Postpartum Depression Treatment: Psychotherapy
As a Clinical Psychologist, I know a thing or two about psychotherapy: I know that it is a highly effective treatment for Pregnancy and Postpartum Mood and Anxiety Disorders (PMADs), that there are some terrific therapists out there, and that it can be tough to find the right therapist for you. However, as a four-time postpartum depression survivor and therapy participant, I know that postpartum psychotherapy works.
Is Psychotherapy An Effective Treatment for Postpartum Depression?
You don’t have to take my word for it—research has demonstrated time and again that psychotherapy is an effective treatment for PMADs. In fact, research now shows that psychotherapy “should be considered a first-line treatment, rather than as an adjunct to medication treatment.”[i]
I couldn’t agree more. In fact, postpartum psychotherapy is a great place for most women and families to start—it’s an opportunity to talk with a trained provider who can identify what’s really going on and help you begin to make positive change. Then, if the therapy is not working well enough, you can always look into adding medication. In fact, psychotherapy plus medication is often recognized as the “gold standard” for postpartum depression treatment. (For severe PMAD symptoms, however, medication or hospitalization may be better indicated to start).
What is Psychotherapy?
The term “psychotherapy” is just another way of saying therapy or counseling. The goal of postpartum psychotherapy is to provide a nurturing environment where you can gain self-understanding and insight, make connections between your past and present, and learn tools to help you cope. Ideally, psychotherapy provides a space that is just for you, with an experienced therapist to show you things you might not otherwise have seen, to support and encourage you, and also to teach new ways of doing things.
Who Provides Postpartum Psychotherapy?
There are several types of mental health specialists who provide psychotherapy—psychologists, psychiatrists, counselors, social workers, therapists, psychotherapists, and even psychiatric nurse practitioners. The different titles refer to the different types and levels of schooling the provider has achieved, and while this may influence a provider’s level of education or how much the provider charges, in general, any one of these might provide the type of psychotherapy you’re looking for.
What Are The Best Therapeutic Approaches?
Each therapist will have their own therapeutic approach, or the way they view and do therapy. Research has shown the following four therapeutic approaches to be the most effective for postpartum depression treatment:
1) Cognitive-behavioral Therapy (CBT) examines the relationship between your thoughts, emotions, and behaviors, with the goal to become more aware of these relationships and make alterations as needed.
2) Interpersonal Therapy (IPT) works on modifying interpersonal relationships, focusing on interpersonal disputes, role transitions, and grief/loss.
3) Couple’s Therapy provides partners with a place where each can feel safe and supported while working through issues like role changes, parenting, communication, negotiation, and strengthening the relationship. Considering the high stress placed on couples in pregnancy and postpartum, couples therapy is an excellent option when both partners are willing.
4) Group Therapy is a support group that’s led by a professional counselor, nurse, or social worker. Participants are taught coping strategies from the group leader, with the added benefit of receiving support and wisdom from other moms or dads who have “been there”.
What Should I Look For in a Postpartum Psychotherapy Provider?
First, does the provider understand Perinatal Mood and Anxiety Disorders? Has s/he had any extra training on the evaluation and treatment of PMADs? If you’re not sure, then ask.
Second, what is the provider’s therapeutic approach? How does s/he “do” therapy? Does it seem in line with what you are looking for?
Third (and most importantly) do you like and trust the provider? The fit between a client and therapist is crucial to making therapy work. If, for any reason, you have doubts, please bring it up with your therapist. And if that doesn’t help, try someone else, and keep trying until you find the person that will best help you.
What Should I Say/Do in Psychotherapy?
Though it may take some time before you establish a trusting relationship with your therapist, you should feel comfortable talking about all of your emotions, thoughts, and behaviors, including (and especially):
- Intrusive thoughts or images
- Feelings or thoughts of suicide
- Sadness, crying
- Feeling overwhelmed
- Feeling disconnected from the baby
- Feeling like you’ll never feel better again
You should be able to share these things without feeling minimized, judged, or blamed.
You should feel BETTER when you leave a therapy practice, not worse. You should feel hopeful, like this person might actually be able to help you, and especially that they understood what you were saying and how you were feeling.
Psychotherapy can make a world of difference in your postpartum depression recovery. Just give it a try, be patient, and soon enough you will feel the hope return.
Pregnancy & Postpartum Resources: http://www.drchristinahibbert.com/resources/
Postpartum Support International www.postpartum.net
[i] Stuart, S., O’Hara, M. , & Gorman, L. (2003). The prevention and psychotherapeutic treatment of postpartum depression. Archives of Women’s Mental Health, 6[Suppl.2]: s57-s69.) Quoted in: American Psychological Association’s Monitor on Psychology, “Treating Postpartum Depression” http://www.apa.org/monitor/2011/02/postpartum.aspx .