Can Online Therapy Improve Postpartum Depression? A Review Of The Literature
Pregnancy, childbirth, and parenthood can bring about an array of emotions such as joy, fear, anxiety, or dejection. Although, new parents may also experience short-term mood disorder like sadness, crying, irritability, and anxiety. Such symptoms often resolve within five days; however, if they persist or worsen, it may be an indication of postpartum depression, a critical mental health condition that requires attention from health care professionals.
What is postpartum depression?
Postpartum depression is a form of depression outlined in the DSM-5. It is a severe mental health condition that can feel devastating for those impacted and is more than "baby blues." Common symptoms of postpartum depression can include:
- Difficulty bonding with your newborn
- Intense irritability and anger
- Feeling restless or moody
- Low motivation or energy
- Thoughts of hurting the baby or yourself
- Feelings of hopelessness, shame, or guilt
Postpartum depression is a type of mood disorder that can affect mothers during the first year after giving birth. It can make it difficult to care for yourself and your baby. Although those with a history of clinical depression may be at higher risk, postpartum depression can also occur in women without any previous history of depression. Individual therapy sessions can provide effective treatment options.
Complications during birth, like stillbirth, premature birth, or birth trauma, may increase the risk of postpartum depression. However, postpartum depression isn't limited to birthing parents or any particular gender, sexuality, or background. Adoptive parents, non-birthing parents, and foster parents may also experience postpartum depression. It is essential to seek help from healthcare professionals and licensed therapists who offer family therapy for effective treatment options.
If you are experiencing thoughts or urges of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. They are available 24/7 to offer support.
Internet‐based interventions for postpartum depression
Treatment for postpartum depression typically involves a combination of talk therapy, medication management, and support from family and friends. The best online therapy options provide messaging and live therapy sessions with your own therapist, making it easier to get treatment, even for those without an insurance provider. Online postpartum therapy is a convenient solution for new parents who may find it challenging to seek support in person while caring for an infant. In some cases, online therapists can even prescribe medication* to help manage symptoms.
Can online therapy improve postpartum depression?
The best online counseling options can typically bypass hurdles such as scheduling conflicts, distance, and a lack of transportation. Online therapy can also be more cost-effective than traditional therapy, as traditional therapy often costs around $100-$200 per session (even with health insurance). In the long run, neglecting to seek treatment for postpartum depression may cost more than a therapist. Reaching out for support can be brave.
Researchers in China sought to analyze the effectiveness of online counseling and interventions in decreasing postpartum depression by examining information from previously published studies. The following summary details their methods and results from the meta-analysis of seven studies on internet-based counseling for postpartum depression.
*It is important to note that BetterHelp's therapists cannot prescribe medication as they are not medical doctors. For assistance with medication management, it’s recommended that you speak with a health care provider.
Included studies
Researchers retrieved 34 full-text articles to assess whether they met inclusion criteria, which were as follows:
- Included adult pregnant parents over 18
- Used an intervention provided by email, phone, Skype, or a website
- Used a waitlist or traditional in-person treatment for the control group
- Measured outcomes focused on postpartum depression
- Were a randomized control trial
Ultimately, seven studies published between 2008-2018 were examined in the meta-analysis, including information about 2,277 parents organized from research in Australia, Sweden, the US, Canada, and the UK.
Although the inclusion criteria narrowed the studies' parameters, they still had varied characteristics. Six studies followed up with participants 10 to 17 weeks after the intervention, but one followed up six months postpartum. The studies used a total of five different assessments to measure postpartum depression.
Method
The outcome of all seven studies was described in one of two ways in the meta-analysis. After completing the intervention, the researchers noted whether the participants still fit the diagnostic criteria for postpartum depression. They used statistical analysis software to dive deeper into the studies, looking at the following aspects:
- Was cognitive behavioral therapy or behavioral action utilized?
- Did they offer less than eight sessions or eight or more?
- Did participants have therapist support or not?
Results
The online interventions produced a moderate effect in eliminating postpartum depression. In almost every study included in the analysis, participants in the intervention group showed improvement compared to those in the control group. In six of the studies, postpartum depression symptoms decreased significantly. The remaining study, which used mood management internet intervention, demonstrated that the intervention significantly lowered the risk of postpartum for parents with the most severe symptoms.
The most influential studies had the following characteristics:
- Followed up for over 12 weeks after the intervention
- Utilized cognitive-behavioral therapy interventions
- Included eight or more sessions
- Offered exclusive therapist support
The research in summary
Researchers continue to examine the efficacy of treating postpartum depression using online interventions, and a meta-analysis was performed on seven studies completed between 2008-2018. The analysis revealed a moderate effect size of 0.642, which means that the interventions effectively reduced symptoms of postpartum depression. In six of the seven studies, symptoms decreased significantly for parents receiving the intervention.
Future research
While online counseling offers several benefits, it may be easier for participants to stop attending sessions without a degree of accountability. In the seven meta-analysis studies, the percentage of participants who didn't follow through from beginning to end ranged from 0% to 87.1%. Future research can examine strategies to encourage follow-throughs, such as phone calls and website contact systems.
Mental health and pregnancy
The bulk of research regarding postpartum depression focuses on mothers. However, approximately one in ten fathers experience depression before and after pregnancy. Providing the appropriate support for new fathers, non-binary parents, transgender parents, adoptive parents, and foster parents may be a priority of future research.
Pregnancy and postpartum depression in transgender men
Transgender men may also give birth and experience postpartum depression. In one study on transgender men and pregnancy, postpartum depression was often connected with gender dysphoria related to chest feeding and the cessation of hormone therapy. This study may indicate a requirement for further studies on the impact of postpartum depression on transgender and gender-diverse parents.
How to reduce symptoms of postpartum depression
Various personal and environmental factors may play into postpartum depression. Below are a few ways to cope with postpartum depression symptoms.
Limit visitors at first
Save your mental and physical energy for family and friends who will refresh you. If certain individuals in your life make you feel disrespected, stressed, or tired, don't invite them to visit your baby at first. Spend time with your immediate family and care for yourself and your child.
Ask for support
On the other hand, if you want to isolate or withdraw from those you love, it may be beneficial to ask for support. Consider that asking for support may show those in your life that you appreciate their guidance and care, and needing help may not be selfish. You can also consider finding support through a postpartum therapist or psychiatrist.
Rest as much as possible
Sleeping with a newborn baby can be challenging. Studies show that a lack of sleep can cause health concerns, so you may want to find creative solutions to sleep. Consider asking your partner or family to help you with your baby when you feel sleep-deprived. Ensure you're not caring for your child alone. Community resources may be available to you if you're a single parent. Try to limit stressful activities and take naps if needed throughout the day.
Engage in healthy habits
Participate in activities that bring you joy before having your child, such as listening to your favorite music or enjoying movie nights with your partner. Modify activities as needed. For example, if you used to take your dog on a weekend hike at the local nature preserve, schedule a shorter walk around your neighborhood instead.
Connect with other parents
There can be many parenting groups online that are dedicated to various niches. You might also find postpartum depression support groups online. Whether you want support from parents with the same age children or parents who have similar hobbies, you may find it through the Internet. You can also visit local playgroups and library classes to meet local parents. Building a relationship with others in a similar situation may assist you in relieving feelings of isolation and loneliness.
Join a support group
Support groups, like those offered at Postpartum Support International, can be a beneficial resource, and they often help parents discuss mental health challenges, including depressive symptoms.
Healthcare providers might recommend that support groups be used in conjunction with traditional therapy, like family counseling. You might also find support groups or group therapy led by a licensed counselor or specialist in postpartum depression or parenting.
How can loved ones offer support?
If you're concerned that someone you know may be experiencing postpartum depression, encourage them to speak to a healthcare provider. In addition, you can provide support through the following methods.
Emotional support
Listen to concerns and complaints to hear them, not solve them. Offer encouragement and the opportunity for an overwhelmed parent to unplug if they can. You might consider taking a crying baby for a walk so the infant can be soothed and the parent can rest. You might also consider inviting them to social activities or including the whole family in events.
Mental support
The mental load of caring for a newborn can be immense and might feel overwhelming at times. Be intentional about noticing tasks you can take care of so the new parent may not have to concern themselves with it. For example, you could take the trash to the curb for pickup, help an older child pick an outfit for school, or bring meals during the week.
Physical support
Volunteer for tasks that might relieve the new parent of any physical burden, such as exercising the dog or doing a load of laundry.
Seeking professional support for mental health and anxiety management
A 2021 clinical trial compared the effect of adding a one-day online cognitive behavioral therapy-based workshop to the usual care offered to parents experiencing postpartum depression. The results revealed that those who completed the additional workshop experienced statistically significant improvements in postpartum depression, anxiety, social support, and the mother-infant relationship. Online therapy services can benefit many parents experiencing this condition.
If leaving the house with an infant in tow feels like a challenge, consider scheduling a check-in with an online mental health provider. The sign-up process to schedule online therapy sessions can be straightforward, and you may receive a therapist match within 24 to 48 hours. A therapist through a platform like BetterHelp can help you work through any distressing emotions related to parenthood, postpartum depression, or other concerns.
How online therapy may improve postpartum depression and anxiety for individuals and couples
Online postpartum depression therapy can be affordable for many people, and clients can choose between video chat, phone, and live chat sessions with their therapist match. If you and your partner are struggling with postpartum depression or experiencing relationship concerns due to a new child, you can also consider reaching out for support through a couples online therapy platform like Regain.
Takeaway
What therapies are available for postpartum patients?
There are several types of psychotherapy that mental health professionals might use to treat postpartum depression (PPD). Here are a few of the most common types of postpartum depression treatment:
Cognitive-behavioral therapy (CBT)
CBT is considered the gold standard for treating depression of most types, and studies show it can not only treat PPD but also help cut the risk of PPD when applied during pregnancy. CBT works by building mindfulness to recognize the thoughts and emotions that cause distress in order to understand them better. Once the patient understands how their thoughts, feelings, and behaviors influence each other, the patient and therapist will work together on reframing negative thoughts into more positive, realistic ones.
CBT is a highly collaborative treatment in which the patient and therapist work together to develop treatment strategies tailored to the patient’s unique experiences. As the intervention progresses, the patient learns to recognize negative thought patterns and signs of regression. The end goal of CBT is for the patient to develop the skills necessary to cope with psychological challenges independent of involvement from a therapist.
Eye movement desensitization and reprocessing (EMDR)
EMDR can be particularly helpful for patients with postpartum post-traumatic stress disorder (PTSD) accompanied by PPD. In EMDR, the individual focuses on the distressing, traumatic experience while engaging in bilateral stimulation exercises, usually in the form of eye movements. Studies suggest that this type of psychotherapy is shown to reduce symptoms of postpartum PTSD in individuals who have had traumatic childbirth experiences.
Interpersonal therapy (IPT)
IPT is a brief (typically 12-16 sessions), structured, attachment-focused therapy in which individuals improve depression symptoms by resolving interpersonal relationship issues. IPT addresses how one’s relationships and social interactions affect one's mental health. Throughout treatment, patients and therapists work together to set goals and find solutions for managing relationship challenges to reduce PPD symptoms.
Couples therapy
PPD can have a significant impact on an individual’s relationships. Like IPT, couples therapy addresses relationship challenges, but both partners must be involved for it to be effective. With the guidance of a counselor, couples therapy offers a safe space where couples can communicate, explore their challenges, and establish healthy ways to resolve conflicts.
Group therapy
Some people find the support and validation provided in group therapy to be an effective method for reducing PPD symptoms. Group therapy often includes PPD education and exercises designed to help participants develop coping skills. Listening to others share their stories and experiences can reduce isolation and cultivate hope for treatment success.
Medication
In some cases, physicians might prescribe medications like selective serotonin reuptake inhibitors (SSRIs) in addition to talk therapy for managing PPD symptoms.
What is the best online therapy for moms?
Most people choose online therapy for its flexibility, convenience, accessibility, and affordability, but the best online treatment depends on the individual’s preferences and unique needs. There are many different online therapy platforms, each with benefits and drawbacks. If you or someone you love is considering online therapy, explore your options and consult unbiased, reputable sources when choosing the right fit.
What is the best app for postpartum recovery?
Like the best online therapy for moms, the best app for postpartum recovery will likely vary between individuals depending on their unique needs and circumstances. When researching postpartum apps, seek reputable sources like Postpartum Support International or PostpartumDepression.org. The Association of Women’s Health, Obstetric, and Neonatal Nurses also offers resources, including apps, for new parents.
What is the best way to heal postpartum?
Postpartum healing is often a holistic process addressing your mental, emotional, and physical health. Work closely with your doctor when seeking guidance on how to heal your body after having a baby. They’ll likely have a specialized nutrition and exercise plan to help you “bounce back,” as well as some tips for getting the best quality sleep possible. Caring for your mental well-being is also integral to postpartum healing. Here are a few tips:
Follow your doctor’s advice
Be sure to follow your doctor’s advice on how to heal your body postpartum. If they advise you to rest and refrain from certain activities, follow their advice. If they believe you’re ready to get moving, ask what types of physical activity they recommend. Eat well and get plenty of quality rest whenever you can.
Ask for help
Whether you need a hand with the household chores, running errands, or getting some sleep, getting help from friends and family can be a key part of supporting your mental health as you recover post-pregnancy. Consider making a list of your daily responsibilities to determine what tasks are priority, which you can delegate, and which you’ll need to postpone.
Stay connected
Whether you call, text, chat online, or meet up in person, keep in touch with friends and family throughout this time. Having someone supportive with whom to talk about your challenges and successes can significantly improve your mental health.
Manage your stress
Meditation, breathing exercises, mindfulness activities, and guided relaxation techniques can help you stay mindful of your emotions and successfully manage challenging times. Some people find taking a walk or spending time in nature to be healing. You might indulge in a warm bath, light some scented candles, and put on relaxing music. With approval from your doctor, consider physical activities like yoga or exercise.
While many people experience mild psychological symptoms associated with what’s sometimes called the “baby blues,” if such symptoms become more persistent or severe, it could be a sign of PPD. Common PPD symptoms include:
- Severe mood swings or depressed mood
- Uncontrollable crying
- Less interest or satisfaction in activities you used to enjoy
- Notable irritability or anger
- Restlessness
- Feelings of fear or hopelessness
- Feelings of shame or guilt
- Feelings of inadequacy or worthlessness
- Difficulty with focus or memory
- Severe anxiety or panic attacks
- Thoughts of self-harm or suicide
- Thoughts of harming your baby
If you or someone you love is experiencing PPD symptoms, speak to a mental health professional. They can help assess your condition and devise a treatment plan tailored to your needs.
Are online therapists effective?
A comprehensive body of research indicates that online therapy is as effective as in-person treatment for a variety of mental health conditions. There are many potential reasons why some might find counseling from an online therapist more effective than talking to a mental health practitioner in a face-to-face setting. These might include:
Online therapy is often available in areas where in-person therapy isn’t
Online therapy can be an excellent solution for people who are unable to leave their home
Due to stigmas sometimes associated with mental health issues, some might feel more comfortable talking to a therapist via an online platform rather than in person
Online therapy may encourage better treatment adherence in some people, which can lead to more successful outcomes
Online therapy is often more affordable than in-person treatment without insurance coverage
How do I tell my mom she needs therapy?
Different people respond to the idea of going to therapy in different ways. It can be challenging to tell your mom you believe she needs therapy if you don’t think she will be receptive or if you simply don’t know how to approach the subject.
How online therapy can improve mental health and postpartum depression
Here are a few tips:
Try therapy yourself
Everyone experiences challenges in life that might be improved through counseling even those with a strong sense of emotional well-being. Try going to therapy and share your experience with your mother. Explain how your therapist helped you cope with your challenges and grow. You might be an excellent example of how effective therapy can be, regardless of one’s mental health situation.
Choose the right time and place
Consider approaching the subject somewhere comfortable at a time when both of you can relax and have an open conversation.
Express concern in a supportive, empathetic way
Address the issue by acknowledging her challenges and show empathy by validating her experiences. Reassure her that what she’s going through could be challenging for anyone and that she deserves the benefits of support from a professional. Normalize therapy by mentioning your own experiences (if you’ve had experiences with therapy), and emphasize that it’s a common, healthy way to work through challenges.
Offer to help and respect her boundaries
Offer to help her find a therapist or attend her first appointment if she feels uneasy. Share resources and information about mental healthcare options but be patient if she is still resistant or doesn’t respond right away. She might need time to process the suggestion—let her know you’re there for her no matter what.
What is the best online platform for therapy?
The best online therapy services should vet mental health professionals who work on the platform carefully and offer multiple benefits to their customers. Therapists must meet specific educational, experiential, and ethical requirements to obtain licensure to practice. These requirements can vary by state, so be sure you verify with the platform that the mental health professionals working on their site meet the qualifications and are licensed in your state.
Additionally, use reputable resources when researching different online therapy platforms. Look for platforms that offer reasonable pricing, a large pool of professionals with diverse backgrounds and experience, and scheduling flexibility. A good platform will be able to match you with a counselor with expertise that fits your therapeutic needs and comfort level. It should also offer flexibility if you need to switch therapists anytime.
How do you treat postpartum?
Treating postpartum conditions, including postpartum depression (PPD), involves guidance from a professional who can tailor a treatment strategy that fits your unique needs. This might include a combination of approaches like psychotherapy, medication, support groups, and self-care strategies. PPD is a serious but treatable condition in which early intervention can lead to a faster and more complete recovery.
How can I help my postpartum woman?
Supporting a partner or loved one experiencing PPD often begins with education. Learn about PPD and its symptoms. Understanding what she’s going through can help you respond more effectively. Be patient and offer emotional support by listening without judgment. Normalize and validate her feelings and reassure her that you’ll support her throughout the healing process.
Take over some night shifts when the baby wakes and take on more domestic duties like cooking, cleaning, and laundry. Encourage self-care and support her in doing things she enjoys. Help her stay connected with friends and encourage her to join a group for new moms if this is her first child. If she doesn’t feel comfortable meeting up in person, suggest that she engage with social media groups or through other online platforms.
Does walking help heal postpartum?
Walking can be beneficial in the postpartum healing process. It’s a low-impact form of exercise that can improve cardiovascular health, strengthen muscles, and improve circulation without putting too much strain on the body. Walking also helps cultivate better overall mental health, including for people experiencing depression symptoms.
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