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Drug-free help for postnatal depression

Two new studies have found that counselling and peer-group support for new mothers might help prevent depression

Sarah Boseley, health editor - guardian.co.uk, Friday 16 January 2009

Postnatal depression, which affects 13% of mothers and can lead to suicide, could be treated without drugs and even prevented, new research suggests today.

While depression following the birth of a baby can have a serious effect on the new mother, it can also prove detrimental to her partner, on the development of the infant and the wellbeing of any other children.

Two studies published in the British Medical Journal today show that the support of health visitors and of other women who have experienced postnatal depression could make a real difference.

Postnatal depression can be hard to identify. Many women struggling with their feelings deny they have a problem or pretend it doesn't matter. They may think what they are experiencing is normal.

Others may be afraid they will be thought to be mentally ill and have their children taken away, or do not want to be seen as failing as a good mother.

GPs may prescribe antidepressants to treat the condition, but some women are reluctant to take them, particularly if they are breastfeeding.

For one of the studies, health visitors trained to diagnose postnatal depression gave psychological counselling to the women taking part for an hour a week for eight weeks.

The study, which was one of the largest ever carried out in postnatal depression, followed around 4,000 new mothers from 101 general practices around the country.

Those found to be depressed were randomly assigned either normal health visitor care, or care from a healthy visitor trained to give cognitive behaviour therapy or another form of counselling.

Dr Jane Morrell from the University of Huddersfield and colleagues, who carried out the study, followed up the women's progress at six months and 12 months. The women who had received psychological therapy were found to have significantly lower levels of depression than the ­others.

Women who had depressive symptoms at six weeks after giving birth and received therapy were 40% less likely to be depressed at six months than those who had not been given counselling help.

For the second study, Dr Cindy-Lee Dennis and colleagues from the University of Toronto enrolled more than 21,000 women from seven different health regions across Canada.

Of those women, 701 were identified as being at high risk of becoming depressed after giving birth. Half were given standard postnatal care and the others were assigned the support of a volunteer who had experienced depression herself.

Those who received peer support, in the form of regular telephone conversations, were half as likely to become depressed by 12 weeks after the birth. More than 80% of those receiving support said they were satisfied with the experience and would recommend it to a friend.

In an editorial in the journal, Dennis, who is an associate professor and Canada research chair in perinatal community health at the University of Toronto, said that in spite of the harm it did, postnatal depression was still undetected in many women. She called for women to be educated about the condition so that they would be more likely to recognise if they had a problem and seek help for it.