Postpartum Depression and Physical Therapy

Postpartum depression is a form of clinical depression that affects women after childbirth. Symptoms can include sadness, anxiety, decreased energy, irritability, feelings of loss of control, and changes in eating and sleeping patterns. When left untreated these symptoms can be debilitating and overshadow what should be a joyous time for new parents. Many women report mild depressive symptoms after childbirth, however when symptoms persist two weeks or more postpartum depression should be suspected. Symptoms may begin before birth to weeks after delivery and the cause remains unclear although hormonal and socioeconomic factors, and a history of depression may play a role. While postpartum depression is not uncommon (studies show 5-25% of women are affected), seeking help can be challenging and it can be difficult to know where to go for help.

The first step in addressing postpartum depression is talking to your physician, whether that be your primary care practitioner or OBGYN. While it can be uncomfortable to initiate this conversation, remember that postpartum symptoms are not uncommon and there is help. Your doctor can help by making a diagnosis, making referrals, or by prescribing medication if needed. Many women find relief and support through individual or group therapy and the social support group therapy provides may be especially beneficial.

Exercise has been shown to have antidepressant effects in other forms of clinical depression including major depression. Preliminary research indicates it may have both preventative and treatment applications in postpartum depression. For many individuals, exercise helps promote general well-being and this is also true in pregnant and postpartum women. A 2009 randomized clinical trial in the Journal of Psychosomatic Obstetrics & Gynecology found that a home-based exercise program was beneficial in alleviating mood symptoms for women suffering from postpartum depression. Most interestingly it was most beneficial to the women who were the most depressed. Another 2010 study found that postpartum women who participated in an 8-week “Mother and Baby” program involving a physical therapist-led exercise program and an education program experienced a significant improvement in overall well-being and decreased depression symptoms when compared to a control group who only received the educational information.

Physical Therapy has also been shown to be effective in treating urinary incontinence, as well as back and pelvic pain in postpartum women. In addition to being physically debilitating, these conditions can increase the risk for developing postpartum depression. By treating these musculoskeletal conditions, which often result from the numerous physical and hormonal changes the body goes through during pregnancy, physical therapy can help both restore function and improve associated depression symptoms. Additionally, hormone levels normalize faster in women who are physically active. A good physical therapy program will address pain and the physical changes the body has gone through, prescribe safe and specific exercise, teach proper body mechanics, and stress the benefits of exercise for stress management.

While physical therapy alone will not solve postpartum depression, it can be an important part of an individual’s journey towards recovery. Most individuals know that exercise is beneficial and numerous studies have demonstrated its effectiveness in helping decrease depression symptoms. It can be very difficult, however, to know where to start, especially with the numerous changes and stresses that come with being a new parent. This is where physical therapy can help, both through overseeing a safe return to exercise, and through addressing the musculoskeletal pain, instability, and weakness that may be limiting a return to physical activity.