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POST PARTUM DEPRESSION


By Birgitta Lauren

I’m here to talk to you about preventing Post Partum Depression (PPD) naturally.  There are many ways to prevent PPD and if this condition can be prevented and stopped there would be less need for heavy duty mind altering drugs which can be so harmful to both mother and the baby.  What if I told you that just 30 min of exercise decreased PPD scores on the Edinburg Post Partum Depression scale; a scale developed to see if a woman is suffering from PPD.  Exercise along with fatty acids or fish oil, a healthy diet, and psycho or talk therapy has been shown in studies to be more effective than SSRI’s or anti depressants.  ACOG says 1 in 10 new moms experience some depression postpartum, 10% of these have severe depression.  Depression is a symptom of the stresses that women may face during pregnancy, child birth, and a change in life style that the arrival of a new baby brings.  It’s not an illness itself that can be cured with a pill – anti depressant is only a temporary Band Aid while the underlying issues will still have to be addressed.  The stresses of becoming a new parent can be a rough transition.  Imagine if you will a small person quite literally living of a mother’s body.  The baby requires a lot of the mother’s nutrients and energy leaving little or any left over for mom.  There is a severe dip in progesterone and omega fatty acid levels right after birth which can affect the mother’s moods.  When the baby comes the mother makes breast milk and her life changes drastically, as she must give her utmost attention to her baby leaving her with little time or sleep for herself.  It’s no wonder she might experience some mood swings all the way to sever depression. 
Now that is what happens in most pregnancies.  If you add on top of that financial and/or domestic problems or possibly an unwanted pregnancy, the issues can really take a toll on some mother’s moods. Other things that might cause PPD are fertility treatments, multiple pregnancies, food allergies, intestinal flora imbalances, lifestyle choices such as lack of exercise, poor food choices, nutritional deficiencies, food additives, such as aspartame which is an artificial sweetener, glutamic acid, MSG, common food additives like artificial flavors, colors, thickeners, moisteners and preservatives that are all neurotoxins that can block serotonin production in our bodies. Medications such as anti depressants, anti inflammatory medication, pain medication, anti-histamines to birth control, illicit street drugs, alcohol, smoking caffeine, Candida problems, cranial compression, stress from emotion, intuitive and spiritual issues can also drain nutrients. So can too, various other medical conditions and/or exposure to environmental chemicals and toxins, whether they are at home, work, food, in your garden, in your teeth, such as mercury fillings or in the air.  30% of stress and neurotic disorders are caused by a chemical toxicity according to the National Institute of Occupational Safety and Health.
Anti depressants and their side effects.
Untreated pregnancy depression may have severe consequences in the form of suicide, miscarriage, hypertension, preeclampsia, low birth weight and PPD leaving the child at risk for depression and other health problems later. Untreated PPD also leaves moms at risk for violent behavior in addition to the above risks. However with the growing mountain of risk to the off spring from the use of anti depressants during pregnancy and postpartum, the FDA and Health Canada have required drug manufacturers to issue warnings on their labels. A report on SSRI’s use and birth defects by Swedish, Danish and American research find that all SSRI’s have been implicated in congenital heart malformation. But the most worrisome evidence concerns the drug Paxil.
According to the University of Montreal Canada, 1st trimester use of anti depressants is associated with major congenital and cardiac malformations. Other research shows increased risk for suicide, violence, homicide, heart disease, and high blood pressure, putting moms at risk for early delivery and preeclampsia, uterine and gastro intestinal bleeding, decrease in bone density, fertility problems, sexual dysfunction, sever withdrawal problems, miscarriage, early delivery. And for the newborn; low birth weight, lower APGAR scores, or increased admition to the neonatal care unit or NCU, jitteriness, tachycardia, hypothermia, vomiting, hypoglycemia, irritability, and constant crying, increased tonus, eating and sleeping difficulties, convulsions respiratory distress and pulmonary hypertension are seen in newborn from prenatal anti depressant exposure in utero through the 3rd trimester. Other side effects that are being discovered are mental problems as child grows up, diabetes and obesity. svm
There are also problems with sudden discontinuation of anti depressants, whether during pregnancy or after delivery. The drugs implicated include Zylexa, generic Fluvoxamine, Lexapro, Paxil, Prozac and Zymbiax.  The FDA advises very careful individual consideration of the risks and benefits of anti depressants. Andy adverse events should be reported to the FDA at 1-800-FDA-1088.
So with anti depressants coming 2nd after only Vioxx having THE MOST side effects, the MOST law suits due to the concealment of studies showing adverse events and overstating the efficacy of the drug by the manufacturers,  as well as a recent big push by doctors , psychiatrists, celebrities and mental health institutions, mostly supported by the big drug manufacturers advocating for depression screening and treatment with SSRI’s and therapy of pregnant and new moms without any consideration or education of natural prevention or alternatives to anti depressants… What is a New Mom to Do?
The mantra is that babies are better off with moms on drugs rather than not. – How far from the truth have we come?
At the American Psychiatric Association 2007 annual meeting it was said that for patients and their physicians opposed to prescription medications during pregnancy and nursing there’s an increased awareness of alternative treatment for depression. Psychotherapy, bright light therapy and psychological interventions have all been successful. Maria Corrall MD at Reproductive Health at St. Paul’s Hospital, Vancouver, Canada also mentions herbal, music, aroma, infant massage, exercise and yoga therapy that all seem to increase dopamine and serotonin levels while reducing cortisol and norepenephrine.
Fit moms have Healthier Babies.
Studies from the University of Birmingham UK, says there is now a lot of evidence to support the anti depressant effect of exercise in general and in the clinical populations. Data shows Australian and other studies supports walking as a very useful treatment for PPD. Studies comparing exercises with SSRI’s and talk therapy show that exercise is as effective as, and sometimes better than SSRI’s in treating and preventing PPD. In combining exercise with talk therapy, it shows a marked improvement over the anti depressants without the any side effects.
Dr. James F. Clapp III, MD and emeritus professor of reproductive biology at Case Western Reserve University and Research Professor of Obstetrics and Gynecology at the University of Vermont College, who has probably done most of the research in the world on prenatal fitness. He has found that there is a substantial reduction in pregnancy depression and PPD for those moms that continue to exercise through pregnancy and resume immediately post baby. Dr. Clapp also found that depression soars from obstetrical complications, and that exercise reduces obstetrical complications, and thus reduces chances of PPD.
On a personal note I have never in 19 years working with pregnant women seen pregnancy depression or PPD in a fit healthy mom, where all lifestyle factors were considered.
Exercise produces endorphins; it’s the feel good hormone that really helps prevent depression. On a separate note, anti depressants also have the effect of lowering the endorphin output of exercise according to the Department of Human Physiology and Sports Medicine at the Vrije University in Belgium. Thus that would reduce and negate the anti depressant effect of exercise. However, exercise is only half the battle; probably one the most promising methods in prevention of PPD lie in nutrition.
You and your baby are what you eat.
In a study published in the American Journal of clinical Nutrition in 2000 by McCrechs and Gibson noted that there is much interest in the needs of preterm delivery and preterm infants of Omega 3 fatty acids for proper development, but also in the need for the pregnant and nursing mother. Biochemically there seems to be a small reduction in fatty acids during pregnancy, but a much sharper drop postpartum, independent of lactation. Supplementation increases gestation, birth weight or both. The 2002 annual meeting of the American Chemical Society summarized many studies to DHA fatty acids supplements as improving infant development and reducing PPD. Dr. David Kyle Phd. From Advanced Bio-nutrition Corp. in Columbia Maryland , The Mother and Child Foundation, and  The Institute of Health says;  - “We believe the high incidence of PPD in the US may be triggered by a low dietary intake of DHA and the higher the intake of DHA the lower the incidence of depression”.  Dr. Hibbeln, another doctor also found a significant correlation with lower levels of DHA with both clinical depression and that of DHA content of breast milk and postpartum depression. While pregnant, the placenta pumps DHA from the mother to the fetus increasing the mothers risk for depression. The mother’s diet influences the breast milk levels of DHA.
Dr. Kyle said that the DHA content of mother’s milk in the US is actually among the lowest in the world. US women only have 40-50 mg in their breast milk, European women, 200 mg, and Japanese women who eat a lot of fish, 600 mg.
Toddlers from moms taking extra DHA perform significantly better on standard neurological motor function tests than those whose mothers don’t.  A recent Lancet issue quotes authors of another long term study by Dr. Joseph Hibbeln from the US national Institute of Alcohol Abuse and Alcoholism: -“Maternal seafood consumption of less than 340 mg / week did not protect children from adverse outcomes, rather the recorded beneficial effects on child development is on maternal seafood intake of more than 340 mg a week. “
These benefits also extend to learning difficulties, behavioral problem, Attention Deficit Hyper Activity Disorder, ADHA in Children.
Michelle Judge writes in the American Journal of Clinical Nutrition that DHA supplementation during pregnancy improved problem solving abilities for the infants first year. Dutch research from the Maastricht University also advocates the association of low Omega fatty acid levels with PPD, and that supplementation with DHA could reduce and prevent the often debilitating symptoms.  - “Our finding highlights that diet can enhance or inhibit depression related inflammation “, wrote Jamie K. Glazer in the Journal of Psychosomatic Medicine. These behavioral dietary interactions have important implications for physical and mental health. The benefits of Omega 3, proteins essential vitamins and minerals from oily fish outweigh the risk of pollutants say American experts as well as British scientists who have found that pollutant levels are falling. At the recent meeting of the American Association of the Advancement of Science, - “ The best studies coming out over the last 2 years have overwhelmingly been in favor of the benefits of seafood consumption”,  said Michael Morresy from Oregon’s State Seafood Laboratory.  –“There is no need to avoid fish, just some fish, like; shark, sward fish, mackerel, halibut and (sushi)  tuna come to mind”. Choose salmon, preferably the wild kind to avoid the red food coloring that may cause ADHD, and other various white fishes and trout.  
Brain function depends on exercise for production of “feel good” chemicals such as dopamines and the reduction of cortisol. When proper foods including these selective omega fatty acids accompany a good exercise program positive outcomes prevail, and my clients seem to rebound from postpartum difficulties. DHA and exercise also play an important role in reproductive health witnessed time and time again in neural and cognitive development of the child, especially when the DHA supplements during nursing is included. DHA supplementation and exercise should be a preconceptional through postpartum strategy, recommended by all OB/Gyn specialists as well as primary care practitioners says Jem Welsh CNC from Jem Welsh Nutrition in Orange County CA,. Welsh also recommend the Healthy Baby prenatal vitamins containing 1000 mg of DHA and EPA.
Other nutrition issues are also implicated in PPD. Michael Biomonte CCN reported in a 1997 that estrogen and copper levels usually increase during pregnancy, but they should return down to normal postbaby, but may remain elevated.  Excess copper has been implicated in PPD. When pregnancies are close together, copper remains high increasing chances of PPD.
Zinc, vitamin B6 and other nutrients can reverse this. Zinc deficiencies can also give rise to copper excess. Progesterone who works closely with zinc also plummets after delivery. Progesterone creams and supplements can be very effective in eliminating depression just like zinc. An ABC story on a 2005 Penn State University study on maternal iron deficiencies causing “bonding difficulties” for mom and child said: -“Experts say that women who forgo vitamin supplementation commonly experience iron deficiency after child birth”. They say iron deficiency is easy to correct and could be a big part of PPD with mother and child interaction. A lack of bonding may also increase PPD as the mother/child bonding produces the hormone “oxytocin”, which is another “feel good“hormone.
Amino acids, vitamin B1, B3, B6, B12, vitamin C, E, Folate, Inositol and calcium / magnesium supplements has been shown to help PPD as well. 
In the last few years, much attention has been paid to our increased knowledge of the importance of Vitamin D. Vitamin D’s role as the “sunshine vitamin” since our bodies produce this vitamin when our skin is exposed to the sun is becoming vital. Vitamin D is found to avert pregnancy depression and PPD, and help in most other nutrient absorption and thus preventing most health problems and diseases, from the common cold to cancer.  Vitamin D deficiencies from excessive use of sunscreen and sun avoidance are causing osteoporosis and cancer. Every minute of sunshine for a Caucasian person produces 1000 iu’s of vitamin D.  However all things in moderation: Caucasian people need a minimum of 10-15 minutes of unprotected sunshine a day, darker skin tones 30 minutes, and black skinned people at least 45 minutes. In winter when this is difficult to achieve in colder climates, supplementation becomes vital for normal health.  Eating an otherwise unbalanced or unhealthy diet can affect mood swings and the health of an unborn baby, such as; too much sugar, and processed, foods such as; thickeners, preservatives, emollients, flavors and colors.
 A pregnant mom only need about 300 extra calories a day while pregnant or about 5-600 if she exercise. This is only a couple of bananas. But she needs double and triple of many nutrients. That’s tough to fit into a couple of bananas. If these bananas turn into donuts or French fries, then neither mom nor the baby has any substantial sustenance to thrive on. It’s of utmost importance that a mom consumes as health of a diet as possible for her baby and herself during pregnancy and nursing.
Herbal remedies that have also shown promise in PPD reduction is St. Johns Work, Sam-e, although they do not work for everyone.
Otherwise reducing toxic exposure, allergens from food or airborne , mold (try not to clean with dangerous chemicals such bleach which is actually a “food source” for mold – use products coming soon from Betanix.com), Candida, food additives, processed and junk foods, checking your nutritional hormonal levels, increasing your light or sun exposure, managing your stress with meditation or exercise and normalizing the body’s energy balance with acupuncture, homeopathic or electromagnetic therapy should all be considered for depression prevention.
 In a summary
In general a mother with healthy lifestyle habits, from preconception through postpartum, is much less likely to suffer from depression. And in accordance with the “Citizens Commission on Human Rights” we need to be more responsible in the case of depression and educate moms to practice a healthier lifestyle, with the alternative treatments and prevention methods that exercise and good nutrition and taking prenatal vitamins and especially Omega fatty acids supplementation before any pharmaceutical drugs are prescribed. Drugs need to be our very last resort for mom and baby’s sake.