postpartum depression treatmentWhile doing my daily required reading of articles, blog posts, tweets and other assorted media across the web about postpartum depression and related illnesses, I came across a question a while back posted on Mamapedia by a mom with postpartum anxiety. She was looking for advice on natural treatments because she didn’t want to take the Prozac prescribed by her doctor.

She received 22 answers by other mothers, many warning vehemently against taking any medication for postpartum depression or anxiety. These are some of the things she was told by the moms:

For many people, postpartum anxiety is caused by a deficiency of omega-3s and a lack of coping mechanisms. Read the book Feeling Good and take omega-3s.

Acupuncture works.

If he is suggesting serotonin imbalance, then speak to your herbologist again. Don’t go on medication! You have to take too much time to wean off. There are many things that will help the levels naturally

If you don’t want to take Prozac, then ask for something less dramatic. (something less dramatic? huh?)

I highly recommend contacting Dr. ____who is truly an amazing Chiropractor and Nutritionist and would definitely be able to help you naturally.

Please don’t settle for drugs that will be only partially successful in masking your issue and give you the side-effects galore. There are so many safe and effective homeopathic remedies.

I don’t know the mom who posed the question. I don’t know if her postpartum anxiety is mild or severe. I don’t know whether she has a history of mental illness. I don’t know if she’s had suicidal thoughts. I don’t know if she’s taken antidepressant medication before and it didn’t work or caused unacceptable side effects for her. I don’t know if she’s tried therapy. All I know is that she has received advice from people with no medical training, some of whom have a bias against medication but claim to know what will work to fix her postpartum anxiety.

To be sure, there were women who responded to the Mamapedia question who I felt had some good suggestions, including reaching out to other moms for support, getting your thyroid checked and getting adequate sleep, nutritionand exercise. Medicine is not the only answer for postpartum depression, and it’s not the answer for every person. But that doesn’t mean it’s evil incarnate, and that going to your “herbologist” is the right answer for people with moderate to severe postpartum depression and related illnesses.

I see this all the time. Natural is better, right? Sometimes, yes. Sometimes, no. It’s not just pharmaceutical companies that have an agenda to sell you their drugs. There are also lots of people who are trying to sell you their unproven, often untested remedies.

Alternative medicine is highly unregulated and not necessarily any more effective, or safer, than mainstream medicine. According to the Associated Press in a story this year on alternative medicine:

“Ten years ago the government set out to test herbal and other alternative healthremedies to find the ones that work. After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine.”

You probably didn’t hear about that, because it’s not a positive outcome for such a popular concept. If you were aware, you likely heard proponents argue that the research wasn’t conducted correctly. You were probably told that the fact that many alternative health remedies work no better than placebo is no different than the fact that some prescription medicines are found to work no better than placebo.

Antidepressants, in fact, have been found in certain studies to work no better than placebo. After reviewing those studies, Dr. Steve Novella, who writes the blog Science-Based Medicine, wrote a great piece about this called “Do Antidepressants Work? The Effect of Publication Bias”.

“At this time it is premature to conclude that modern antidepressant medications do not work. There is sufficient evidence for efficacy to continue to use medication as part of the overall treatment approach to depression. The current consensus is that therapy is also a critical component of the long term treatment of depression, and therefore looking at the use of medications in isolation may not reflect their actual clinical use. Multiple studies have now shown that combination treatment (medications and therapy) are better than either alone. There is also evidence that medication treatment is more successful when multiple agents are tried in order to find the optimal treatment.”

I like Dr. Novella’s blog because he gives everybody the “business” if they don’t get their science right, whether it’s claims made about homeopathy or antidepressants. He explains his belief that the problem with Complementary and Alternative Medicine (CAM) is ” … that they aggressively market CAM as ‘harmless’ and ‘natural.’ They point to the warning labels and informed consents associated with science-based medicines as evidence that the alternative must be safer. In reality, many alternative practices are less effective, and can carry serious risks (usually undisclosed to the patient).”

We need more research on what causes postpartum depression and what the most effective methods are to treat it. This should include looking more closely at alternative forms of treatment, whether it’s acupuncture or yoga or light therapy or omega-3s, to make sure that we aren’t missing anything. Unfortunately, there’s just not a whole lot ofinformation available on that yet, especially for moms who are breastfeeding.

One interesting piece, the best I’ve found so far, took a look at the more common natural treatments suggested to women with postpartum depression. It was published in the Journal of Midwifery and Women’s Health in 2004 and looks at both pros and cons.Their conclusion?

“Especially for women with moderate to severe symptoms, complementary and alternative medicine is a complement to conventional treatments, not a replacement for it.”

So what should you do if you have postpartum depression? One of the MDs who writesthe blog Denialism suggests the following in his post “There is No Such Thing As Alternative Medicine”:

“When someone offers you an ‘alternative therapy’, ask them what it is an alternative to. Does it work better than something else? Is it safer? How do you know? Why should I believe you?”

Then, talk to your doctor.

Update to this piece: I think some readers are getting the impression I think alternative treatments are bad. That’s not my point at all. I simply think we should always look at both sides of any treatment suggested. Everything has side effects of some sort. Everything has risks and benefits.Just because a treatment method is “natural” doesn’t necessarily mean it is safer or more effective. That’s all. If you want to try an alternative method, you should. That’s why I report on them here and here whenever research comes out. I want you to know everything that’s available. You have to make your own choices.

For related articles on this topic, you might want to check out the alternative treatments category here at Postpartum Progress, or the following blog posts:

Psych Central: Consumer Reports on Antidepressants

Mamapedia: The Postpartum Prozac Roller Coaster

Mayo Clinic: Postpartum Depression and Alternative Treatments

Dr. Shoshana Bennett: Natural and Alternative Treatments for Perinatal Mood Disorders

MGH Center for Women’s Mental Health: Fish Oil and Postpartum Depression and Using Omega-3 Fatty Acids to Treat Depression During Pregnancy and Can Estrogen Be Used to Treat Postpartum Depression?

Psych Central: Alternative Practices May Complement Western Medicine