Postpartum depression

Postpartum can be an exciting time for a new mom but it can also be a stressful time dealing with and adapting to the new baby lifestyle. The fluctuating hormones don’t help and combining this with a lack of sleep and adapting to the new lifestyle can all lead to feelings of postpartum depression, anxiety, and/or a sense of general tiredness. Postpartum depletion is a real thing!


HORMONAL CHANGES


 

Right after labour and delivery, progesterone and estrogen drop significantly with a return to pre-pregnancy levels in as little as 24 hours following the birth.  The drop in estrogen and progesterone is necessary for milk production. Estrogen is needed to make serotonin (mood balancing neurotransmitter) and progesterone’s breakdown metabolite, allo-pregnenolone, can bind to GABA receptors helping to mitigate anxiety.  Therefore, the drop in estrogen and progesterone can be one of the reasons women can experience feelings of anxiety, change in mood, postpartum depression, and insomnia.  Breastfeeding can often suppress ovulation and menstruation, which can keep estrogen and progesterone levels low as well.

Thyroid hormone fluctuations and thyroid disorders are not uncommon postpartum either.  While they are usually transient and will return to normal as things normalize, sometimes they can be permanent.  This can be another reason contributing to exhaustion, low mood, insomnia and mood changes.  Hypothyroidism is very common and may be the reason you have a difficulty shedding pounds and feeling exhausted following pregnancy.  This is a reason I like to do a full thyroid workup postpartum, including assessing thyroid antibodies to rule out postpartum autoimmune thyroiditis (1) ESPECIALLY if you are struggling with low energy and unable to lose weight and are 6 months or more postpartum plus you experience joint pain and body aches.


NEW LIFESTYLE


 

New Baby

The stresses of adapting to the new lifestyle raises your stress hormone, cortisol. Experiencing disturbed sleep disrupts your normal circadian rhythm and your cortisol/melatonin rhythm and a lack of sleep has been shown to increase cortisol.  Increased cortisol and/or adrenaline (norepinephrine/epinephrine) can be another reason contributing to tiredness, feeling “tired but wired”, anxiety and mood changes, increased irritability or a “short fuse”.

It’s no wonder new moms can develop postpartum depression (PPD) – It’s not your fault for you feeling the way you are!  Dr. Schiller et al (2) even mention that PPD is a complex interplay between new life changes and changes to the adrenal hormones like cortisol, estrogen, progesterone, and thyroid hormones as mentioned above.


WHAT IS PPD?


 

PPD usually sets in within the first month and lasts longer than just a few days but it can come about anytime for the first year after giving birth.  This is generally diagnosed the same as general depression with the following signs and symptoms:

  • Not feeling like themselves for at least two weeks
  • Loss of interest in normal activities, including being with the baby
  • Feeling “on edge”
  • Feeling sad and low mood
  • Anxiety
  • Sleep disturbance (although this is also normal part of motherhood)
  • Brain fog
  • Changes in appetite

PPD is different from baby blues.  The latter can kick in soon after birth and usually just lasts a few days and disappear soon after.

While some women may take antidepressants, there are ways naturopathic medicine can help if you don’t want to have to resort to antidepressants right away.  Lots of natural therapies are safe while breastfeeding too.  Sometimes, it even just helps to talk to a wellness professional, psychologist, counselor or someone that just gets it.


SUPPORT


 

support

Check out postpartum support groups in your area as well.  Here in Calgary, there is Postpartum Support YYC.  Being with other mums who understand what you are going through can help greatly PLUS it provides an environment for your babies and children to make new friends too.


FOR THE DADS:


 

baby and dad

We can’t forget all the dads out there that probably experience the stress of adapting to a new lifestyle, sleepless nights and having to go to work every day. This new lifestyle can affect mood and energy in dads too but it’s a known fact that males will not typically speak up about how they are feeling because society has put a stigma that the male figure must appear strong and cannot appear weak/soft/emotional.  Naturopathic medicine has lots to offer for all those dads out there experiencing stress, low energy and struggling to cope with the new lifestyle. 


References:

  1. Keely EJ, MD FRCPC. Postpartum thyroiditis: an autoimmune thyroid disorder which predicts future thyroid health. Obstet Med. 2011 Mar; 4(1):7-11.
  2. Schiller CE, Ph.D., Dr. Meltzer-Brody S, MD, MPH., and Dr. Rubinow DR. The role of reproductive hormones in postpartum depression. CNS Spectr. 2015 Feb;20(1):48-59.
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