 |
 |
 |
|
After having a baby, many women have mood swings. One minute they feel happy, the next minute they start to cry. They may feel a little depressed, have a hard time concentrating, lose their appetite or find that they can't sleep well even when the baby is asleep. These symptoms usually start about 2 to 4 days after delivery and may last for several days.
If you are a new mother and have any of these symptoms, or have had them in the past, you are amongst the 70-80% of women who get what is called the "baby blues". The "blues" are considered a normal part of early motherhood and usually go away within 10 days of the delivery. However, some women have worse symptoms or symptoms that last longer. This is called postpartum depression.
Instead of the normal and relatively mild sadness and anxiety, about 10% of new mothers develop a more troubling condition called postpartum depression. Postpartum depression lasts longer, is more intense, and often requires counseling and treatment. Postpartum depression can occur after any birth, not just the first.
Feeling depressed doesn't mean that you're a bad person, or that you did something wrong or that you brought this on yourself.
Causes & Development; Risk Factors
Although many women get depressed right after childbirth, some women don't feel "down" until several weeks or months later. Depression that occurs within 6 months of childbirth may be postpartum depression.
There are many causes. Hormone levels change during pregnancy and right after childbirth. Those hormone changes may produce chemical changes in the brain that play a part in causing depression.
Low thyroid functioning is very common in women after childbirth. The baby's thyroid can produce antibodies against the mother's thyroid and causes it to under-function. This may be one of the chief causes of postpartum depression and weight gain.
Long chain polyunsaturated omega-3 fatty acid deficiency may contribute to depressive symptoms in alcoholism, multiple sclerosis and postpartum depression. Adequate long chain polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA), may reduce the incidence of depression just as omega-3 fatty acids may reduce the incidence of coronary heart disease.
In studying 20 healthy primiparous women (women bearing their first child) without significant health or psychiatric problems, a significant connection between reduced serum cholesterol levels and depressive symptoms postpartum was found.
Persons with elevated copper are prone to tinnitus and postpartum depression.
Postpartum depression is more likely if you had any of the following:- Previous postpartum depression or another psychiatric condition not related to pregnancy
- Severe premenstrual syndrome (PMS)
- A difficult marriage or lack of supportive partner
- Few family members or friends to talk to or depend on
- Stressful life events during the pregnancy or after the childbirth.
Signs & Symptoms
Here are some symptoms of postpartum depression:- Postpartum blues that don't go away after 2 weeks
- Strong feelings of depression and anger that begin to surface 1-2 months after childbirth
- Loss of interest in things that used to bring pleasure in life
- Less energy and motivation to do things
- Marked changes in appetite
- A hard time falling asleep or staying asleep or sleeping more than usual
- Increased crying or tearfulness
- Feelings of sadness, doubt, guilt, helplessness, or hopelessness that seem to increase with each week and begin to disrupt a woman's normal functioning. The woman may not be able to care for herself or her baby. She may have trouble handling her usual responsibilities at home or on the job.
- Feeling restless, irritable or anxious (for example being frightened of being left alone in the house with the baby)
- Unexplained weight loss or gain
- Having thoughts about hurting yourself, including suicide
- Fear of harming the baby. These feelings are almost never acted on by women with postpartum depression, but they can be very frightening and may lead to guilty feelings, which only make the depression worse
- Extreme concern and worry about the baby, or lack of interest in or feelings for the baby. Feeling unable to love the infant or rest of the family.
Treatment & Prevention
Postpartum depression is treated much like any other depression. Support, counseling ("talk therapy") and medicines can help. If you take an antidepressant medicine, it will go into your breast milk. Talk to your doctor about the risks of taking an antidepressant while breast-feeding. Your doctor can decide which medicine you can use while nursing your baby.
TMG or SAMe may be superior to methionine for the treatment of depression. It may be especially useful in treating postpartum depression and depression associated with drug withdrawal.
Tryptophan at 1-3gm per day can be used to treat a variety of depression syndromes. It is especially effective when treating depression which is accompanied by insomnia. Depression associated with menstrual cycles and postpartum depression sometimes responds very well to tryptophan supplementation. Postpartum women usually have high estrogen levels and it has been found that high estrogens increase the conversion of tryptophan to niacin. Progesterone and hydrocortisone decrease its conversion. Women on birth control pills, when given vitamin B-6 and tryptophan, generally tend to metabolize tryptophan more normally.
When postpartum depression occurs with megaloblastic anemia, the depression many times responds extremely well to folate supplementation.
If you have given birth recently and are feeling sad, blue, anxious, irritable, tired or have any of the other symptoms mentioned here, remember that many other women have had the same experience. You're not "losing your mind" or "going crazy" and you shouldn't feel that you just have to suffer. Here are some things you can do that other mothers with postpartum depression have found helpful:- Find someone to talk to -- and tell that person about your feelings.
- Get in touch with people who can help you with child care, household chores and errands. This social support network will help you find time for yourself so you can rest.
- Find time to do something for yourself, even if it's only 15 minutes a day. Try reading, exercising (walking is good for you and easy to do), taking a bath or meditating.
- Keep a diary. Every day, write down your emotions and feelings as a way of "letting it all out." Once you begin to feel better, you can go back and reread your diary -- this will help you see how much better you are.
- Even if you can only get one thing done in any given day, this is a step in the right direction. There may be days when you can't get anything done. Try not to get angry with yourself when this happens.
- It's OK to feel overwhelmed. Childbirth brings many changes, and parenting is challenging. When you're not feeling like yourself, these changes can seem like too much to cope with.
- You're not expected to be a "supermom". Be honest about how much you can do, and ask other people to help you.
- Find a support group in your area or contact an organization that can put you in touch with people near you who have experience with postpartum depression.
- Talk with your doctor about how you feel. He or she may offer counseling and/or treatments that can help.
Prognosis
How long does postpartum depression last? It's hard to say. Some women feel better within a few weeks, but others feel depressed or "not themselves" for many months. Women who have more severe symptoms of depression or who have had depression in the past may take longer to get well. Just remember that help is available and that you can get better.
References & Further Information
(1) "Dietary Polyunsaturated Fatty Acids and Depression: When Cholesterol Does Not Satisfy", Hibbeln, Joseph R. and Salem, Norman, Jr., American Journal of Clinical Nutrition, 1995;62: pp.1-9.
(2) "Rapid Decrease of Serum Cholesterol Concentration and Postpartum Depression," Ploeckinger, Barbara, et al, British Medical Journal, September 14, 1996;313: p.664.
|
|
 |
|
 |
Risk factors for Tendency Toward Postpartum Depression:
Recommendations and treatments for Tendency Toward Postpartum Depression: | | | | | Amino Acid / Protein |  Tryptophan / 5HTP |
Hormone |
Not recommended:
 Melatonin | On the basis of theoretical ideas about how melatonin works, some authorities specifically recommend against using it for depression, schizophrenia, autoimmune diseases and other serious illnesses, and in pregnant or nursing women. |
|
Lab Tests/Rule-Outs |
 Test Thyroid Function
Test Estrogen Level
Test Copper Levels |
Nutrient |
 DHA (docosahexaenoic acid)| | US scientists found low levels of omega-3 fatty acids, especially DHA, in mother's milk and in the red blood cells of women with postpartum depression. The difference was significant compared to those without depression. The reason for this finding was related to low intake of fatty fish such as salmon and herring containing large amounts of DHA. [Hibbeln JR., Seafood consumption, the DHA content of mother's milk and prevalence rates of postpartum depression: J Affective Disorders 2001]
Breast milk remains the primary source of DHA for the baby and a mother's brain the primary source of DHA for the milk. Researchers found significant variations in breast-milk DHA levels around the world. The lowest concentrations were found in vegan and American mothers, and the highest in mothers who ate fish regularly. [NOAA technical memorandum, NMFS-SEFSC-367, NIH meeting on omega-3 fatty acid research, May 12, 1994] |
TMG (Tri-methyl-glycine) |
| | | | |
KEY | | Proven definite or direct link | | | May do some good | | | Likely to help | | | Highly recommended | | | Avoid absolutely |
GLOSSARY
Anemia (Anaemia, Anemias)
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Antibody (Antibodies)
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Antidepressant (Antidepressants)
Literally, substances meant to oppose depressions or sadness, and generally heterocyclic types such as Elavil, MAO inhibitors like phenelzine, or lithium carbonate. This category of substances formerly included stuff like amphetamines and other stimulants. Botanical examples include Hypericum, Peganum and Oplopanax.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Copper
An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.
DHA
Docosahexanoic Acid. A metabolite of the omega-3 fatty acid alpha-linolenic acid.
Estrogen (Oestrogen)
One of the female sex hormones produced by the ovaries.
Fatty Acids (Fatty Acid)
Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Megaloblast (Megaloblastic, Megaloblasts)
An abnormally large nucleated red blood cell found especially in people having pernicious anemia or certain vitamin deficiencies.
Melatonin
The only hormone secreted into the bloodstream by the pineal gland. The hormone appears to inhibit numerous endocrine functions, including the gonadotropic hormones. Research exists on the efficacy of melatonin in treating jet lag and certain sleep disorders. Dosages greater than l milligram have been associated with drowsiness, headaches, disturbances in sleep/wake cycles and is contraindicated in those who are on antidepressive medication. It also negatively influences insulin utilization.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.
Methionine
Essential amino acid. Dietary source of sulfur and methyl groups. Important for proper growth in infants, nitrogen balance in adults, healthy nails and skin and the synthesis of taurine, cysteine, phosphatidylcholine (lecithin), bile, carnitine and endorphins. It is an antioxidant nutrient and lipotropic agent which promotes the physiological utilization of fat.
Multiple Sclerosis (MS)
Demyelinating disorder of the central nervous system, causing patches of sclerosis (plaques) in the brain and spinal cord, manifested by loss of normal neurological functions, e.g. muscle weakness, loss of vision, and mood alterations.
Niacin (B3, B-3, Niacinamide, Vitamin B3)
A coenzyme B-complex vitamin that assists in the breakdown of carbohydrates, fats and proteins. Essential for the health of the skin, nerves, tongue and digestive system. It is found in every cell of the body and is necessary for energy production. Niacin is also needed for DNA formation.
NIH
National Institutes of Health.
Polyunsaturated
Polyunsaturated fats or oils. Originate from vegetables and are liquid at room temperature. These oils are a good source of the unsaturated fatty acids. They include flaxseed with added vitamin B6 (pyridoxine), sunflower oil, safflower oil, and primrose oil.
Polyunsaturated Fatty Acid (Polyunsaturated Fatty Acids, PUFA, PUFAs)
A polyunsaturated fatty acid is one that is missing more than one pair of hydrogen atoms. Polyunsaturated fatty acids are mostly found in plant and sea foods. Safflower, sunflower, corn and soy oils are high in polyunsaturated fatty acids.
Postpartum
After childbirth.
Postpartum Depression
The "baby blues" are a very frequent and completely normal consequence of childbirth, usually wearing off soon afterwards as hormonal and psychological systems get back to normal. Postpartum depression is a less common but severe depression that begins in the weeks following delivery. It impairs the ability of the mother to care for the child and fall in love with it. This makes her feel even more depressed and inadequate thinking that she can not be a good mother. At the extreme, postpartum depression may lead to dangerous delusions (for example, thinking the baby is in some way deformed or cursed) or hallucinations (that may command violent acts). This can occasionally result in a tragic episode of suicide and/or infanticide.
Premenstrual Syndrome (PMS)
PMS consists of various physical and/or emotional symptoms that occur in the second half of the menstrual cycle, after ovulation. The symptoms begin about midcycle, are generally the most intense during the last seven days before menstruation and include: acne; backache; bloating; fatigue; headache; sore breasts; changes in sexual desire; depression; difficulty concentrating; difficulty handling stress; irritability; tearfulness.
Progesterone
This is the hormone secreted after ovulation by the corpus luteum. It is a steroid (similar to a cholesterol), enters receptive cells to stimulate their growth, and acts as an anabolic agent. Estrogen should be viewed as the primary coat underneath all the cycles during a woman's reproductive years, with progesterone, its antagonist, surging for ten or twelve days in ovulatory months. Most of the actions of progesterone cannot occur without estrogen having previously induced the growth of progesterone-receptive binding sites.
Red Blood Cell (Erythrocyte, Erythrocytes, RBC, Red Blood Cells)
Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.
Schizophrenia
Any of a group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions, and hallucinations, and accompanied in varying degrees by other emotional, behavioral, or intellectual disturbances. Schizophrenia is associated with dopamine imbalances in the brain and defects of the frontal lobe and is caused by genetic, other biological, and psychosocial factors.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating protein, fat and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.
Tinnitus (Tinnitis)
A sensation of noise (ringing or roaring) that is caused by a bodily condition and can usually only be heard by the person affected.
Tri-Methyl-Glycine (DMG, TMG)
After supplying a methyl group, TMG becomes di-methyl-glycine. DMG, a natural component of animal and plant metabolism, positively influences the immune response in laboratory animals and humans and boosts physical and mental performance.
Tryptophan
Essential amino acid. Natural relaxant and sleep aid due to its precursor role in serotonin (a neurotransmitter) synthesis. Along with tyrosine, it is used in the treatment of addictions.
Vegan (Veganism, Vegans)
A person who consumes no animal products of any kind. In other words, vegans do not consume meat, fish, fowl, dairy products, eggs, honey, or products containing gelatin or any other animal-derived ingredients such as whey powder or food colorings.
Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Last updated: Jun 01, 2008
|
 |
|
|
