This is Part 2 of my Nutrition and Postpartum Depression series. If you're just joining us, please start with Part 1 here! In Part 1 of this series, we talked about what postpartum depression is and how it is impacted by lifestyle factors like untreated mental illnesses in pregnancy, physical activity, sleep, social isolation, stress, and skin-to-skin care. Today, we're going to move on to talk about two other important factors: hormones and nutritional factors (including deficiencies and insufficiencies). Hormones A woman’s hormones are constantly in flux, but there is nothing that changes them quite so dramatically and quickly as pregnancy and childbirth. Many different types of hormones are suspected to play a role here, from adrenal hormones (like cortisol) to placental hormones (like the estrogens and progesterone), thyroid hormones, and peptide hormones (like oxytocin and prolactin).
Hormone balancing is often going to take time, but a lot of the same lifestyle factors we discussed in the first post actually may be able to modify some of these hormone levels. Some important things to consider include:
Nutrients Everyone is aware that nutrition is exceptionally important in pregnancy—but sometimes we focus on Baby’s nutritional needs (both during pregnancy and after birth) so much that we might forget about our own nutritional needs in the postpartum period. Of course, if some women are not meeting their increased nutritional needs during pregnancy, they may have lingering deficiencies that persist into the postpartum period. But we also know that there are substantial changes that occur in mom’s nutrient status because of childbirth itself, the healing process, breastfeeding, stopping the prenatal vitamin (as many women do immediately after childbirth), and poorer dietary quality in the struggle that is postpartum life. Some nutrients that I primarily focus on with my clients are:
Obviously, there are a lot of factors to consider here. Diversity in the diet and a balanced, mindful lifestyle can make a big difference in both risk and ability to manage postpartum depression. But there are even MORE factors to consider here. In our next post, we'll talk about the gut microbiome and inflammation, and how these two factors can play into postpartum depression--and then we'll try to wrap all these bits and pieces of information up into an actionable, doable package. If you're comfortable sharing with this community, I'd love to hear from you in the comments. Have you ever struggled with postpartum depression, or are you struggling now? What was the most important step you took to help manage your symptoms? Erica Golden, RDN, IFNCPIntegrative and functional registered dietitian nutritionist.
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Postpartum depression is shockingly common for how infrequently it actually gets talked about. Sure, we’ve all done the screening questionnaires in the hospital, and those are very important. But many women are shamed into feeling that the way they feel is a sign that they are bad mothers or that something is wrong with their ability to love their babies. But more than one in 10 women experience postpartum depression. It’s the most common postpartum mood disorder—and if you’re wondering why there even is a most common postpartum mood disorder, why this is such a sensitive time period in a woman’s life, I hope to partially answer that question in this series. But also, along with telling you about why postpartum is SO HARD (you already knew it was, I’m just going to give you even more reasons why it’s hard), my goal is also to give you hope—that maybe there is more you can do about it, more that is actually within your locus of control, than you might have thought. What is postpartum depression? Postpartum depression is a depressive episode that occurs during pregnancy or within a year of giving birth. The symptoms in general are a lot like those of major depressive disorder (MDD), but these symptoms will look different, and perhaps in some cases more pronounced, because of the context in which they are occurring. Common symptoms include difficulty with self-care, changes in appetite, sleep, energy, motivation, and concentration, low self-esteem, guilt, and feelings of worthlessness. In some cases, women may also experience suicidal thoughts or thoughts of harming baby. Unlike the “baby blues” (which are experienced by up to 85% of women postpartum), postpartum depression is much more debilitating, lasts much longer, has a much more substantial impact on a woman’s ability to care for herself and for baby, and requires treatment. It’s so important that women recognize that care is available, and that they don’t have to “go it alone.” Screening for postpartum depression If you’re thinking that some of these symptoms sound familiar and want to dig a little deeper, a lot of physicians, psychologists, psychiatrists, and OB-GYNs use a screening form called the PHQ-9. You can take it on your own and bring it to your next appointment to discuss with your provider. Why postpartum? The period from conception to childbirth to the months following the birth (or loss) of a baby is filled with change—lifestyle changes, hormonal changes, inflammatory changes, dietary changes, and microbiome changes, just to name a few. This is an incredibly sensitive period in a woman’s life, including her physical, mental, and spiritual life. Some of these factors are easy to understand but difficult to address. Some are difficult to understand in layman’s terms and still difficult to address. There’s nothing really easy about mental health in general. But we’ll start today by zooming in on some of the specifics, and then end by zooming out to what implementation of these specifics might look like in simple but broad sweeps. In this series of articles, we’ll cover lifestyle factors, hormones, nutrients, inflammation, and the gut microbiome in a deep dive into preventing postpartum depression and promoting postpartum mental well-being. Lifestyle factors We’ll start with the lifestyle factors, because in some ways these are the most important—and in some ways also the most challenging to address.
In the next couple of posts (Part 2 and Part 3), we'll cover hormone changes, nutritional changes, changes in the gut microbiome, and inflammation, and how these factors can also have significant implications for postpartum mental health. In the meantime, let me know how I can support you in your journey. Postpartum is hard! But it's easier together. Erica Golden, RDN, IFNCPRegistered Dietitian Nutritionist with a passion for helping people improve their mental health and gut health using integrative and holistic therapies. |
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January 2025
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