Postpartum Depression

It’s not uncommon for women to experience baby blues – feelings of sadness, anxiety, restlessness, stress, weepiness or exhaustion after giving birth to a baby. However, some women go through a much more serious condition called postpartum depression or PPD. It’s a mood disorder that makes it difficult for women to get through the day or to take care of the baby, family, and oneself. Some of its symptoms include extreme anger or irritation, crying continuously for hours, fear of not being a good mother, sleeping too much, disinterest in the baby, family, and friends, difficulty concentrating, and thoughts of harming oneself or the baby. PPD can hit a woman within the first few weeks, months or a year after having a baby. It doesn’t go away easily like baby blues but lasts for days and months if left untreated. The condition can also affect women who already have children.

Well, the good news is that there is hope. Postpartum depression can be treated! The recent approval of the drug called Zulresso (brexanolone) by the Food and Drug Administration offers hope to millions of women suffering from PPD every year. The drug was granted to Sage Therapeutics and is taken as a continuous IV infusion over 60 hours. As the drug can bring the risk of harm due to the sudden absence of consciousness, it is extremely necessary that patients are monitored for excessive sedation and sudden loss of consciousness. It is also necessary to monitor oxygen levels in the blood continuously. Patients are informed about the risks of Zulresso treatment and that they must be monitored for these effects at a healthcare facility for the 60 hours of infusion. Moreover, patients should avoid driving, using machinery, or doing other dangerous activities until feelings of sleepiness from the treatment go away completely. The treatment runs between $20,000 and $35,000.

The working of brexanolone works is unknown. However, as the chemical structure of the drug is similar to allopregnanolone, a naturally occurring steroid, it’s believed to function in the same manner. Allopregnanolone improves the effects of gamma-aminobutyric acid (GABA) – a neurochemical which prevents brain nerve cells from firing, thereby suppressing one’s anxiety or stress.

During pregnancy, a woman’s allopregnanolone levels in the brain shoot up, leading some neurons to temporarily tune out GABA so that the nerve cells don’t become too inactive. The steroid levels come back to normal soon after delivery and the neurons once again respond to GABA. However, this process takes longer in some women, leading to postpartum depression. The drug brexanolone temporarily increases the brain’s allopregnanolone levels, leading to an enhanced mood in patients.

PPD can also be treated by counselling therapy. It involves talking personally with a mental health professional such as a counselor, psychologist, or psychiatrist. There are two types of counseling known to be useful in treating postpartum depression including cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). The former helps one figure out and change their negative thoughts and behaviors and the latter helps one understand and work through problematic personal relationships.