Postpartum depression occurs in 8%-20% of all new mothers. If a woman with no history of depression develops postpartum depression, is there a greater likelihood of developing recurrent mood disorders later? Should a woman who has had one prior major depressive episode be treated prophylactically for postpartum depression? — SUSANNA CHYU, DO, Philadelphia

Postpartum depression is the most common complication of pregnancy, occurring in as many as 20% of new mothers. Women with this problem have a greater incidence of recurrent mood disorders than women without postpartum depression. In subsequent pregnancies, women with prior postpartum depression should be treated prophylactically with emotional support and psychotherapy provided by primary health-care providers, not by a psychiatrist.

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Nutritional supplements of mercury-free fish oil, algae, and dihydroxyacetone docosahexaenoic acid may be beneficial if given in subsequent pregnancies. Prophylactic administration of psychotropic drugs should not be given in pregnancies following an episode of depression because of possible adverse effects on the fetus. — Daniel R. Mishell Jr, MD (150-6)