It Takes a Village: Social Engagement with Family Is Associated with Reduction in Postpartum Depression During Psychotherapy

Purpose: Social disconnection is one of the strongest risk factors for postpartum depression (PPD). Prior correlational studies have found an association between perceived social support and PPD. However, it is unclear whether social engagement reduces PPD, and if so, which activities are most beneficial. We examined a scalable psychotherapy aimed to increase social engagement reduces PPD. Specifically, we tested which social activities were most preferred by women, and which were most predictive of reduction in depression severity. Methods: Thirty-eight mothers with PPD completed 9 weeks of Engage and Connect – a novel social reward psychotherapy for PPD. Women engaged in weekly rewarding social activities. Activities were categorized as: with friends, with partner, with infant, with family members (e.g. parents, siblings, older children, cousins), or alone in a social setting. Mixed-effects models examined which activities were most frequently selected by women. We then examined which activities were associated with PPD reduction during psychotherapy. Results: Activities with friends were most frequently selected, followed by those with partner, infant, family, and alone in a social setting. A higher percentage of activities with family members was associated with a PPD reduction during psychotherapy. Conclusion: While women most commonly chose activities with friends, social engagement with family members was most beneficial in reducing PPD. Results underscore the protective effects of social engagement and the need to assess and enhance social connectedness during the postpartum period. Findings also suggest that Engage and Connect may be a promising first-line intervention for PPD.