Postpartum Depression Therapy: Benefits, Types, What to Expect, & More

Postpartum depression is a common mental health disorder affecting parents of newborns. Around 1 in 7 women will develop postpartum depression (PPD). Dads and adoptive parents can also experience symptoms.

There are several factors thought to contribute to the development of PPD, including hormone fluctuations, family history, inadequate social support, prior mental health issues, and life stressors.

While the baby blues consist of mild emotional discomfort such as frequent crying and fatigue, PPD symptoms are more intense and pervasive. A few symptoms indicative of PPD include high irritability, feeling hopeless, and major mood swings.

Treatment for postpartum depression typically begins with a medical evaluation to rule out other possibilities for the reported symptoms. Sometimes a doctor will prescribe an antidepressant that is safe to use while breastfeeding. Other recommendations for treatment may include psychotherapy, group support, an exercise program, or childcare respite.

Read on to find out how a postpartum mental health therapist can help with postpartum depression, what to expect at your appointments, how to find the right therapist, and more.

Postpartum mood disorders mental health therapists can help with

The Cleveland Clinic defines a mood disorder as a mental health condition in which your emotional experience is not consistent with your circumstances, and these emotions negatively impact your ability to function.

Mood disorders are highly treatable. The combination of medication and talk therapy results in the most successful outcome.

Common postpartum mood disorders include baby blues, postpartum depression, postpartum anxiety, and postpartum rage. Let’s take a closer look at each of them:

Baby Blues

The baby blues can occur shortly after the birth of a baby and involves crying, sadness, mood swings, and fatigue. These symptoms though uncomfortable, feel manageable and fleeting.

Baby blues affects up to 80% of moms and symptoms can last up to two weeks. If symptoms persist after this time, this may indicate a more challenging mood disorder like postpartum depression.

Postpartum Depression

Postpartum depression is a common complication of childbirth and those experiencing PPD should not feel ashamed or embarrassed of a condition outside of their control.

According to the Mayo Clinic, symptoms of PPD include:  

• Excessive crying
• Fluctuating moods
• Feeling anxious or irritable
• Feeling overwhelmed, hopeless and sad
• Withdrawing from friends and family
• Feeling foggy-headed
• Feeling self-loathsome
• Losing interest or pleasure in activities you used to enjoy
• Sleeping too little or too much
• Having thoughts of harming the baby or yourself
• Lacking energy and motivation
• Significant appetite changes, eating too little or too much (learn more about postpartum loss of appetite here)
• Difficulty bonding with your baby

Moms experiencing PPD often feel out-of-control, ashamed, fearful, overwhelmed, and often struggle to find help because of the stigmatization of it. While postpartum depression usually peaks around 2 to 4 weeks after delivery, it can last a while if left untreated, therefore it’s imperative to seek support as soon as possible.

>> Read More: Postpartum Depression vs. Baby Blues

Postpartum Anxiety

Postpartum anxiety is less often discussed than its counterpart, PPD. Postpartum anxiety can manifest as irritability, trouble sleeping, racing thoughts, heart palpitations, feeling out of control, and difficulty connecting with your baby.

About postpartum anxiety treatments available—including both therapy and medication—that can help.

Postpartum Rage

It is reported that about 31% of moms feel intense anger shortly after the birth of a baby. Since our society tends to stigmatize angry women, many moms won’t report their postpartum anger and inevitably, don’t receive the treatment they deserve.

Symptoms of postpartum rage include throwing things, yelling, swearing, violent thoughts, intense irritability, misdirecting anger onto others, and difficulty bonding with the baby.

Treating Postpartum Depression and Anxiety With Therapy

There are many different treatment options for those experiencing postpartum or postpartum anxiety.

Within the context of psychotherapy, there are a variety of therapeutic interventions known to be successful in treating these challenging symptoms.

If childcare or scheduling is difficult, consider online therapy, as its success rate is comparable to in-person therapy.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) has been shown to be a very effective form of treatment for postpartum depression and anxiety.

The core tenet of CBT is that the client’s thoughts and beliefs directly affect their behavior.

In order to produce positive change, the therapist and the client must address these thoughts and beliefs, examine their usefulness, and substitute maladaptive thoughts and beliefs, with healthier concepts—leading to improved behavior and emotional state.

Interpersonal Psychotherapy

Interpersonal psychotherapy is a directive form of talk therapy, with treatment typically lasting 12 weeks.

This type of therapy places a heavy focus on relationships and how they contribute to or alleviate depressive symptoms in the client.

There are four main issues interpersonal psychotherapy focuses on:

1. Interpersonal deficits, such as social isolation or conflict-riddled relationships are addressed. The goal is to improve relationships and build a strong support system.
2. Grief is examined, whether past or present. Grief can include the loss of identity as a new mother.
3. Life transitions are discussed and involve investigating the impact of these transitions. The loss of independence is a common life transition among new moms.
4. Interpersonal disputes resulting from unmet or conflicting expectations of others are discussed. Often, mothers report feeling as though they need more help from their partner, which can cause conflict if the moms don’t receive the support they need.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is based on Cognitive Behavioral Therapy principles but is adapted and designed to support clients with more intense emotions, such as those living with Borderline Personality Disorder.

DBT is another effective form of treatment for PPD. DBT focuses on teaching clients important skills in the following four areas:

1. Emotional regulation
2. Distress tolerance
3. Mindfulness
4. Interpersonal effectiveness

Psychodynamic Psychotherapy

Psychodynamic psychotherapy is one of the oldest forms of therapy, originally based on Sigmund Freud’s theory that our past relationships and experiences have a direct impact on how we feel and act presently.

For moms experiencing postpartum depression or anxiety, a psychodynamic therapist would review the client’s history to help inform them of how the past is affecting the mom currently. Together they would work towards healing the past in order to live more fully in the present.

Eye Movement Desensitization Reprocessing (EMDR)

EMDR is a well-researched methodology for treating trauma and has a high success rate for those living with Post Traumatic Stress Disorder (PSTD). Many moms experience their birth as traumatic, especially those who experienced complications.

A therapy session utilizing EMDR would include having the client think of a traumatic experience or a challenging situation during a bilateral stimulation process. Bilateral stimulation includes stimulating the left and the right side of the brain through eye movement, bilateral sound, or tactile stimulation.

As the client does this, the trauma or negative experience is “digested” in a way that no longer elicits an intense emotional response.

Solution-Focused Brief Psychotherapy

Solution-focused brief therapy highlights the client’s strengths and looks to empower the client to develop solutions for solving their problems.

Solution-focused therapy tends to be brief, from 6 to 12 weeks of treatment.

For new moms, this type of therapy might focus on creating a stronger support network and developing better self-care practices.

Nondirective Counseling

Nondirective counseling is based on the work of psychologist Dr. Carl Rogers and is often misunderstood.

Dr. Rogers believed clients are the experts in their own lives and the client is better served by creating their own path forward, rather than relying on the advice of a therapist. He believed if a client feels understood in a non-judgmental way, the client can process their feelings and produce healthy solutions to their problems.

For new moms, having a safe space to discuss their emotions is imperative. Nondirective counseling would validate their experiences as a mom, and as they felt more accepted and understood, they would then be able to reflect on their lives more clearly with better solutions in mind. 

Group Therapy

Group therapy is another successful form of treatment for postpartum depression and anxiety, and it can also help to create a support system for moms.

Group therapy typically consists of a lead therapist and a co-leader therapist. Everyone in the group has a unifying issue, such as postpartum depression.

Clients feel supported by the fact they are not alone, and often feel very validated and supported by this type of treatment.

What to Expect in Postpartum Mental Health Therapy

The most important thing to know about seeking therapy for postpartum depression is that therapists are non-judgmental and want to help. It may sound overly simplistic, but many moms avoid seeking treatment for fear of being seen as a bad mom who can’t cope.

I can confidently assure you, if you seek a licensed and seasoned therapist experienced with treating PPD, you will be treated with dignity, respect, and understanding, and you will feel empowered to resolve your symptoms.

Often diagnosis for PPD begins with a medical exam, as physicians want to rule out other possibilities for depression and anxiety.

Though talk therapy is a successful form of treatment regardless of the modality used, prescription medication might also be indicated. Take comfort in knowing there is safe medication to use while breastfeeding and that medication use is often temporary.

Treatment length will depend on the type of therapy used and the specific circumstances of the client. Therapists will often inquire about your family of origin, current relationships, any prior experiences with depression or anxiety, and the strength of your current support system and assess the strengths and weaknesses of your current life situation.

You will then talk through these issues, your feelings, and other things to work towards more constructive thoughts and ultimately relief from your symptoms.

How to Find a Postpartum Depression Therapist

After living through the COVID-19 pandemic, mental health care has become less stigmatized and highly valued.

If you know of someone who has sought therapy and had a good experience, reach out and ask for their therapist’s contact information. If you are not comfortable asking for a therapist within your social circle, your primary doctor or OBGYN would know appropriate referrals.

If you are seeking treatment online, oftentimes, the therapist’s bio is listed and this will help you understand their background, credentials, and experience with PPD.

However you conduct your therapist search, it is always important to confirm their licensure, their credentials, and their experience with PPD. You want to make sure they are legally qualified to help you and that they have the experience necessary to be helpful.

For instance, you would not want to work with a licensed marriage and family therapist (LMFT) if their only experience is working with children.

Here are some ways to find postpartum depression therapists:

• American Psychological Association Locator is an online tool to help you find a licensed therapist in your area. The search tool is not very sensitive in terms of deciphering therapists’ specialization areas, however, they do provide a direct email and phone number, so you can contact the therapist directly and inquire about their experience.
• American Psychiatric Association offers an online search tool to help you locate a licensed psychiatrist in your area. Psychiatrists prescribe and manage medication and are covered by most insurance plans.
• Society of Clinical Psychology is a website intended to help you understand a specific treatment, the research behind the treatment, and resources related to the treatment. Resources include videos, articles, and more.
• National Association of Social Workers is a membership organization intended to enhance the professional growth of social workers and help maintain professional standards. Though they do not provide a list of social workers, a therapist might list this organization on their bio, indicating professionalism and a commitment to continuing education.
• Open Path Psychotherapy Collective is a non-profit nationwide network of mental health professionals who provide online and in-person treatment at a significantly reduced rate to clients in need. You can search for your therapist by location, specialty, cost of treatment, and more.
• Online Therapy is a good option for busy moms who may not have time to attend an in-person appointment. Some options include:
  • Brightside Health is an online therapy platform that can prescribe and manage medication as well as provide talk therapy. Brightside also accepts many major insurance plans.
  • Amwell is another online therapy platform that accepts many major insurance carriers. Amwell also provides medication prescriptions and management, as well as talk therapy.
  • Talkspace is an online therapy platform specializing in various talk-therapy modalities. They do not provide medication. There are several ways in which to engage in sessions with a therapist, including texting, live video chat, live messaging, and over the phone.

Tips for Choosing a Postpartum Mental Health Therapist

Once you come up with a list of a few potential postpartum depression therapists, it’s important to determine the best fit for you and your needs.

Many therapists offer a brief consultation that lasts 15 to 30 minutes. All therapists should offer a free consultation, regardless of their status, as it is important for the client to feel they have some sense of the person they are about to begin treatment with.

Other things to consider when choosing a postpartum mental health therapist include:

• Are they licensed or are they an intern acquiring hours for licensure?
• What do they charge per session?
• Do they accept insurance or payment from a Health Savings Account (HSA)?
• What is their availability?
• Is there a waitlist prior to being seen?
• Do you feel comfortable talking to them during the consultation?
• What is their specialty?
• What type of therapy do they perform?
• What is their experience treating postpartum depression or anxiety?

Other Suggestions and Resources for Dealing with PPD and Anxiety

In addition to therapeutic treatment, other forms of support are valuable in helping mothers cope, including:

• Joining a support group for PPD has been shown to be very helpful in reducing symptoms in moms. Postpartum Support International offers online support groups and helps people locate support in their area. Smart Patients Postpartum Community also offers online support groups and other resources.
• Self-care is a very important component in alleviating symptoms. Self-care can include something as simple as taking a nap to treating yourself to a professional massage.
• Exercise is very effective in elevating mood. There are many exercise programs that include bringing your newborn, such as fit4mom, so you don’t have to worry about childcare.
• Eating nutritious foods is just as important for mental health as it is for physical wellness. Learn more about what a healthy postpartum diet looks like here.
• Getting outside into the sunshine and fresh air can work wonders for improving your mood.
• Writing in a journal has been proven to boost mood and improve immune functioning according to the American Psychological Association.

What Expert Lily McWilliam, MSW, LCSW Has to Say

Lily McWilliam, MSW, LCSW is a licensed clinical social worker with a Master’s Degree in Social Work. Lily specializes in providing talk therapy, CBT, DBT, mindfulness, and psychodynamic services. 

Q: What type of therapy is best for postpartum mood disorders?

As potential clients might find in many therapist’s bios, therapists typically wait to determine the best use of therapeutic approaches once they begin to meet with the client, and although therapists typically may specialize in their work and therapeutic approaches, commonly their work will really vary in terms of what is most appropriate for the client’s clinical needs and symptomology. It is important to note that as a client, you should never feel you have to adapt to a therapist’s expectations or expertise if you feel it is not helping your clinical needs.

The two evidenced-based therapeutic approaches most commonly used for individual treatment of Perinatal Mood Disorders include CBT (Cognitive Behavioral Therapy) and IPT (Interpersonal Psychotherapy).

IPT is noted to be the most effective treatment for Perinatal Depression and focuses on the relationship between interpersonal and life events with mood and is structured around 3 main pillars: grief, role transitions, and interpersonal disputes. IPT is the most “time-limited” therapeutic approach and is usually completed in 12-16 weeks. A central theme of IPT in treating Perinatal Depression is looking at how a client’s role and identity as a mother is impacted and supported by interpersonal relationships/communication, here-and-now relationships, and may explore the ways in which grief and loss may be experienced in this new or ongoing role.

CBT focuses on helping perinatal clients cope and shift/restructure their thoughts and incorporates practices including relaxation techniques (such as mindfulness, grounding, etc), psychoeducation, cognitive restructuring (working on your thought patterns), and desensitization/exposure (this, in particular, requires specific skill set and experience). CBT can be used in a range of disorders, but you may more commonly hear of its use for treating Anxiety based disorders such as Perinatal Anxiety (constant fear and panic) or Perinatal OCD (intrusive and repetitive thoughts). 

An additional therapeutic modality that therapists might use to help clients cope with their symptoms of Perinatal Mood and Anxiety disorders includes DBT (Dialectical behavioral therapy) which supports clients in identifying and learning to cope and regulate their emotions and feelings.

Postpartum Support International (PSI) also recognizes peer support groups, group therapy, mother-infant therapy, and education and partner-assisted therapy as additional evidenced-based therapies for perinatal clients.

Many clients may find it overwhelming to know which modalities or approaches may suit them best, especially if they’ve not been to therapy before. While each type of modality has a specific purpose, it’s most important as the client that you feel safe and comfortable with your therapist, to feel heard, and to ask questions and schedule a consultation (if offered) to get to know them better!

While you want a therapist that is versed and experienced in their treatment modalities, if a client does not feel comfortable or safe with their therapist, the modalities and approaches used will become insignificant.

Q: How long should someone struggling with postpartum depression and/or anxiety see a therapist for?

Perinatal Mood and Anxiety disorders can be first diagnosed up to a year or sometime later postpartum. I believe that someone should be in therapy for Perinatal Mood Disorders, or any mental health diagnosis/concern, as long as they are needing, wanting, and can afford to be in therapy.

The duration of therapy really depends on what the client enters therapy for and how their symptoms persist. However, to offer some insight into the general structure of therapy, the standard setup of therapy is 45 minutes once per week. Just like with MDD (Major Depressive Disorder) or the cluster of Anxiety Disorders, Postpartum Depression and Anxiety similarly can present with different levels of severity, duration, and symptomology and, therefore, it is really up to the clinician and client to establish a plan and remain in communication regarding progress and therapeutic needs.

It’s important to note that therapeutic modalities like IPT (Interpersonal Psychotherapy) can be more time-specific (such as 12-16 weeks) and, depending on the therapist’s experience and specialties, treatment may stop there. However, in my work with expectant and postpartum moms, many moms present to therapy to address their imminent symptoms due to Perinatal Mood and Anxiety disorders but find that separate from these specific set of symptoms ad concerns, there is more from their life they are wanting to work on and therefore choose to stay in therapy longer.

Some moms come to the realization that they were perhaps struggling with a subset of mental health concerns prior to their perinatal journey and perhaps even lived a life with an undiagnosed disorder and feel they need or want the support for the foreseeable future. 

As therapists, it’s important to frequently check in with clients about how they are feeling in the therapeutic process and it is especially important to check in with clients when there is notable progress to reassess needs and goals.

As clients, it’s important to notice if you ever feel forced into staying in therapy or if you feel you have become stagnant in your progress. While the hope is to feel comfortable and safe to bring such concerns forth to your therapist, it’s not uncommon to also feel nervous and unsure of how to suggest feelings of stagnation/not a good clinical fit or that perhaps you feel you have reached your therapeutic goals and would like to terminate.

While it may be uncharted territory, try to keep in mind that more often than not, your therapist will have had experience with such thoughts/feelings and would welcome the opportunity to address such concerns. And for clients that choose to terminate therapy due to completion or other reasons, it is important to know that there will always be therapists and it is okay to come back at any point.

If you have a history of attending therapy, it is also important to consider re-establishing therapy when you are planning on or trying to conceive and if you have a history of experiencing Perinatal Mood and Anxiety Disorders or a history of mental health concerns it is also important to also establish or re-establish care.

Therapy does not have to be permanent, and breaks are allowed. You are allowed to change therapists and try to always remember that it’s not about the time you didn’t spend in therapy but the fact you made it to or back to a therapist.