Postpartum depression — CCFP MCQ

Correct answer: A — Assess safety comprehensively, offer psychotherapy and/or SSRI compatible with breastfeeding, and arrange close follow-up

An EPDS score of 17 at 6 weeks postpartum far exceeds the diagnostic threshold (≥10–12) and indicates postpartum depression, not baby blues. The clinical presentation—persistent low mood, guilt, sleep disturbance, and intrusive worries—is consistent with moderate postpartum depression. The appropriate management combines safety assessment (already completed: no self-harm or infant harm intent), evidence-based treatment (psychotherapy ± SSRI), and close follow-up. Canadian guidance (CFP) confirms that newer SSRIs are safe during breastfeeding, with minimal infant exposure and no documented serious adverse effects; therefore breastfeeding should continue. Option B incorrectly dismisses a treatable disorder. Option E unnecessarily interferes with breastfeeding and maternal–infant bonding. Option C (involuntary admission) is inappropriate without active safety risk or psychosis. Option D prescribes benzodiazepines as primary therapy; these are adjunctive for short-term anxiety/sleep disturbance only, not first-line. The correct answer prioritizes evidence-based, breastfeeding-compatible treatment aligned with Canadian practice standards.

Reference: College of Family Physicians of Canada, Update on antidepressant use during breastfeeding, CFP 2013; https://www.cfp.ca/content/59/6/633