"Crying, anxiety, insomnia and fear, something was going to happen to my baby every second of the day sent me to the ER with a racing heart,” is how one woman described her experience with postpartum depression, a condition that can totally devastate new mothers. Celebrities like Brooke Shields and Chrissy Teigen have opened up about their struggles with the condition and helped raise awareness — but it’s still far more common than you might think.
Studies have shown that postpartum depression affects one in seven women. There are so many ways that it can manifest — hopelessness, isolation, anger, fear, even thoughts of wanting to harm your baby and yourself — and it’s historically been a difficult condition to get help for. Women were dismissed as being overtired or just having a touch of the “baby blues.” Even though now we treat it with the gravity it deserves, treatment has still been limited.
But there are signs of a change. A new drug, Brexanolone, is being tested for postpartum depression with heartening results. Though still in trial phases, its fast-acting nature may make it enormously beneficial to new moms who can’t wait through the normal six week period for SSRIs to kick in. Here’s what you need to know about the drug.
Slowing Things Down
The idea behind Brexanolone is that it can slow down the hyperactive brain. “There was a theory that suggested depression was the result of hyperactivity in the brain,” Jeff Jonas, M.D., CEO of Sage Therapeutics, developers of the drug, told The Cut. “A lot of things are sped up: You’re not sleeping, you don’t eat, you experience racing, negative thoughts. [Brexanolone] tones down brain activity, basically functioning as a natural relaxant.” The idea is that the drug allows to the brain to reset and return to its normal function.
Women were given IV infusions of the drug over a two-day period—and results are incredibly promising. “By the second trial, women had about a 70 percent remission rate,” Jonas said. “The changes were drastic. These were women who were profoundly depressed and then within 48 hours got significantly better. We followed these patients out to about a month, and the large majority remained well.” Those results certainly sound amazing—but we’ll have to wait what happens next and if the drug will become available.
It’s Not Just About Treatment — It’s About Changing The Conversation
Even the fact that researchers are looking for a cure specific to postpartum depression is, in some ways, a victory in itself. Stigmas around mental health remain — and people are still too slow to give mothers the benefit of the doubt. Some people assume that there must be something wrong with their maternal instincts, that they must be selfish or just lazy—radically unfair to mothers suffering from a chemical imbalance. But looking for a treatment might show a shift in the conversation. It’s acknowledging the fact that this is a real medical condition — and, in many cases, an acute one — that warrants its own treatment. This is not a case of a mom who’s over tired or somehow wired wrong because she doesn’t love her baby enough. You don’t come down with postpartum depression because you’ve done something wrong. It’s an internal imbalance — and one that desperately needs to be rectified.
But currently, even for the women who are lucky enough to receive treatment for postpartum depression, many are not treated with the urgency they deserve. It’s more of a “try this, see if it helps” approach. But Jonas hopes this drug could change that attitude. “It would force a significant change in the way people think about treatment for mental health,” Jonas said. “Most treatments for depression take six weeks to show any effect, so there’s not always a lot of urgency to begin treatment. It’s not seen as an acute condition. But if you walk into the emergency room in diabetic shock or with a 105-degree fever, you see the specialist right away, and are treated immediately for a life-threatening condition. Now, you have a drug that potentially will make people better within two days, so maybe we’ll start to treat postpartum depression as the acute, life-threatening condition it is. The most common cause of maternal death after birth is suicide. It’s not a trivial issue. This is not something that should be treated in a leisurely fashion.”
With the number of women struggling with postpartum depression, it’s shocking and disappointing that there’s not more specific, targeted care available — especially when both the mother and the baby’s health can be at risk. For some people SSRIs might do the trick, but many of them are unsuitable because of other complications — like interfering with breast milk and the time it takes for them to kick in. It’s a grave problem that warrants better treatment. And maybe this treatment is a step in the right direction.