Post Natal Depression – More Than Just Baby Blues
Childbirth is a powerful experience that brings feelings of joy, excitement and anticipation. But this isn’t always the case, especially so for women who experience postnatal depression (PND).
It is common for new mums to experience liability of mood and tearfulness – “baby blues” following childbirth. Nearly three quarters of new mums feel down shortly after birth, complaining of sadness, mood swings, anxiety and loss of appetite. This mild and self limiting condition typically disappears two weeks after delivery.
In around one in ten new mothers this continues with more intense symptoms, in some cases, including thoughts of self harm or of harming the baby, and is classed as post-natal depression.
The condition is thought to be considerably under-reported.
Major risk factors for PND include history of mental illness, recent psychological stress, inadequate social or economic support and difficult pregnancy or birth experience. Women who are experiencing significant physiological stress may also be at risk for PND.
According to a study on 500,000 mothers in Finland, expectant women with prenatally diagnosed fear of childbirth are at an increased risk of postpartum depression.
Unfortunately, the neurobiological mechanisms that may be related to mood dysregulation in the early postpartum period are unclear.
Within 48 hours of delivery, maternal levels of oestrogen and progesterone fall dramatically, which has been suggested to contribute to PND. However, other studies suggest that hormonal changes are not the major determinant of PND.
Greater levels of a brain protein called monoamine oxidase A (MAO-A) – may explain why postpartum blues and clinical depression are so common after childbirth. Researchers at the Centre for Addiction and Mental Health discovered that levels of brain MAO-A in healthy women four to six days after delivery were 43% greater as compared to women not recently pregnant. The findings were strongest on day 5, the day when postpartum blues is usually the most severe.
Monoamine oxidase A (MAO-A) is an enzyme that metabolizes neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. As well as being responsible for transmitting signals between nerve cells, these neurotransmitters also influence our mood. If they are deficient, we initially feel sad, and later have a high risk of becoming depressed.
So how you do you know if you have PND?
- sadness – tearfulness for ‘no reason’
- mood swings
- feelings of inadequacy, an inability to cope
- loss of motivation, self-esteem and confidence
- anxiety, panic attacks, fear of being alone
- poor concentration and memory
- difficulty sleeping (regardless of the baby’s routine)
- loss of appetite
- weight loss or weight gain
- reduced libido
- suicidal thoughts and ideas
Mums describe it as like living in a fog, feeling numb inside, with no laughter or excitement in what can be (but is not always) one of the best times in their life.
The consequences of postpartum depression may be severe and can affect the way a mother bonds with her child. It also can affect how the child develops, putting him or her at risk for attachment, cognitive, behavioural and emotional problems.
Steps you can take to reduce your risk of getting PND as well as minimise its impact
Proper nutrition during pregnancy is vital to the health of the mother and her baby.
Researchers believe that inadequate nutrition and nutrient deficiency (folate, vitamin B12, calcium, iron, selenium, zinc and especially omega-3 fatty acids) is a risk factor for perinatal depression. Use a multivitamin and mineral formula to provide nutritional foundation during preconception, pregnancy and breastfeeding.
Anaemia in the postnatal period could also have a detrimental effect on a woman’s ability to bond with her new child and has been identified as a contributory factor in the initiation of postnatal depression.
Emed’s Nutrient Status Profile can help identify nutritional deficiencies which can severely impact on both the physical and emotional wellbeing of the mother and dramatically slow down the recovery process after giving birth.
Because of depletion of maternal essential fatty acids by the fetus during pregnancy and lactation, in addition to insufficient dietary consumption, Omega-3 is used at therapeutic doses to benefit both the mother and the infant. Omega 3 fish oil will help prevent the inflammatory state that characterises depression and help regulate the production, metabolism and function of serotonergic neurotransmitter.
Vitamin D has profound effects on the brain’s neurotransmitters an there have been many studies confirming that low vitamin D levels are associated with depression. Make sure you have you Vitamin D levels tested and start supplementing if your levels are low.
Disturbances in thyroid function may significantly affect mental status including emotion and cognition. Both excess and insufficient thyroid hormones can cause mood abnormalities including depression .
Immediately after pregnancy the levels of thyroid hormones drop and in about 6-7 per cent of women this can lead to an underactive thyroid gland (hypothyroidism). The symptoms of hypothyroidism are very similar (lack of energy and fatigue, weight gain, feelings of despair, etc) and can be misdiagnosed and therefore sufferers can be wrongly diagnosed.
Have the Emed’s Comprehensive Thyroid test done to find out if your symptoms are due to thyroid dysfunction.
Postnatal Depression Fighting Tips
- Realise the importance of rest and keeping stress levels low
Chronic sleep deprivation often causes serotonin (a hormone that regulates mood) levels to drop. Rest and finding ways to lowering your stress can bring serotonin levels back to a healthy balance. It can be very challenging to do this while pregnant if you have little ones to care for, but make it a priority and creatively find ways how.
- Eat A Healthy Well-Balanced Diet
With all the new demands on your body, eating well is important. Try not to go for long periods without eating. Food fuels your energy and immune system, so a balanced diet will prevent you from becoming tired and feeling run down.
Focus on having good quality lean protein, eg grass fed meat, fish and organic chicken or eggs, beans, peas, lentils, fresh nuts and seeds.
Absolutely avoid the mood and health stealers that are processed foods, gluten (bread, biscuits cake etc), alcohol, caffeine and sugar – all will rob you of health and energy.
Stay away from hormone-laden foods such as cheeses, meats and milk. If you are concerned about your calcium intake, you can find it in other sources such as seeds, broccoli, beans, dried fruits and nuts.
- Drink plenty of water
Water is required for all body functions. Even mild dehydration can reduce physical and mental performance and increase fatigue.
- Aim to do some light exercises
Regular exercise stimulates pleasure centres in the brain which improve mood.
Walking will do wonders. Start with short walks – say 15-20 minutes at a time – can make the thought of exercise less daunting. You can walk with your baby in a pram.
- Keep Connected With Your Partner-This bond will give you a sense of security, comfort and will help you to build your confidence.
1.S. Raisanen, S. M. Lehto, H. S. Nielsen, M. Gissler, M. R. Kramer, S. Heinonen. Fear of childbirth predicts postpartum depression: a population-based analysis of 511 422 singleton births in Finland. BMJ Open, 2013; 3 (11): e004047 DOI: 10.1136/bmjopen-2013-004047
2.Julia Sacher; Alan A. Wilson; Sylvain Houle; Pablo Rusjan; Sabrina Hassan; Peter M. Bloomfield; Donna E. Stewart; Jeffrey H. Meyer. Elevated Brain Monoamine Oxidase A Binding in the Early Postpartum Period. Archives of General Psychiatry, 2010; 67 (5): 468 DOI: 10.1001/archgenpsychiatry.2010.32