I've received two calls from women in the past week who've been told that
they had postpartum depression and had to wean so they could take
medications. I won't even comment on how much this type of advise annoys me.
 I suspect I'm not the only one who has encountered this situation but I've
been getting lot's of questions about what to do about it.

1) First, I try to get some sense of how badly they are feeling and whether
they want to take meds. Many women have their mind made up before I ever talk
to them.  If they've decided to take meds, I refer them to recently published
article in the Depression After Delivery newsletter (800-944-4PPD) on
antidepressant use during bf.  There are meds that are considered OK to take
while bf (usually the tricyclics are recommended).
2) Second, I try to get a sense of what's going on that is making the woman
feel depressed.  Sometimes, it's lots of things.  Other times, there are one
or two specific things like social isolation, a negative birth experience,
fatigue, or a crying baby.  Often, we as caring LC's or LLLL's can gently
steer mothers toward resources/organizations that can help with a specific
issue.
3) Finally, I discuss with them alternative treatments to depression.
 Antidepressants work by influencing levels of serotonin in the brain.  What
we frequently don't hear about though is that moderate exercise and a diet
rich in complex carbs will also influence these same levels.  We sometimes
talk about possibly trying a more non-invasive approach first, with the
possibility of meds later.  If appropriate, I might recommend a counselor.
 Interestingly,  a study recently published in the APA Monitor described how
psychotherapy alone caused changes in neurotransmitter levels in patients
with Obsessive-compulsive disorder.  As measurement techniques become more
sophisticated, I think we'll find that this is true for depression as well.

Thousands of mothers become depressed every year.  The APA Task Force on
Women and Depression identified being a mother of young children as an
independent risk factor for depression.  The good news is that there is a lot
you can do to help, and mothers do not need to choose between their mental
health and nursing their babies.

Kathy Kendall-Tackett, Ph.D., LLLL
Author, Postpartum depression: A comprehensive approach for nurses