“kind people who understand what it’s like to be a new and overwhelmed mom”
Peaceful building, beautifully decorated, kind people who understand what it’s like to be a new and overwhelmed mom.
-Tiffany A.
What is Postpartum Depression?
Postpartum depression (PPD) is a common, treatable mood disorder that can appear anytime in the first 12 months after birth. It’s different from the “baby blues,” which are milder and usually resolve within two weeks.
Common symptoms include:
- Persistent sadness or anxiety
- Irritability or mood swings
- Changes in sleep or appetite
- Guilt, shame, or feeling “not yourself”
- Trouble bonding with your baby
- Intrusive or scary thoughts
- Difficulty concentrating
When to get help right away: If you have thoughts of harming yourself or your baby, or your symptoms are rapidly getting worse, call 911 or 988 and contact your OB/pediatrician or go to the nearest emergency department.
How PPD Is Treated
Most people do best with a personalized plan that may include:
- Therapy and support: Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), and support groups. When possible, we involve partners and family.
- Medications (when appropriate): Many postpartum patients use antidepressants under prescriber guidance. If you’re breastfeeding, your clinician will help weigh the benefits and risks for you and your baby. ACOG
- TMS at Ascend: A non-invasive, non-systemic option that may help some postpartum patients, especially when meds aren’t preferred or tolerated. We evaluate candidacy on a case-by-case basis. Brain Stim Journal+1
- Care coordination: We work with your OB/GYN, primary care, and therapist so your plan is consistent and coordinated.
Medical disclaimer: This page is for educational purposes and is not a substitute for professional medical advice. Always consult your clinician for diagnosis and treatment.
If You’re Breastfeeding, Read This First
Ascend does not recommend Spravato® (esketamine) or ketamine for ongoing depression treatment while breastfeeding.
- The FDA-approved Prescribing Information for Spravato states that esketamine is present in human milk, and breastfeeding is not recommended during treatment. FDA Access Data
- For ketamine (racemic) used as ongoing antidepressant therapy, human lactation data are limited; given the uncertainty and Spravato’s labeling, our clinic does not recommend ketamine while breastfeeding. We’ll help you consider safer alternatives. MGH Women’s Mental Health Center
What about a one-time anesthetic?
Suppose a breastfeeding mother receives a brief, single anesthetic (e.g., surgery or a procedure). In that case, national guidance indicates “pump and dump” is outdated, and most patients may resume breastfeeding as normal once awake and alert. This is different from repeated dosing for psychiatric care. Confirm timing with your nurse anesthetist. American Society of Anesthesiologists+1
Ketamine or Spravato® as Options (When They May Fit)
We recognize that not every postpartum patient is breastfeeding, and some may, with their clinicians, choose to pause or stop breastfeeding. In those situations, additional treatment options may be considered:
Spravato® (esketamine) for treatment-resistant depression (TRD)
- FDA-approved for adults with TRD (and for depressive symptoms with acute suicidal ideation/behavior) under a REMS program. For non-breastfeeding postpartum patients who meet criteria, Spravato may be considered as part of a comprehensive plan. FDA Access Data
- What the research shows: across RCTs in adults with MDD/TRD, esketamine can reduce depressive symptoms rapidly; separate randomized trials in peripartum settings (peri-cesarean IV esketamine) show lower PPD incidence versus controls, suggesting biologic plausibility in the postpartum population. (These trials are largely preventive/perioperative/not chronic intranasal treatment, but they inform risk–benefit talks). JAMA Network+1
Ketamine (IV) in depression care
- Ketamine is FDA-approved as an anesthetic; its use in depression is off-label. For non-breastfeeding postpartum patients, IV ketamine may be considered for appropriate candidates under careful monitoring. Note: FDA has cautioned about non-approved/at-home uses; Ascend provides monitored, in-clinic care. Health
- Perinatal literature (small RCTs/feasibility studies and meta-analyses, often peri-cesarean) suggests ketamine/esketamine can reduce early postpartum depressive symptoms; longer-term outcomes and optimal protocols need more study. BioMed Central+2ScienceDirect+2
If you’re considering pausing breastfeeding:
That decision is deeply personal and should be made with your OB/pediatrician and our therapists/prescribers. We do not make feeding recommendations. If you and your clinicians choose to pause or discontinue breastfeeding, treatments like Spravato or ketamine may be discussed as part of your plan. We’ll coordinate timing, safety monitoring, and follow-up together.
Talk with us: Not sure what’s right for you? [Schedule an assessment] and we’ll map options that fit your goals and values.
TMS: A Non-Systemic Option
What it is: Transcranial Magnetic Stimulation (TMS) uses gentle magnetic pulses to target mood-regulating areas of the brain. There’s no medication circulating in your bloodstream or breast milk. Ascend Health Center
Why consider it postpartum or while pregnant:
- Non-invasive and medication-free
- Outpatient sessions, no anesthesia
- Evidence suggests TMS can reduce depressive symptoms in postpartum patients; we decide together if it’s appropriate for you. ScienceDirect
Next step: Book a consultation to learn whether TMS fits your situation.
What to Expect at Your First Visit
- Warm welcome + intake: We’ll review your symptoms, history, goals, and any past treatments.
- Safety first: We’ll discuss therapy options, breastfeeding considerations, and whether TMS, Spravato, or ketamine could be a fit for your situation.
- Shared decision-making: You’ll leave with a plan and clear next steps.
Get Help Now
- Schedule an Assessment (same-week openings)
- Talk to Our Care Team
- Crisis support: Call 988 or 911 for immediate help, or go to the nearest emergency department.
