Advantages of Non-Pharmacologic Approaches, by Kathleen Kendall-Tackett

 

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, Research Associate and Affiliate Research Associate Professor of Psychology specializing in women’s health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology.  Dr. Kendall-Tackett is a La Leche League Leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire. Dr. Kendall-Tackett is author of more than 170 journal articles, book chapters and other publications, and author or editor of 17 books on stress, depression and trauma in the lives of women. Her Web sites are www.GraniteScientific.com and www.BreastfeedingMadeSimple.com

Kathleen says, “I started looking at alternative treatments after spending lots of time consulting with moms about depression. So many were adamant about not using meds….and what were we supposed to do for them? Leave them depressed? Also, I’ve always believed in complementary and alternative medicine, so it was a natural fit for me to start looking for other ways to treat depression.”

This article was reprinted with permission from the author.

Non-Pharmacologic Treatments for Depression in New Mothers (Clinics in Human Lactation) by Kathleen Kendall-Tackett dicusses evidence-based support of Omega-3s, bright light therapy, exercise, social support, psychotherapy, and the herb St. John’s Wort.  A must-read, this book is diligently referenced. Ms. Kendall-Tackett’s book is the most complete body of work to date on Omega-3 fatty acids and St. John’s Wort for treating maternal depression. 

Non-pharmacologic treatments are widely used in the general population and among patients with psychiatric disorders. In a recent review, Werneke and colleagues (2006) noted that up to 57% of psychiatric patients have used alternative treatments, usually to treat depression and anxiety. From the patient’s perspective, non-pharmacologic approaches offer a number of advantages. If you understand why women might prefer these modalities, you can talk more comfortably with them about their choices. And women are more likely to be forthcoming about using them.

  • Control: One reason patients prefer non-pharmacologic treatments is that they can control their own health care. Instead of having to wait for a doctor’s appointment, they can address their depression right away. They have control over when they start treatment and when they stop.
  • Privacy:  Patients may be ashamed to admit that they are depressed and are frightened by the possibility that their employers or others will find out that they are taking antidepressants. Unfortunately, on occasion, medication information does get released to employers via insurance forms or just plain gossip—even with confidentiality regulations in place. And antidepressant use can influence hiring and promotion decisions in some types of jobs. Even if that’s not the case, patients may still not want others to know.
  • Costs: Newer and name-brand antidepressants can be expensive, especially if not covered by insurance.  In contrast, non-pharmacologic treatments are generally reasonably priced and can be purchased at discount and warehouse stores.  The savings each month can be substantial compared with name-brand non-generic prescription drugs. This is becoming less of an issue as many popular antidepressants are available in generic form. But it still can be a concern for some mothers.
  • Side Effects and Safety: The side-effect and safety profiles of non-pharmacologic treatments are significantly better than those associated with medications (Klier et al., 2006; Schultz, 2006).  For example, the tricyclic antidepressants have anti-cholinergic side effects, including dry mouth, constipation, and blurred vision.  The selective serotonin reuptake inhibitors (SSRIs) have sexual side effects, such as inorgasmia. For some, side effects prove intolerable and are a common reason why patients stop taking their medications. Most non-pharmacologic treatments have very low incidence of adverse effects. For example, according to one recent review, risk of adverse events associated with St. John’s wort was 10 times lower than with standard antidepressants (Schultz, 2006).
  • Patient Compliance: Patient compliance is an important issue. Just because women are prescribed antidepressants, doesn’t mean they will take them. In one recent study of depressed men and women in New York City (N=829), only 28% were still taking their antidepressants three months later (Olfson et al., 2006). Patients were more likely to stop taking them if they were Hispanic, had less than 12 years of education, or were low income. They were more likely to continue taking their medications if they had more than 12 years of education, had participated in psychotherapy at some point, and had private health insurance.

Look for more of Dr. Kendall-Tackett’s work coming up soon on www.wellpostpartum.com!

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  1. […] unknown wrote an interesting post today onHere’s a quick excerptDr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, Research Associate and Affiliate Research Associate Professor of Psychology specializing in women’s health at the Family Research Lab, … […]



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