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Postpartum depression, a severe mental condition that affects approximately 1 in 7 new mothers after childbirth, has not been treated with oral medication. However, recent news from Opinions’ ArrowRight newsletter highlights the importance of using zuranolone, an oral pill taken for two weeks, as if it were another medical condition.
I wish I could have heard this message six years ago. The first time I gave birth, I was crying frequently and felt scared and anxious for unknown reasons. I initially blamed lack of sleep, breastfeeding issues, and the difficulty of managing work and responsibilities with my newborn over the last few weeks. Was this expected?
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I sensed that something was amiss. Activities that once brought me happiness were no longer relevant. Despite having supportive colleagues and friends at work, I felt increasingly isolated and disconnected.
I recently completed a depression screening questionnaire during recurring appointments with my OB/GYN. Although my initial score was very high, I requested reassurance and changed my responses instead of disclosing my concerns to my physician. My guilt and shame were overwhelming, and the fear of being diagnosed with postpartum depression made me feel inadequate.
Monitor the thoughts and viewpoints of Leana S. Wen, the writer who wrote this article.
I was hesitant to seek help for months, but I’ve encountered similar situations with other women. Most people were reluctant to report their treatments to their doctors because they didn’t have an interest in them. If someone started using medications, they would probably have to take them for at least six months (with the exception of an intravenous infusion that required a hospital stay and 60 hours of continuous ingestion, which most new mothers find incredibly frustrating).
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A two-week course of an oral medication is far more reasonable, and the evidence is encouraging. In clinical trials, women with severe postpartum depression experienced a significant improvement in symptoms. They stopped taking the pill, which continued for at least 45 days.
The medication’s effectiveness was boosted within three days of initial use by some women, which is an added benefit over other antidepressants that take longer to effect than those that typically take a month or more.
As with most drugs, zuranolone has negative side effects such as drowsiness and fatigue. To avoid these effects, patients are advised to take it at night and not drive for more than 12 hours after ingestion. It also passes into breast milk, and it is unclear whether the baby could be lactated or not. Mothers who want to continue breastfeeding can “pump and dump” to maintain milk supply and then resume breastfeeding once the medicine is finished by noon.
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The decision to pause breastfeeding may discourage many mothers from using the drug due to its proven health benefits and the positive effects of bonding with their infant. However, untreated postpartum depression can have serious consequences for both the mother and her baby. Research indicates that it is linked to shorter breastfeeding sessions, greater difficulty bondING, and even developmental and learning problems in the child’s later years. Additionally, suicide and mental health conditions are major factors contributing to maternal mortality.
Although zuranolone is an effective treatment, it is not suitable for all women. Women with mild to moderate postpartum depression can benefit from talk therapy alone, as I did. Some women with depression and anxiety before pregnancy should be prescribed longer-term medications. Additionally, additional measures must be taken to provide social support to new mothers, including guaranteed health coverage for the first year after birth and paid maternity leave.
Nevertheless, I am convinced that zuranolone, which is expected to be available later this year, will not only drive up the number of mothers who undergo postpartum depression screenings and treatment options but also help dispel the myth that one can survive with mental health issues.