Did you know that up to 85% of women experience some form of disturbed mood following pregnancy? 

If left untreated, unaddressed, or unrecognized, this can lead to Post-Partum Depression which puts both the mom and baby at risk of negative long term effects, both  behavioural and developmental. 

While it is difficult to accurately predict who is most at risk, there are 3 main areas to consider:

1. Hormonal
2. Psychological
3. Biological

Hormonal: 

• Estrogen, progesterone, and cortisol take a dramatic fall 48 hours following delivery. While this is a normal experience after pregnancy, some women may be more sensitive to these changes [their hormone receptors may be less sensitive, they may have different genes turned on/off during pregnancy]. 
• It's also been shown that women with PMS are up to 2x more likely to have post-partum depression. 

Psychological:

• Lack of support, recent negative experiences or significant stressors increase the risk of post-partum depression.
• Financial, employment, and relationship concerns can be large contributing factors.

Biological:

• A history of depression, depression in pregnancy, or family history of mood disorders all increase the risk as well. 

• Having experienced post-partum depression or psychosis in a previous pregnancy increases the recurrence rate by up to 90%. 

Since the best medicine is prevention, what can we do to prevent post-partum depression from happening in the first place? What can we do to reduce these risk factors?

Healthy Hormone Balance: 
Since a history of PMS is associated with post-partum, getting hormone balance in check prior to pregnancy could help with prevention. Estrogen dominance, which is often involved in PMS and other hormonal concerns, is a state where estrogen is higher relative to progesterone. This does not always mean that there is too much estrogen however, it could be more of a lack of progesterone from anovulatory cycles for example [lack of ovulation] which could occur for several reasons. [Treat the cause!] 

• Improving liver detoxification which helps in the clearance of estrogen [B5, NAC, folic acid, amino acids like glutamine, glycine, and taurine]  
• Progesterone promoting herbs like Maca and Vitex

• Healthy hormone clearance through regular fiber intake, proper hydration, and reduction of refined sugars, saturated fats, and processed foods. 

Stress management:
Our experience of stress causes the release of cortisol. Since the creation of cortisol, which is a hormone much like estrogen or progesterone, requires the same building blocks as our other hormones, it can actually lead to decreased production of progesterone. Our body would rather use it's resources to deal with stress rather than focus on conception!

• Take time to restore using: deep breathing exercises, mindfulness, yoga, time in nature.
• Reduce the physical stress on your body by reducing or eliminating things like caffeine, alcohol, excess sugars, fast/fried foods, eating on the go, etc.  
• Consider counselling or cognitive behavioural training to learn to build stress awareness and resiliency 
• Adaptogens like withania, glycyrhiza, rhodiola, or schisandra can all help to promote a healthy stress response as well

Mood Support:
Because both personal and family history of mood concerns can increase the risk of post-partum, it is important to reflect on this prior to pregnancy. There can be many factors involved in mood disturbances such as inflammation, hormone imbalance, poor blood sugar regulation. Depending on which triggers are involved, different supplements and dietary approaches can be used to create a more stable mood. For example:

• Omega 3's: EPA in particular has been shown to be useful for depression and anxiety, particularly if there is inflammation contributing to the mood issues.
• Probiotics: By helping to regulate the gut-brain axis, probiotics can support a healthy mood. They are also involved in the absorption and creation of key nutrients for mood health. 
• Blood sugar balance: If your diet is high in refined sugars, flours like breads, pastas, cookies, etc, this can raise cortisol, lower progesterone levels, and promote insulin resistance. Choosing whole grains, more fiber based starches, consuming meals with protein and healthy fats like coconut oil or olive oil can all help to regulate blood sugars. 

While prevention is ideal, many of these strategies are still useful and can be applied for women experiencing post-partum depression!

As always, before making any dietary or supplement changes, it is important to consult with your Naturopathic Doctor or Family Doctor.

Yours in health,

Dr. Ashley Nelson, ND