Having a baby is the most beautiful, exciting moment of your life, right? Not for some. Postpartum depression, anxiety, OCD and psychosis – a collection of mental illnesses particular to the circumstances of pregnancy and mothering – are estimated to affect about 10-15% of women (1).
That some moms go through this is nothing short of tragic.
The Canadian Mental Heath Association and The Mayo Clinic offer counselling, meditation and medication as the appropriate treatment for postpartum mental illness (2), however I want to spread the word that new and exciting research suggests that maternal diet might also play a profound role.
Every mother suffering from postpartum mood disorder should seek the advice of a medical expert. The intention of this article is to explain some of the research around how food and nutrients can be related to postpartum mood changes and offer strategies that can help, as part of a more comprehensive plan, to get a mom back on her feet.
What makes one woman’s experience with her baby delightful and another woman’s gloomy? There is some debate as to what causes postpartum mood changes – likely because no two women have the same physiology.
According to the Mayo clinic some possible factors could be post pregnancy drops in estrogen, progesterone and/or thyroid hormones. They also point to changes in blood volume, blood pressure, immune system, metabolism, sleep deprivation, and stress as causal factors for mood changes.
If we draw on some of the emerging brain research, however, we can look to metabolic, immune, inflammatory and nutrient changes particular to pregnancy to explain postpartum mood changes, making what and how a new mom eats an important thing to consider.
Low levels of B12, folate (B9) and B6 have been shown to promote inflammation and mood conditions, likely because they are critical players in the methylation cycle – a natural cycle in the body that is involved in the activation of mood hormones, the neutralization of toxins and the management of oxidative stress.
Take note that long term stomach acid suppression can block the absorption of B12. So if you were on medication for reflux or heartburn during pregnancy (Nexium, Dexilant, Prilosec, Zegerid, Prevacid, Protonix, and AcipHex), a low B12 level might be part of the postpartum mood issues. Your doctor can easily check B12 levels.
If you have a genetic variant known as MTHFR your ability to convert folate from food can be up to 70% impaired. In this is the case, taking an activated folate supplement is a way to get sufficient folate. Choose a supplement that contains either folate, Methylfolate or 5-MTHF. Not folic acid.
Other nutrient deficiencies that have been implicated in mood disorders are: vitamin D, Calcium, zinc, magnesium, copper (deficiency or toxicity), Omega 3 fatty acids, B3, protein.
In some cases, the physical stress of pregnancy along with the hormone shifts it involves, coupled with other factors like poor digestion or medication that can impair absorption, leaves a mother depleted of the critical nutrients needed for proper brain function and results in altered mood.
Regardless of whether a mother suffered from gestational diabetes, stabilizing blood sugar in the postpartum months is an important factor to regulating mood. It can be particularly difficult to do this because of sleep disturbances and demands on your time. Asking friends or family to help you keep a steady supply of nutrient-dense snacks handy can be helpful.
When blood sugar is awry, insulin levels spike causing a cascade of events and resulting in inflammation and undue stress on the adrenal and thyroid glands. The result can be profound changes in mood.
Here are a few suggestions to keep blood sugar stable.
A fairly new area of study is looking at the connection between high inflammation markers and altered mood states. This article reviews some of this research and this article nicely outlines the connection between inflammation and postpartum mood disorders.
Nutritional researchers are still trying to come to some consensus about how to use foods to modulate inflammation however, here are some ideas to try:
Oxidative Stress is the term used to explain damage to tissues that comes about when the bi-products of metabolic functions are not effectively neutralized. This is also called “free radical damage”. The stress of pregnancy increases a mother’s oxidative stress, particularly if she is undernourished.
Antioxidants are chemicals that neutralized free radicals, reducing oxidative stress. While the most powerful of antioxidants, such as glutathione, are created by the body, a significant amount also comes through diet. Vitamins A, C, E, and minerals zinc and selenium are well know antioxidants.
One study suggests that selenium supplementation, in particular, may protect against the development of postpartum depression (10). Fish oil has also been associated with a reduction of oxidative stress in pregnancy (11). Magnesium deficiency also seems to be inversely related to oxidative stress.
New moms are particularly prone to autoimmune expression after the stress of pregnancy. More research here is needed but it is certainly worth asking your doctor to rule out autoimmune conditions, particularly Hashimoto’s Thyroiditis and Celiac, as they have been shown to deeply affect mood.
As with all illnesses, while a group of women may share the same symptoms, no two women’s physiology is the same and therefore there can not be a one sized fits all explanation or treatment for postpartum mood disorders. Each mother should work with a qualified practitioner to determine the most appropriate course of action she should take. But can you see now how there can be multiple causes and multiple solutions?
One thing is certain…. we all need to help moms feel good so they can take care of their babies. When a mother suffers from a postpartum mood disorder, she needs support from every direction to implement these strategies.
NOTE: For a great run down on what PPD, PPA and PPP look like, check this article out.
(4) Mokhber N, Namjoo M, Tara F, Boskabadi H, Rayman MP, Ghayour-Mobarhan M. Effect of supplementation with selenium on postpartum depression: a randomized double-blind placebo-controlled trial. J Matern Fetal Neonatal Med 2011 Jan;24(1):104-8.
(5) Messaoudi M, Lalonde R, Violle N, Javelot H, Desor D, Nejdi A. Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Br J Nutr 2011 Mar;105(5):755-64.)
(6) Hibbeln JR . Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression: a cross-national, ecological analysis. J Affect Disord 2002 May;69(1–3):15-29.
(7) Golding J, Steer C, Emmett P, Davis JM, Hibbeln JR. High levels of depressive symptoms in pregnancy with low omega-3 fatty acid intake from fish. Epidemiology 2009 Jul;20(4):598-603.
(8) De Vriese S, Christophe AB, Maes M. Lowered serum n-3 polyunsaturated fatty acid (PUFA) levels predict the occurrence of postpartum depression: further evidence that lowered n-PUFAs are related to major depression. Life Sci 2003 Nov 7;73(25):3181
(9) Otto S, De Groot RH, Hornstra G. Increased risk of postpartum depressive symptoms is associated with slower normalization after pregnancy of the functional docosahexaenoic acid status. Prostaglandins Leukot Essent Fatty Acids 2003 Oct;69(4):237-43.
(10) Heh S, Huang L, Ho S. Effectiveness of an exercise support program in reducing the severity of postnatal depression in Taiwanese women. Birth 2008 Mar;35(1):60-5.
Osborne LM, Monk C. Perinatal depression—the fourth inflammatory morbidity of pregnancy? Theory and literature review. Psychoneuroendocrinology 2013 Apr 19;S0306–4530(13):00114-5.
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