum depression, neither of which has had much empirical testing. The first strategy is to focus directly on the individual woman, with the main goal of reducing her depressive symptoms. As discussed above, postpartum depression is by definition a major depression that occurs during the postpartum period. There is ample evidence to suggest that major depression can effectively be treated with psychopharmacological intervention (i.e., antidepressant medication). Mothers (and physicians) are generally reluctant, however, to use medication during the postpartum period given potential complications associated with breast-feeding. Alternatively, individual psychotherapy has been used to help improve the moods of depressed women. For example, Michael O'Hara and his colleagues reported in 2000 that interpersonal psychotherapy (IPT) was an effective treatment for reducing depressive symptoms, and improving social adjustment, in women with postpartum depression. Initially, IPT involves identifying depression as a medical disorder that occurs within an interpersonal context. The next stage of treatment focuses on current interpersonal challenges identified by the patient (i.e., difficulties with a partner or extended family, role transitions, and/or losses related to the birth). The final stage of treatment consists of reinforcing the patient's competence related to symptom reduction, as well as future-oriented problem solving related to the potential recurrence of depressive symptoms.

The second general strategy for treatment is to focus on maladaptive relationship patterns or parenting practices that are often associated with maternal postpartum depression, in order to improve and enhance parent-infant interactions. There are a number of techniques that have been examined, including relationship-based intervention conducted in the family's home, interaction guidance, and touch or massage therapy for infants. Although these approaches vary in technique, all are generally designed to enhance maternal sensitivity, responsivity to infant cues, and positive parent-infant interaction. Primary outcomes are examined in terms of improvement in factors such as infant regulatory capacities, social-emotional development, and parent-infant attachment. In addition, reduction in maternal depressive symptoms is usually reported, although this is not the direct focus of the intervention. Overall, improvements are noted, although minimal information is available to determine the duration or the specific effects.