It is not uncommon for new mothers to have a period of depression or anxiety after the birth of their Mother baby heartchild, generally referred to as the “baby blues.”  This can include disruption in sleep, increase in anxiety, mood swings, crying, etc.  In about 15% of cases, these symptoms become long-lasting and more severe, turning into what is clinically referred to as postpartum depression.

In postpartum depression, women have more severe depression and mood swings.  There can be difficulty bonding with the baby.  Mothers can have other classic signs of depression such as withdrawing from family and friends, loss of appetite, and increased insomnia—although sometimes they may sleep too much, often accompanied with significant fatigue or loss of energy.  Anxiety can increase as well, and at times, women can have a sense of hopelessness.  If it persists, mothers can develop thoughts of harming themselves or their child, and they may have recurring thoughts of death or suicide.  Left untreated, postpartum depression can last for a long period of time.

 

Studies at Harvard have identified five subtypes of postpartum depression.  Subtype 1 involves a severe anxious depression which often emerges in the first trimester of pregnancy.  Subtype 2 is described as moderate anxious depression, like subtype 1 but less pronounced.  Subtype 3 is described as anxious anhedonia, which means the patient is not only anxious, but they find that activities that used to bring them pleasure no longer do so.  Subtype 4 is described as pure anhedonia, and at this time patients can have self-harm or suicidal thoughts.  Subtype 5 is a resolved depression in which symptoms occur during the time surrounding pregnancy but resolve by the time of the postpartum evaluation.

 

Historically, electroconvulsive therapy (ECT) had been the default treatment when medications did not work.  85% of post-pregnant women experience some type of mood disturbance, and more than 400,000 infants are born each year to mothers who are depressed.  Postpartum depression generally develops within the first four months following delivery, but can occur anytime during the first year.

  • Zulresso (Brexanolone) is the first and only FDA-approved treatment for postpartum depression.
  • Zulresso is given by continuous intravenous (IV) infusion into the patient’s vein.
  • A Zulresso infusion lasts a total of 60 hours (2.5 days) at a cost $34,000. 

 

TMS and Postpartum Depression

TMS can be the treatment of choice for most mothers suffering from postpartum depression, especially if they wish to continue breast feeding.  

  • Because TMS works with magnetic pulses traveling about 3 cm into the brain, there is nothing systemic traveling through the blood stream and being ingested by nursing babies.  
  • Additionally, there are no concerns about a drug-drug interaction.  
  • Mothers who want to nurse their children can do so throughout treatment with no concerns.

Struggling with depression. Looking for a drug-free alternative? Speak with a Patient Advocate and find out if TMS Therapy can help!

 

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Topics: Postpartum Depression, TMS Therapy Treatment

Robert A. Sammons, Jr., M.D., Ph.D.

Written by Robert A. Sammons, Jr., M.D., Ph.D.

Dr. Bob Sammons received a bachelor's and master's degree from Auburn University, a PhD in clinical psychology from the University of North Carolina at Greensboro, and a medical degree from the University of North Carolina at Chapel Hill. He did a residency in psychiatry at the University of Virginia as well as a forensic psychiatry fellowship. While a Captain in the Air Force he helped set up and run the treatment phase of the Air Force Drug Treatment program in 1971. He has practiced adult psychiatry in Grand Junction for 29 years. He received training in TMS in 2006 from Dr. Alvaro Pascual-Leone, from Dr. Mark George in 2017 and returned to Harvard for Dr. Pascual-Leone's intensive course in TMS in 2018. He is Medical Director for TMS Solutions with TMS offices in various locations in the West. He has been known to cook a little BBQ.