Management of Postpartum Anxiety and Depression: A Narrative Review

Abstract

Postpartum anxiety and depression are two of the leading causes of maternal morbidity and emerge from being one of the most underdiagnosed and undertreated mental health problems. Its prevalence has been reported to affect about 10%–20% of pregnant women. Due to such large-scale prevalence, the need for better diagnostic techniques and therapeutic management has been addressed in this review. Maternal health largely influences the health of the newborn, affecting not only the growth and development of the child but also the mother-child bond as mothers with postpartum depression reportedly have a lack of interest in their child. Understanding the pathophysiology of the disease including the hormonal factors, the neurotransmitter pathways that become skewed, genetic influences and psychosocial factors, are essential to develop treatment options. This review outlines all the different pathophysiology and theories so far researched in this field. Although significant strides have been made in developing diagnostic and therapeutic management, the need for further research and testing is emphasized. Unfortunately, research testing the safety of several antidepressant classes that can be used to treat postpartum anxiety, and depression cannot be undertaken due to the major ethical issues it raises in conducting such research in pregnant women. This review highlights the promising avenues of further research that have the potential to treat and prevent this debilitating disease. Using biomarkers for early detection, the field of pharmacogenomics which helps to tailor prescriptions for personalized treatment, and pharmacological treatments which include antidepressants like serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors and various nonpharmacological measures including massages, psychotherapy, co-parenting, postnatal exercises, kangaroo care, and music remedies, have been discussed. Finally, the role of public education in highlighting the prevention of stigma surrounding postpartum anxiety and depression has been addressed.