Treatment for mild to moderate<unk>  includes psychological interventions or antidepressants. Women with moderate to severe<unk>  would likely experience a greater benefit with a combination of psychological and medical interventions. Light aerobic exercise has been found to be useful for mild and moderate cases. Therapy Both individual social and psychological interventions appear equally effective in the treatment of<unk> . Social interventions include individual counseling and peer support, while psychological interventions include cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). Interpersonal therapy (IPT) has shown to be effective in focusing specifically on the mother and infant bond. Support groups and group therapy options focused on psychoeducation around<unk>  have been shown to enhance the understanding of postpartum symptoms and often assist in finding further treatment options. Other forms of therapy, such as group therapy, home visits, counseling, and ensuring greater sleep for the mother may also have a benefit. While specialists trained in providing counseling interventions often serve this population in need, results from a recent systematic review and meta-analysis found that nonspecialist providers, including lay counselors, nurses, midwives, and teachers without formal training in counseling interventions, often provide effective services related to perinatal depression and anxiety. Internet-based cognitive behavioral therapy (iCBT) has shown promising results with lower negative parenting behavior scores and lower rates of anxiety, stress, and depression. iCBT may be beneficial for mothers who have limitations in accessing in person CBT. However, the long term benefits have not been determined. Medication A 2010 review found few studies of medications for treating<unk>  noting small sample sizes and generally weak evidence. Some evidence suggests that mothers with<unk>  will respond similarly to people with major depressive disorder. There is low-certainty evidence which suggests that selective serotonin reuptake inhibitors (SSRIs) are effective treatment for<unk> . The first-line anti-depressant medication of choice is sertraline, an SSRI, as very little of it passes into the breast milk and, as a result, to the child. However, a recent study has found that adding sertraline to psychotherapy does not appear to confer any additional benefit. Therefore, it is not completely clear which antidepressants, if any, are most effective for treatment of<unk> , and for whom antidepressants would be a better option than non-pharmacotherapy. Some studies show that hormone therapy may be effective in women with<unk> , supported by the idea that the drop in estrogen and progesterone levels post-delivery contribute to depressive symptoms. However, there is some controversy with this form of treatment because estrogen should not be given to people who are at higher risk of blood clots, which include women up to 12 weeks after delivery. Additionally, none of the existing studies included women who were breastfeeding. However, there is some evidence that the use of estradiol patches might help with<unk>  symptoms. Oxytocin has been shown to be an effective anxiolytic and in some cases antidepressant treatment in men and women. Exogenous oxytocin has only been explored as a<unk>  treatment with rodents, but results are encouraging for potential application in humans. In 2019, the FDA approved brexanolone, a synthetic analog of the neurosteroid allopregnanolone, for use intravenously in<unk> . Allopregnanolone levels drop after giving birth, which may lead to women becoming depressed and anxious. Some trials have demonstrated an effect on<unk>  within 48 hours from the start of infusion. Other new allopregnanolone analogs under evaluation for use in the treatment of<unk>  include SAGE-2017 and ganaxolone. Brexanolone has risks that can occur during administration, including excessive sedation and sudden loss of consciousness, and therefore has been approved under the Risk Evaluation and Mitigation Strategy (REMS) program. The mother is to enrolled prior to receiving the medication. It is only available to those at certified health care facilities with a health care provider who can continually monitor the patient. The infusion itself is a 60-hour, or 2.5 day, process. People's oxygen levels are to be monitored with a pulse oximeter. Side effects of the medication include dry mouth, sleepiness, somnolence, flushing and loss of consciousness. It is also important to monitor for early signs of suicidal thoughts or behaviors. Breastfeeding Caution should be exercised when administering antidepressant medications during breastfeeding. Most antidepressants are excreted in breast milk in low quantities which can have adverse effect on babies. Regarding allopregnanolone, very limited data did not indicate a risk for the infant. Other Electroconvulsive therapy (ECT) has shown efficacy in women with severe<unk>  that have either failed multiple trials of medication-based treatment or cannot tolerate the available antidepressants. Tentative evidence supports the use of repetitive transcranial magnetic stimulation (rTMS). As of 2013 it is unclear if acupuncture, massage, bright lights, or taking omega-3 fatty acids are useful.
Postpartum depression
Postpartum blues
Postpartum disorder
Dysphoric milk ejection reflex
Postpartum psychosis
Premenstrual syndrome
Post-adoption depression syndrome
Premenstrual dysphoric disorder