Postpartum Depression
It is not unusual for a woman to experience "the baby blues" after the birth of a child. This consists of periods of tearfulness mixed with happiness, loss of concentration, loss of appetite and inability to sleep. Usually, these mild symptoms last no longer than 2 weeks. However, when these feelings take weeks to months to go away, and when they are accompanied by more profound depression, loss of interest in activities or taking care of the child, severe loss of appetite, feelings of guilt or hopelessness, suicidal thoughts, or thoughts or fears of harming the baby, this is postpartum depression, and it needs to be treated.
What causes postpartum depression? Certainly socioeconomic factors (money, relationship) can contribute to a depression when one suddenly has a new life to care for. However, scientific studies have shown a strong correlation to physical factors such as hormonal imbalance, thyroid disruption, anemia, and low fatty acid levels. Also, women having an emergency caesarean section had more than six times the risk of developing postnatal depression three months postpartum. It could be that cesareans alter hormones, such as decreasing oxytocin--a strong bonding hormone released when the baby passes through the birth canal.
Hormones decrease rapidly in the first 72 hours after birth. This change alone can negatively affect women sensitive to changes in hormones, such as those who normally experience PMS or have trouble taking contraceptives. The typical hormonal pictures associated with postpartum depression are low prolactin levels, low estrogen, and high progesterone. Prolactin is the hormone that stimulates milk production and attachment and causes menstruation to cease (which results in a period of amenorhea). Prolactin is secreted by the pituitary gland, a gland which may shrink after childbirth (Sheehans' syndrome). Also, prolactin is stimulated by breastfeeding. Therefore, if a woman does not breastfeed, she will have lowered prolactin levels and could run the risk of being affected by postpartum depression. Prolactin causes the hypothalamus to secrete dopamine which is usually associated with reward or positive feelings--to the point of being the star hormone in addiction research. However, abnormally high dopamine levels can cause paranoid, delusional, or otherwise warped thinking. So dopamine levels either low or too high may be indicated in postpartum depression/psychosis. Dopamine lowers estrogen levels, which is related to postpartum depression, so high dopamine could have a dual effect.
ACTH--the hormone that stimulates the adrenals into releasing cortisol (the energy-giving, fight or flight hormone) is found to be high in relation to cortisol release in women experiencing postpartum depression. During pregnancy, the adrenals get bigger (hypertrophy) due to the extra hormones needed by the fetus and during birth. After birth, the adrenals are mildly supressed--via receptor regulation--in order to return to a pre-pregnancy state. This can lead to incredible fatigue that for depressed women, goes on longer than normal. This continued supression could be due to adrenal fatigue or a problem with the communication between the glands that secrete hormones (the HPA axis--hypothalamic/pituitary/adrenal). There could also be an altered learned response to ACTH which does not result in increased cortisol release. This pattern is seen in people who have experienced early life stressors (trauma in childhood). Stress during pregnancy can also change ACTH and cortisol levels after birth. It makes sense that ACTH without increased cortisol may be related to a feeling of being trapped--an inability to act on the feelings the hormones give--a feeling that could easily be attributed to caring for a newborn, thus affecting the mother's attachment to the child. ACTH is found in tears, so perhaps the uncontrollable crying in the postpartum time is the body's response to rid itself of ACTH instead of turning on cortisol. People at risk of experiencing this kind of imbalance are those who felt fatigued before pregnancy and people who are risk-takers (love the adrenaline rush).
Iron deficiency anemia is common among pregnant and post-partum women. There is scientific evidence to prove that iron supplementation relieves postpartum depression.
Treatments:
Exercise--can help the body put ACTH on track with cortisol, increasing cortisol production and therefore reconnecting the communication in the HPA axis.
Supplements--a supplement with thyroid co-factors, and especially iodine, give the thyroid the substrates needed for making thyroid hormone. Iron is needed to replace the iron lost in the loss of blood and will give both energy and a more balanced mental/emotional state. Also, B-vitamins are needed for energy production, so a good multi-vitamin (usually the prenatal) is a good item to add. In addition, a multivitamin will help adrenal function.
Herbs--herbs can provide nutrients, calm nerves, and rebalance hormones. For instance, Blessed thistle (Cinicus benedictus) can improve milk supply and relieve postpartum depression and suicidal feelings. Cimicifuga racemosa (Black cohosh) can relieve dark depressions that are related to decreased estrogen. Other herbs can support adrenal function. A tea made of fenugreek, fennel, and red raspberry leaf can increase prolactin, estrogen and oxytocin.
Homeopathy--Aurum, Causticum, Cimicifuga, Kali carb, Lycopodium, and Sepia are some of the remedies that can help postpartum depression. See a qualified homeopathic practitioner to get the right remedy.
No one should feel guilt over having postpartum depression. Although counseling/psychotherapy has been shown to help, you can't just talk yourself out of postpartum depression. It is a biochemical problem that needs to be treated by a qualified practitioner. The sooner you can start enjoying motherhood, the better for everyone!
