Having experienced postnatal depression (PND) myself I work with passion in the area of postnatal support and have served on the Postnatal Distress Board, which is part of the Post Natal Distress Support Network Trust (www.postnataldistress.org.nz). I also see many clients with PND in my clinic. Every woman’s experience of PND is different and the triggers are different. The single most important thing to do if you are feeling depressed is to reach out for help. Like all things in life, there is a spectrum of dysphoria or unhappiness that can kick in after the birth of your baby, and finding out where you sit along the spectrum can be difficult, which is why it is good to talk to health professionals, such as your midwife, naturopath or GP. PND affects 10-20% of women and it’s important that it’s diagnosed and support sought early. The longer PND goes undiagnosed and unmanaged, the worse it is for mother and baby.
Common symptoms are:
- Depression, lack of joy
- Anxiety and panic attacks
- Sadness, tearfulness, frequent crying
- Feeling overwhelmed for long periods
- Feeling unable to cope or concentrate
What causes PND?
Hormonal factors: Women experience a massive hormonal shift following birth. Oestrogen and progesterone levels drop dramatically, prolactin levels suddenly increase and cortisol and serotonin levels may be disrupted. Adrenal and thyroid health is of key importance. Nutritional and biochemical factors: Low levels of zinc, essential fatty acids and B vitamins are all associated with an increased risk of PND. Iron levels are also important. Elevated copper can also negatively affect mood and energy following birth. Adequate protein is essential for healthy neuro-transmitter production so increase your consumption of egg yolks (runny), brewer’s yeast, seaweeds, wheatgerm, nuts and dark, green leafy vegetables.
Personal circumstances: Many personal circumstances relating to individual health can increase the risk of PND. They include a history of depression or anxiety, low thyroid function, lack of financial support, a history of alcoholism or recreational/prescription drugs. Relationship stress and loss of identity and personal freedom is something I hear a lot about from my clients.
Birth factors: Women who have had some form of technological intervention during the birth are 24% more likely to develop PND. Those who
have had an emergency Caesarean section are six times more likely than other women to develop PND.
Cultural and social factors: Many social and cultural factors can contribute to PND and they have a lot to do with the way motherhood is valued (not highly) and the lack of support for new mothers. A woman with true PND should always consult her health practitioner. But you can also seek natural healthcare. It’s much better to have an individualised prescription than something generic off the shelf. Your PND may be very different to someone else’s, and the herbs and remedies that will suit you may not be the best for someone else. These remedies can be used whether or not you take prescription drugs as well.
Common herbs and nutrients for PND
A personalised formula may contain:
- Chaste tree, withania, St John’s wort, lemon balm, lavender, rhodiola, American ginseng, kava and liquorice.
- High-dose B vitamins to support the adrenal and thyroid glands and my personal favourite, MH Enhance Thyrogen.
- Zinc and omega-3 fish oils are both very important for mental, emotional and physical health. Both are nutrients often lacking in the diet. Countless studies show that fish oil helps to reduce the symptoms of depression. It also works really well with antidepressant medication. If you are breastfeeding you should choose a fish oil that has a balance of EPA and DHA. You need to take 1000mg or more daily to have a positive effect on your mood.
- Bach Flowers including pine, larch, walnut, elm, aspen, sweet chestnut, hornbeam, gentian and star of Bethlehem.
- Magnesium levels drop when the body is under stress, good magnesium levels are important to calm the nervous system and feed the adrenal glands.
- Vitamin D levels are something I look at very closely. Low vitamin D levels directly relate to our moods.
Other forms of support
- Routine: This is particularly beneficial for women who feel “out of control” or lost. Knowing when your baby will sleep and be awake, will create a feeling of calm and reduce the anxiety.
- Dietary changes: I spend a bit of time tweaking my clients’ diets. It’s important to have high levels of protein, moderate amounts of complex carbs, no sugar, plenty of vegies, good fats and lots of water.
- Adequate sleep: It is so important for any new mum to get enough sleep. During my own experience with PND, the more sleep I had the better I felt, as sleep deprivation severely affects your mood and immune system. I expressed a milk feed which my husband gave our baby at 10pm and this gave me much more sleep.
- Get outdoors: Do gentle exercise, see friends, spend time with someone who comforts you. I walked every day with a friend, rain or shine.
- Seek professional help: There are plenty of good support groups, counsellors and therapists. See below for recommendations.
- l Spoil yourself: Massages, essential oils, baths, foot rubs and treats.
It’s taken almost four years since I started battling PND (which I suffered for 18 months), for me to get a healthy perspective on it. But out of every low comes a wonderful journey of learning about oneself, making changes and then gradually reaching acceptance, kindness and understanding. I have learnt to be kinder to myself, to say no (no to others is a yes to yourself), I’ve simplified my life, I put myself and my wellbeing first. I ask for help when I feel overwhelmed and don’t sweat the small stuff. Although it took me a long time to feel I could have another child (mostly because of the fear of getting PND again) I have been blessed with the most wonderful experience with my second son. I did not suffer PND, and I put this down to knowing exactly what I needed to do for myself and having systems in place to support me. If you have PND there is comfort in knowing that many women experience it. So reach out to others, talk about your experience and help each other. Motherhood is all about sisterhood.
Help when you need it
Seek professional advice via these websites:
Visit the Living With Postnatal Depression forum at www.ohbaby.co.nz/forum
Natasha Berman-Carter is a naturopath, medical herbalist and managing director of QBaby (www.qbaby.co.nz). She’s mum to Eli and Asher.
This article first appeared in OhBaby!