Skip to main content

Advertisement

SpringerLink
Log in

Alternative Treatments for Postpartum Depression

  • Hot Topic
  • Published:
Current Treatment Options in Psychiatry Aims and scope Submit manuscript

Abstract

Purpose of review

While pharmacotherapy is often used in the treatment of postpartum depression, there have been few positive randomized controlled trials that have supported this practice. Prior studies eliciting the treatment preferences of postpartum women have shown that this population is often hesitant to use antidepressant medications and have expressed a strong preference for psychotherapeutic interventions. Despite this, access to high-quality psychotherapy remains problematic in many regions. Given the concerns that many postpartum women have around the safety of antidepressant medications, it is important to consider alternative treatments that have some literature supporting their use in the treatment of postpartum depression. These alternative treatments include omega 3 fatty acids, vitamin D3, bright light therapy, repetitive transcranial magnetic stimulation, electroconvulsive therapy, exercise, parenting skills training, and social/peer support. In this narrative review, we will summarize the available literature for these treatments and discuss their potential incorporation into clinical practice.

Recent findings

Among alternative treatments for postpartum depression, we feel that there is a high level of support for psychosocial interventions targeting the women’s primary support network. The neuro-interventional treatments electroconvulsive therapy and repetitive transcranial magnetic stimulation have a moderate level of support. Treatments with a low level of supportive evidence include omega 3 fatty acid supplementation, vitamin D3 supplementation, exercise programs, parenting skills training, and bright light therapy.

Summary

Despite their popularity among this patient population, alternative treatments for postpartum depression other than primary psychosocial support lack a sufficient evidence base to recommend routine use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 Studies from 56 Countries. Front Psych. 2018;1:8.

    Google Scholar 

  2. Falana SD, Carrington JM. Postpartum depression: are you listening? Nurs Clin North Am. 2019;54(4):561–7.

    Article  PubMed  Google Scholar 

  3. Dadi AF, Miller ER, Mwarni L. Postnatal depression and its association with adverse infant health outcomes in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2020;20(1):416.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dias CC, Figueiredo B. Breastfeeding and depression: a systematic review of the literature. J Affect Disord. 2015;171:142–54.

    Article  PubMed  Google Scholar 

  5. Paulson JF, Dauber S, Leiferman JA. Individual and combined effects of postpartum depression in mothers and fathers on parenting behaviour. Pediatrics. 2006;118(2):659–68.

    Article  PubMed  Google Scholar 

  6. Do T, Hu Z, Otto J, Rohrbeck P. Depression and suicidality during the postpartum period after first deliveries, active component service women and dependent spouses, U.S. Armed Forces, 2007–2012. MSMR. 2013;20(9):2–7.

    PubMed  Google Scholar 

  7. Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279–81.

    Article  PubMed  Google Scholar 

  8. Luca DL, Garlow N, Staatz C, Margiotta C, Zivin K. Financial toll of untreated perinatal mood and anxiety disorders among 2017 births in the United States. Am J Public Health. 2020;110(6):888–93.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Smith MS, Lawrence V, Sadler E, Easter A. Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK. BMJ Open. 2019;9(1):e024803.

    Article  Google Scholar 

  10. Manso-Cordoba SM, Pickering S, Ortega MA, Asunsolo A, Romero D. Factors related to seeking help for postpartum depression: a secondary analysis of New York City PRAMS Data. Int J Environ Res Public Health. 2020;17(24):9328.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Dennis C, Chung-Lee L. Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth. 2006;33(4):323–31.

    Article  PubMed  Google Scholar 

  12. Thomson M, Sharma V. Between a rock-a-bye and a hard place: mood disorders during the peripartum period. CNS Spectr. 2017;22(S1):49–64. https://doi.org/10.1017/S1092852917000852.

    Article  PubMed  Google Scholar 

  13. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing; 2012. https://doi.org/10.1176/appi.books.9780890425596.

  14. Yonkers KA, Vigod S, Ross Le. Diagnosis, pathophysiology, and management of mood disorders in pregnant and postpartum women. Obstet Gynecol. 2011;117(4):961.

    Article  PubMed  Google Scholar 

  15. O’Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):3–12.

    Article  PubMed  Google Scholar 

  16. Schiller CE, Meltzer-Brody S, Rubinow DR. The role of reproductive hormones in postpartum depression. CNS Spectr. 2015;20(1):48–59.

    Article  PubMed  Google Scholar 

  17. Vigod SN, Brown HK, Huang A, Fung K, Barker LC, Hussain-Shamsy N, Weight E, Dennis C, Grigoriadis S, Gozdyra P, Corsi D, Walker M, Moineddin R. Postpartum mental illness during the COVID-19 pandemic: a population-based, repeated cross-sectional study. CMAJ. 2021;193(23):E835–43.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. SIGN 127 – Management of perinatal mood disorder: a national clinical guideline. Scottish Intercollegiate Guidelines Network. 2012. Available online: https://www.sign.ac.uk/assets/sign127_update.pdf. Accessed 1 Sept 2021

  19. Kennedy SH, Lam RW, McIntyre RS, Tourjman SV, Bhat V, Blier P, Hasnain M, Jollant F, Levitt AJ, MacQueen GM, McInerney SJ, McIntosh D, Milev RV, Müller DJ, Parikh SV, Pearson NL, Ravindran AV, Uher R. CANMAT depression work group. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical guidelines for the management of adults with major depressive disorder: section 3: pharmacological treatments. Can J Psychiatry. 2016;61(9):540–60.

  20. Weisskopf E, Fischer CJ, Bickle GM, Morisod HM, Tolsa JF, Claris O, Vial Y, Eap CB, Csajka C, Panchaud A. Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence. Expert Opin Drug Saf. 2015;14(3):413–27.

    Article  PubMed  CAS  Google Scholar 

  21. Appleby L, Warner R, Whitton A, Faragher B. A controlled study of fluoxetine and cognitive-behavioral counseling in the treatment of postnatal depression. BMJ. 1997;314:932–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Sie SD, Wennink JM, van Driel JJ, te Winkel AGW, Boer K, Casteelen G, van Weissenbrunch MM. Maternal use of SSRIs, SNRIs and NaSSAs: practical recommendations during pregnancy and lactation. Arch Dis Child Fetal Neonatal Ed. 2012;97(6):F472-476.

    Article  PubMed  CAS  Google Scholar 

  23. Misri S, Reebye P, Corral M, Milis L. The use of paroxetine and cognitive-behavioral therapy in postpartum depression and anxiety: a randomized controlled trial. J Clin Psychiatry. 2004;65(9):1236–41.

    Article  PubMed  CAS  Google Scholar 

  24. Cohen LS, Viguera AC, Bouffard SM, Nonacs RM, Morabito C, Collins MH, Ablon JS. Venlafaxine in the treatment of postpartum depression. J Clin Psychiatry. 2001;62(8):592–6.

    Article  PubMed  CAS  Google Scholar 

  25. Nonacs RM, Soares CN, Viguera AC, Pearson K, Poitras JR, Cohen LS. Bupropion SR for the treatment of postpartum depression: a pilot study. Int J Neuropsychopharmacol. 2005;8:445–9.

    Article  PubMed  CAS  Google Scholar 

  26. McAllister-Williams RH, Baldwin DS, Cantwell R, Easter A, Gilvarry E, Glover V, Green L, Gregoire A, Howard LM, Jones I, Khalifeh H, Lingford-Hughes A, McDonald E, Micali N, Pariante CM, Peters L, Roberts A, Smith NC, Taylor D, Wieck A, Yates LM, Young AH. British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum. J Psychopharmacol. 2017;31(5):519.

    Article  PubMed  Google Scholar 

  27. Thomson M, Sharma V. Therapeutics of postpartum depression. Expert Rev Neurother. 2017;17(5):495–507.

    Article  PubMed  CAS  Google Scholar 

  28. Sharma V, Sharma P. Postpartum depression: diagnostic and treatment issues. JOGC. 2012;9:436–42.

    Google Scholar 

  29. Stamou G, Carcia-Palacios A, Botella C. Cognitive-Behavioural therapy and interpersonal psychotherapy for the treatment of post-natal depression: a narrative review. BMC Psychol. 2018;6(1):28.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Dennis C, Grigoriadis S, Zupancic J, Kiss A, Ravitz P. Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: nationwide randomised controlled trial. Br J Psychiatry. 2020;216(4):189–96.

    Article  PubMed  Google Scholar 

  31. Lau Y, Htun TP, Wong SN, Tam WSW, Klainin-Yobas P. Therapist-support internet-based cognitive behavior therapy for stress, anxiety and depressive symptoms among postpartum women: a systematic review and meta-analysis. J Med Internet Res. 2017;19(4):e138.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Evans M, Donelle L, Hume-Loveland L. Social support and online postpartum depression discussion groups: a content analysis. Patient Educ Couns. 2012;87(3):405–10.

    Article  PubMed  Google Scholar 

  33. Duffecy J, Grekin R, Hinkel H, Gallivan N, Nelson G, O’Hara MW. A group-based online intervention to prevent postpartum depression (Sunnyside): feasibility randomized controlled trial. JMIR Ment Health. 2019;6(5):e10778.

    Article  PubMed  PubMed Central  Google Scholar 

  34. House TS, Alnajjar E, Mulekar M, Spiryda LB. Mommy meltdown: understanding racial differences between black and white women in attitudes about postpartum depression and treatment modalities. J Clin Gynecol Obstet. 2020;9(3):37–42.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Goodman JH. Women’s attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth. 2009;36(1):60–9.

    Article  PubMed  Google Scholar 

  36. Verkerk GJM, Denollet J, Van Heck GL, Van Son MJM, Pop VJM. Patient preference for counselling predicts postpartum depression: a prospective 1-year follow up study in high-risk women. J Affect Disord. 2004;83(1):43–8.

    Article  PubMed  Google Scholar 

  37. • Simhi M, Sarid O, Cwiek J. Preferences for mental health treatments for postpartum depression among new mothers. Isr J Health Policy Res. 2019;8(1):84. This article shows preferences in treatment options that have been expressed by perinatal women. A preference was seen for group interventions and individual psychotherapy despite the continuous emergence of new technology-based treatments.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lara MA, Navarrete L, Nieto L, Berenzon S. Acceptability and barriers to treatment for perinatal depression. An exploratory study in Mexican women. Salud Mental. 2014;37:293–301.

    Article  Google Scholar 

  39. Pearlstein TB, Zlotnick C, Battle CL, Stuart S, O’Hara MW, Price AB, Grause MA, Howard M. Patient choice of treatment for postpartum depression: a pilot study. Arch Womens Ment Health. 2006;9(6):303–8.

    Article  PubMed  CAS  Google Scholar 

  40. Appleton KM, Sallis HM, Perry R, Ness AR, Churchill R. Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev. 2021;11(11).

  41. Liao Y, Xie B, Zhang H, He Q, Guo L, Subramaniapillai M, Fan B, Lu C, Mclntyer RS. Efficacy of omega-3 PUFAs in depression: a meta-analysis. Transl Psychiatry. 2019;9(1):190. https://doi.org/10.1038/s41398-019-0515-5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  42. Mocking RJT, Steijn K, Roos C, Assies J, Bergink V, Ruhé HG, Schene AH. Omega-3 fatty acid supplementation for perinatal depression: a meta-analysis. J Clin Psychiatry. 2020;81(5):19r13106. https://doi.org/10.4088/JCP.19r13106.

    Article  PubMed  Google Scholar 

  43. • Zhang MM, Zou Y, Li SM, Wang L, Sun YH, Lu L, Bao UP, Li SX. The efficacy and safety of omega-3 fatty acids on depressive symptoms in perinatal women: a meta-analysis of randomized placebo-controlled trials. Transl Psychiatry. 2020;10:193. https://doi.org/10.1038/s41398-020-00886-3. This article is a recent meta-analysis showing support for the use of omega 3 fatty acids in the treatment of depression in non-perinatal populations.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  44. Amini S, Jafarirad S, Amani R. Postpartum depression and vitamin D: a systematic review. Crit Rev Food Sci Nutr. 2019;59(9):1514–20.

    Article  PubMed  CAS  Google Scholar 

  45. Vaziri F, Nasiri S, Tavana Z, Hosseindabbaghmanesh M, Sharif F, Jafari P. A randomized controlled trial of vitamin D supplementation on perinatal depression: In Iranian pregnant mothers. BMC Pregnancy Childbirth. 2016;16:239.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Amini S, Amani R, Jafarirad S, Cheraghian B, Sayyah M, Asghar Hemmati A. The effect of vitamin D and calcium supplementation on inflammatory biomarkers, estradiol levels and severity of symptoms in women with postpartum depression: a randomized double-blind clinic trial. Int. J. Nutr. Pharmacol. Neurol. Dis. (2020) 22–23.

  47. Corral M, Kuan A, Kostaras D. Bright light therapy’s effect on postpartum depression. Am J Psychiatry. 2000;157(2):303–4. https://doi.org/10.1176/appi.ajp.157.2.303-a.

    Article  PubMed  CAS  Google Scholar 

  48. Corral M, Wardrop AA, Zhang H, Grewal AK, Patton S. Morning light therapy for postpartum depression. Arch Womens Ment Health. 2007;10(5):221–4. https://doi.org/10.1007/s00737-007-0200-1.

    Article  PubMed  CAS  Google Scholar 

  49. Swanson LM, Burgess HJ, Zollars J, Arnedt JT. An open-label pilot study of a home wearable light therapy device for postpartum depression. Arch Womens Ment Health. 2018;21(5):583–6.

    Article  PubMed  PubMed Central  Google Scholar 

  50. •• Peng L, Fu C, Xiong F, Zhang Q, Liang Z, Chen L, He C, Wei Q. Effects of repetitive transcranial magnetic stimulation on depression symptoms and cognitive function in treating patients with postpartum depression: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res. 2020;290:113124. https://doi.org/10.1016/j.psychres.2020.113124. This recent systematic review and meta-analysis demonstrated support for rTMS in treatment postpartum depression with improvement of both depressive symptoms and cognition.

    Article  PubMed  Google Scholar 

  51. Gressier F, Rotenberg S, Cazas O, Hardy P. Postpartum electroconvulsive therapy: a systematic review and case report. Gen Hosp Psychiatry. 2015;37(4):310–4. https://doi.org/10.1016/j.genhosppsych.2015.04.009.

    Article  PubMed  Google Scholar 

  52. Rundgren S, Brus O, Båve U, Landén M, Lundberg J, Nordanskog P, Nordenskjöld A. Improvement of postpartum depression and psychosis after electroconvulsive therapy: a population-based study with a matched comparison group. J Affect Disord. 2018;1(235):258–64. https://doi.org/10.1016/j.jad.2018.04.043.

    Article  Google Scholar 

  53. Dennis CL, Dowswell T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev. 2013;28(2):CD001134. https://doi.org/10.1002/14651858.CD001134.pub3.

    Article  Google Scholar 

  54. Shorey S, Chee CYI, Ng ED, Lau Y, Dennis CL, Chan YH. Evaluation of a technology-based peer-support intervention program for preventing postnatal depression (part 1): randomized controlled trial. J Med Internet Res. 2019;21(8):e12410. https://doi.org/10.2196/12410.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Berkule SB, Cates CB, Dreyer BP, Huberman HS, Arevalo J, Burtchen N, Weisleder A, Mendelsohn AL. Reducing maternal depressive symptoms through promotion of parenting in pediatric primary care. 2014;53(5):460–9.

    Google Scholar 

  56. Heh SS, Huang LH, Ho SM, Fu YY, Wang LL. Effectiveness of an exercise support program in reducing the severity of postnatal depression in Taiwanese women. Birth. 2008;35(1):60–5. https://doi.org/10.1111/j.1523-536X.2007.00192.x.

    Article  PubMed  Google Scholar 

  57. Armstrong K, Edwards H. The effects of exercise and social support on mothers reporting depressive symptoms: a pilot randomized controlled trial. Int J Ment Health Nurs. 2003;12(2):130–8. https://doi.org/10.1046/j.1440-0979.2003.00229.x.

    Article  PubMed  Google Scholar 

  58. Poyatos-Leon RP, Garcia-Hermoso A, Sanabria-Martinez G, Alarez-Bueno C, Cavero-Redondo I, Martinez-Vizcaino C. Effects of exercise-based interventions on postpartum depression: a meta-analysis of randomized controlled trials. Birth. 2017;44(3):200–8.

    Article  PubMed  Google Scholar 

  59. Coll CVN, Domingues MR, Stein A, da Silva BGC, Bassani DG, Hartwig FP, da Silva ICM, da Silveira MF, da Silva SG, Bertoldi AD. Efficacy of regular exercise during pregnancy on the prevention of postpartum depression: the PAMELA randomized clinical trial. JAMA Netw Open. 2019;2(1):e186861. https://doi.org/10.1001/jamanetworkopen.2018.6861.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Özkan SA, Kücükkelepce DS, Korkmaz B, Yılmaz G, Bozkurt MA. The effectiveness of an exercise intervention in reducing the severity of postpartum depression: a randomized controlled trial. Perspect Psychiatr Care. 2020;56(4):844–50. https://doi.org/10.1111/ppc.12500.

    Article  PubMed  Google Scholar 

  61. Pritchett RV, Daley AJ, Jolly K. Does aerobic exercise reduce postpartum depression symptoms? A systematic review and meta-analysis. Br J Gen Pract. 2017;67(663):e684–91.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Murphy RA, Devarshi PP, Ekimura E, Marshall K, Mitmesser SH. Long-chain omega-3 fatty acid serum concentrations across life stages in the USA: an analysis of NHANES2011-2012. BMJ Open. 2021;11(5):e043301.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Abdelamid AA, Brown TJ, Brainard JS, Biswas P, Thrope GC, Moore HJM, Deane KH, AlAbdulghafoor FK, Summerbell CD, Worthington HV, Song F, Hooper L. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2018;7(7):CD003177.

    Google Scholar 

  64. Koletzko B, Lien E, Agostoni C, Böhles H, Campoy C, Cetin I, Decsi T, Dudenhausen JW, Dupont C, Forsyth S, Hoesli I, Holzgreve W, Lapillonne A, Putet G, Secher NJ, Symonds M, Szajewska H, Willatts P, Uauy R, World Association of Perinatal Medicine Dietary Guidelines Working Group. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008;36(1):5–14. https://doi.org/10.1515/JPM.2008.001.

    Article  PubMed  CAS  Google Scholar 

  65. Starling P, Charlton K, McMahon AT, Lucas C. Fish intake during pregnancy and foetal neurodevelopment – a systematic review of the evidence. Nutrients. 2015;7(3):2001–14.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  66. Logan AC. Omega-3 fatty acids and major depression: a primer for the mental health professional. Lipids Health Dis. 2004;3:25.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Mazereeuw G, Herrman N, Andreazza AC, Scola G, Ma DWL, Oh P, Lanctot KL. Oxidative stress predicts depressive symptom changes with omega-3 fatty acid treatment in coronary artery disease patients. Bran Behav Immun. 2017;2:136–41.

    Article  Google Scholar 

  68. Campbell PD, Miller AM, Woesner ME. Bright light therapy: seasonal affective disorder and beyond. Einstein J Biol Med. 2017;32:E13–25.

    PubMed  PubMed Central  Google Scholar 

  69. Benedetti F. Rate of switch from bipolar depression into mania after morning light therapy: a historical review. Psychiatry Res. 2018;261:351–6. https://doi.org/10.1016/j.psychres.2018.01.013.

    Article  PubMed  Google Scholar 

  70. Bais B, Kamperman AM, van der Zwaag MD, Dieleman GC, Harmsen van der Vliet-Torij HW, Bijma HH, Lieverse R, Hoogendijk WJ, Lambregtse-van den Berg MP. Bright light therapy in pregnant women with major depressive disorder: study protocol for a randomized, double-blind, controlled clinical trial. BMC Psychiatry. 2016;16(1):381. https://doi.org/10.1186/s12888-016-1092-2.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  71. Obeysekare JL, Cohen ZL, Coles ME, Pearlstein TB, Monzon C, Flynn EE, Sharkey KM. Delayed sleep timing and circadian rhythms in pregnancy and transdiagnostic symptoms associated with postpartum depression. Transl Psychiatry. 2020;10(1):14. https://doi.org/10.1038/s41398-020-0683-3.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Berlim MT, Van den Eynde F, Daskalakis ZJ. Efficacy and acceptability of high frequency repetitive transcranial magnetic stimulation (rTMS) versus electroconvulsive therapy (ECT) for major depression: a systematic review and meta-analysis of randomized trials. Depress Anxiety. 2013;30(7):614–23. https://doi.org/10.1002/da.22060.

    Article  PubMed  Google Scholar 

  73. Peng Z, Zhou C, Xue S, Bai J, Yu S, Li X, Wang H, Tan Q. Mechanism of repetitive transcranial magnetic stimulation for depression. Shanghai Arch Psychiatry. 2018;30(2):84–92.

    PubMed  PubMed Central  CAS  Google Scholar 

  74. George MS, Post RM. Daily left prefrontal repetitive transcranial magnetic stimulation for acute treatment of medication-resistant depression. Am J Psychiatry. 2011;168(4):356–84.

    Article  PubMed  Google Scholar 

  75. Brunoni AR, Chaimani A, Moffa AH, Razza LB, Gattaz WF, Daskalakis JD, Carvalho AF. Repetitive transcranial magnetic stimulation for acute treatment of major depressive episodes: a systematic review with network meta-analysis. JAMA Psychiatry. 2017;74:143–52.

    Article  PubMed  Google Scholar 

  76. Kellner CH, Greenberg RM, Murrough JW, Bryson EO, Briggs MC, Pasculli RM. ECT in treatment-resistant depression. Am J Psychiatry. 2012;169(12):1238–44.

    Article  PubMed  Google Scholar 

  77. Rudorfer MV, Risby ED, Hsiao JK, Linnoila M, Potter WZ. Disparate biochemical actions of electroconvulsive therapy and antidepressant drugs. Consuls Ther. 1988;4(2):133–40.

    Google Scholar 

  78. Ota M, Noda T, Sato N, Okazaki M, Ishikawa M, Hattori K, Hori H, Sasayama D, Teraishi T, Sone D, Kunugi H. Effect of electroconvulsive therapy on gray matter volume in major depressive disorder. J Affect Disord. 2015;186:186–91.

    Article  PubMed  Google Scholar 

  79. Bergink V, Rasgon N, Wisner KL. Postpartum psychosis: madness, mania, and melancholia in motherhood. Am J Psychiatry. 2016;173(12):1179–88. https://doi.org/10.1176/appi.ajp.2016.16040454.

    Article  PubMed  Google Scholar 

  80. Chaudron LH, Pies PW. The relationship between postpartum psychosis and bipolar disorder: a review. J Clin Psychiatry. 2003;64(11):1284–92.

    Article  PubMed  Google Scholar 

  81. Brockington IF, Marginson FR, Schofield E. The clinical picture of the depressed form of puerperal psychosis. J Affec Disord. 1998;15(1):29–37.

    Article  Google Scholar 

  82. Munk-Olsen T, Laursen TM, Meltzer-Brody S, Mortensen PB, Jones I. Psychiatry disorders with postpartum onset: possible early manifestations of bipolar affective disorders. Arch Gen Psychiatry. 2012;69(4):428–34.

    Article  PubMed  Google Scholar 

  83. Griffiths C, O’Neill-Kerr A. Patients’, carers’, and the public’s perspectives on electroconvulsive therapy. Front Psychiatry. 2019;10:304.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Kaster TS, Vigod SN, Homes T, Sutradhar R, Wijeysundera DN, Blumberger DM. Risk of serious medical events in patients with depression treated with electroconvulsive therapy: a propensity score-matched, retrospective cohort study. Lancet Psychiatry. 2021;8(8):686.

    Article  PubMed  Google Scholar 

  85. Torring N, Sanghani SN, Petrides G, Kellner CH, Ostergaard SD. The mortality rate of electroconvulsive therapy: a systematic review and pooled analysis. Acta Psychiatr Scand. 2017;135(5):388.

    Article  PubMed  CAS  Google Scholar 

  86. Gan Y, Xiong R, Song J, Xiong X, Yu F, Gao W, Hu H, Zhang J, Tian Y, Gu X, Zhang J, Chen D. The effect of perceived social support during early pregnancy on depressive symptoms at 6 weeks postpartum: a prospective study. BMC Psychiatry. 2019;19(1):232. https://doi.org/10.1186/s12888-019-2188-2.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Kim TH, Connolly JA, Tamim H. The effect of social support around pregnancy on postpartum depression among Canadian teen mothers and adult mothers in the maternity experiences survey. BMC Pregnancy Childbirth. 2014;14:162.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Heh S. Relationship between social support and postnatal depression. Kaohsiung J Med Sci. 2003;19(10):491–6.

    Article  PubMed  Google Scholar 

  89. Cankorur VS, Abas M, Berksun O, Stewart R. Social support and the incidence and persistence of depression between antenatal and postnatal examinations in Turkey: a cohort study. BMJ Open. 2015;5(40):e006456.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Nakamura A, Melchior M, Waerden J. Social inequalities of postpartum depression: the mediating role of social support during pregnancy. Eur J Public Health. (2019) 29(4).

  91. Nakamura A, Lesueur FE, Sutter-Dally A, Franck J, Thierry X, Melchior M, Waerden J. The role of prenatal social support in social inequalities with regard to maternal postpartum depression according to migrant status. J Affect Disord. 2020;272:465–73.

    Article  PubMed  Google Scholar 

  92. Craighead EW, Johnson BN, Carey S, Dunlop BW. Psychosocial treatments for major depressive disorder. In A guide to treatments that work. Nathan PE, Gorman JM. Oxford University Press: 381–408.

  93. Dennis CL. The effect of peer support on postpartum depression: a randomized controlled trial. Can J Psychiatry. 2003;48(2):115–24.

    Article  PubMed  Google Scholar 

  94. Szuhany KL, Otto MW. Efficacy evaluation of exercise as an augmentation strategy to brief behavioural activation treatment for depression: a randomized pilot trial. Cogn Behav Ther. 2020;49(3):228–41.

    Article  PubMed  Google Scholar 

  95. Danielsson L, Kihlbom B, Rosberg S. “Crawling Out of the Cocoon”: patient’s experiences of a physical therapy exercise Intervention in the treatment of major depression. Phys Ther. 2016;96(8):1241–50.

    Article  PubMed  Google Scholar 

  96. Kolomanska-Bogucka D, Mazur-Bialy AI. Physical activity and the occurrence of postnatal depression – a systematic review. Medicina (Kaunas). 2019;55(9):560.

    Article  PubMed  Google Scholar 

  97. Ghaedrahmati M, Kazemi A, Kheirabadi, Ebrahimi A, Bahrami M. Postpartum depression risk factors: a narrative review. J Educ Health Promot. (2017);6(60).

  98. Qi W, Zhao F, Liu Y, Hu J. Psychosocial risk factors for postpartum depression in Chinese women: a meta-analysis. BMC Pregnancy Childbirth. 2021;21(1):174.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Pawluski JL, Lonstein JS, Fleming AS. The neurobiological of postpartum anxiety and depression. Trend Neurosci. 2017;40(2):106–20.

    Article  PubMed  CAS  Google Scholar 

  100. Sit D, Seltman H, Wisner KL. Seasonal effects on depression risk and suicidal symptoms in postpartum women. Depress Anxiety. 2011;28(5):400–5. https://doi.org/10.1002/da.20807.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Goyal D, Gay C, Torres R, Lee K. Shortening day length: a potential risk factor for perinatal depression. J Behav Med. 2018;41(5):690–702.

    Article  PubMed  Google Scholar 

  102. Guintivano J, Putnam KT, Sullivan PF, Meltzer-Brody S. The international postpartum depression: action towards causes and treatment (PACT) consortium. Int Rev Psychiatry. 2019;31(3):229–36.

    Article  PubMed  Google Scholar 

  103. Yim IS, Stapleton LRT, Guardino CM, Hahn-Holbrook J, Schetter CD. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol. 2015;11:99–137.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Dr. Dwight Mazmanian for reviewing their manuscript.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Western University, London, Canada

    Michael Thomson MD & Verinder Sharma MD

  2. Department of Obstetrics and Gynecology, Western University, London, Canada

    Verinder Sharma MD

Authors
  1. Michael Thomson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Verinder Sharma MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Thomson MD.

Ethics declarations

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thomson, M., Sharma, V. Alternative Treatments for Postpartum Depression. Curr Treat Options Psych 10, 288–312 (2023). https://doi.org/10.1007/s40501-023-00295-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40501-023-00295-5

Keywords

Search

Navigation