Support and advice
The most important step in treating PND is recognising the problem and then taking steps to deal with it. The support and understanding of your partner, family, and friends, can play a big part in your recovery. However, to benefit from this, it is important for you to talk to those who are close to you and explain how you feel, rather than keeping everything pent-up inside. This can cause tension, particularly with your partner, who may feel that he or she is being shut out.
The support and advice from social workers, or counsellors, can also be very helpful if you have PND. Ask your health visitor about what services are available in your area. Self-help groups can also provide you with a good advice about how to cope with the effects of PND, and you may find it reassuring to meet other women who feel the same as you.
Medication
Medication is sometimes used to treat PND. Antidepressants are often prescribed to treat moderate or severe cases. They work by balancing the mood-altering chemicals in your brain. Antidepressants can help ease symptoms such as low mood, irritability, lack of concentration, and sleeplessness, allowing you function normally, and giving you the ability to cope better with your new baby.
A course of antidepressant medicines usually lasts for between 4-6 months. However, if your symptoms improve, the dose may be reduced. Antidepressants take 2-4 weeks to start working, so it is important to keep taking them even if you do not notice an improvement straight away. It is also important to continue taking your medicine for the full length of time recommended by your doctor because if you stop taking it too early, your depression may return.
The type of medication that you are prescribed will depend on how severe your PND is and also whether you are breastfeeding your baby. For example, some types of medicines, such as lithium, clozapine, and lamotrigine, are not recommended while breastfeeding. Your GP should recommend a medicine that has the least risk to both you and your baby, and it should be started on the lowest possible dose.
You should talk to your GP about the type of medicine that is most suitable for you, and any possible side effects that may be caused. If you do experience any side effects from the medicine that you are prescribed, you should tell your GP so that s/he can alter your dose or change your medicine.
In severe cases PND, such as postnatal psychosis, where symptoms can include irrational behaviour, hallucinations and suicidal thoughts, tranquillisers may be prescribed as a possible treatment option. However, they are usually only recommended for short-term use.
Between 50-70% of those who have moderate to severe PND improve within a few weeks of starting treatment with antidepressants. However, they are not an effective method for everyone.
Counselling
Counselling, or talking treatments, can be useful in treating PND. If your GP feels it may help you, you will be referred to a psychologist, or other mental health specialist. There are various different types of counselling, but their availability on the NHS may vary depending on where you live in the country. Talking treatments can include:
 Cognitive therapy (CT) is based on the idea that certain thoughts can trigger mental health problems, such as depression. The therapist will help you to understand how your thoughts can be unhelpful, or harmful, and make you depressed. Sessions are usually conducted on a weekly basis, over several months, and the aim is to help you to change your thought patterns in a way that is more helpful and positive.
Cognitive behavioural therapy (CBT) combines cognitive therapy and behaviour therapy. Behaviour therapy is about changing any behaviour that is harmful or unhelpful. The aim of CBT is to help you change the way that you think, feel, and behave for the better.
Other talking therapies include interpersonal therapy and problem solving therapy. Also, trained health visitors sometimes give short counselling sessions over several weeks, and these have been shown to help ease PND.
For those who have moderate PND, talking treatments, such as CT and CBT, have about the same success rate as antidepressants (50-70%). However, talking treatments may not be as effective for people with severe depression because they require a certain level of motivation, and those with severe depression often find it difficult to motivate themselves.
Some research has suggested that a combination of antidepressants and counselling is better than either treatment alone.
Other treatments
There are various other treatments that are sometimes recommended to treat PND. They include:
Regular exercise such as walking, jogging, cycling, or swimming can help to ease the symptoms of depression.
St Johns Wort is a herbal antidepressant that is available to buy over-the-counter (OTC) from pharmacies without prescription. However, some doctors do not recommend it because its effectiveness has not been proven, and it can cause side effects. You should not take St Johns Wort if you are taking certain medications, such as warfarin, oral contraceptives anticonvulsants, or antidepressants. Check with your GP if you are unsure.
Specialist treatments such as electro convulsive therapy (ECT), which involves giving electric shocks to the brain, may be recommended if you have severe depression that has not improved after trying other treatments.
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