Are You More Predisposed to Getting Postpartum Depression?
In the United States alone, it is estimated that approximately 70-80% of women will experience some form of mood disorder postpartum. But did you know that according to the American Psychiatric Association, the onset of postpartum major depression can occur both before or after delivery. In fact, in a prospective study of 546 women who were later diagnosed with postpartum depression, 20% had depression prior to pregnancy, 38% developed depression during pregnancy and 42% of women experienced the onset of their depression postpartum. So what predisposes a woman to postpartum depression and is there anything we can do to reduce your risk?
During pregnancy your hormones change drastically in order to maintain a healthy and viable pregnancy. Although hormone levels normally fluctuate both pregnancy and postpartum, researchers have noticed that there are certain hormone fluctuations more likely to trigger postpartum depression including decreases in estrogen and progesterone as well as other changes from cortisol, melatonin, oxytocin and thyroid hormones. Although these changes are “normal” researchers have found that some women may be more susceptible to these hormone fluctuations which may make them more susceptible to depression. In fact, differences in the activity of certain genes in the hippocampus may increase your vulnerability to postpartum depression by making women more sensitive to the drop in estrogen that occurs after birth.
Abnormal neurotransmitter activity also appears to be associated with postpartum depression. In fact, one study found that women with postpartum depression had a dysregulation in a particular enzyme known as monoamine oxidase-A in the prefrontal and anterior cingulate cortex. This enzyme normally metabolizes neurotransmitters such as dopamine, norepinephrine, and serotonin. Since these women had elevated levels of monoamine oxidase-A, they were considered “rapid metabolizers” and experienced more rapid depletion of these neurotransmitters which may explain why they were more predisposed to experiencing -postpartum depression.
We may not be able to change our DNA but we can alter the way genes are turned on or off. This is the study of epigenetics.. Interestingly enough many of the factors that appear to have the biggest impact on our genetics include environmental, dietary and lifestyle factors. So although you can’t change your DNA, what you do each and every day can ultimately determine which genes are turned on and off. Other factors that appear to impact our genes that most include hormones. In fact, researchers have found that estrogen, in particular, seems to behave like an antidepressant in the brain. This may explain why when we experience a drop in estrogen levels postpartum we are more susceptible to depression. Estrogen appears to behave like an antidepressant in the brain. By studying mice, Johns Hopkins researchers suspected that estrogen epigenetic changes in cells in the hippocampus may be a predictable factor for postpartum depression. Their research was later confirmed in human trials when looking for epigenetic changes in thousands of genes in blood samples from 52 pregnant women with mood disorders. Researchers found that women who developed postpartum depression exhibited stronger epigenetic changes in particular genes (TTC9B and HP1BP3).
How to Reduce Your Risk of Postpartum Depression
Use Food As Medicine
What you eat really matters, especially when it comes to reducing your risk of postpartum depression. Since postpartum depression can be associated with an imbalance in neurotransmitters it is important that we provide our body with the proper nutrients it needs to make neurotransmitters. One of the most important ways we can support our neurotransmitters is by consuming enough amino acids. Amino acids, often referred to as the building blocks of proteins, are compounds that play many critical roles in our body. Without proper amino acids, our body is unable to make the proper amount of neurotransmitters we need to balance our body. Although some amino acids are created by the body, there are certain amino acids, known as essential amino acids, that we must get from our diet and can not be made by the body. The 9 essential amino acids are histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine. Often the best food sources of essential amino acids are found in animal proteins such as beef, poultry and eggs. This is also the reason why if you are more genetically predisposed to develop mood disorders like postpartum depression, following a vegan or strictly vegetarian diet may not be the best option. In our clinical practice, we have found that patients with mood disorders do best on a paleo based diet. If you are considered a paleo based diet, make sure to speak with your local naturopathic doctor or nutritionist to help guide you along the journey. Many people who try to switch to a paleo diet themselves, often eat way too much animal protein per meal and not enough vegetables or omega-3 rich foods.
High quality, physician grade postnatal multivitamins are an important way to fill in the gaps postpartum. Although I recommend postnatal vitamins to our patients, remember that a supplement can not replace a poor diet. Making your diet a priority postpartum is really where my patients get the best results. It is also the reason I also like to suggest that patients add a meal delivery service to their baby registry list rather than yet another outfit or unnecessary gadget. We know that life postpartum can be a little hectic and it can be hard to remember what day it is and when was the last time you showered, so help make your life easier with some at-home staples and, if possible, a meal delivery service.
Remember that scene from Legally Blonde where Elle Woods recites one of her most famous lines “ exercise gives you endorphins. Endorphins make you happy. Happy people just don't shoot their husbands, they just don‘t”. Well maybe Elle Woods wasn’t too far off. Researchers have found that exercise has a profound impact on our health including the release of neutrophic or growth factors, which cause nerve cells to grow and make new conditions. Now when I say move your body daily, I don’t mean run a marathon or spend an hour each day at your gym. Start with five minutes a day of walking or any activity you enjoy. Soon, five minutes of activity will become 10, and 10 will become 15.
Counseling and Support
Building your support team may include your friends, family and ideally a licensed counselor or therapist. Having a therapist either for in-person or virtual consults is an important way to help provide you with the support you need. Although for some women their depression comes on gradually for others depression can come on quickly. Creating a relationship with a therapist or counselor during your pregnancy can be a great way to feel supported and also provide you with the safety measures you need. If any any moment, you experience suicidal thoughts or attempts or are worried about the safety of yourself or others, please seek immediate medical attention. National Suicide Prevention Lifeline :800-273-8255
About the Author: Meet Dr. ZenAlissia Zenhausern- Pfeiffer, NMD, FABNE, (commonly known by her patients as Dr. Zen), is a licensed naturopathic doctor board certified in naturopathic endocrinology and the founder of NMD Wellness of Scottsdale, a premier naturopathic medical practice that focuses on helping women to take a proactive approach to their hormone and fertility health. Dr. Zen has been featured as a lead expert in Forbes, Shape Magazine, and Instyle and is deeply passionate about bridging the gap between traditional and natural medicine in the world of fertility. She works with a variety of hormone related issues including PCOS, endometriosis and unexplained infertility. Her goal is to help more women get back into the driver’s seat of their own health to make lasting transformational changes to their health to bring more cute and adorable babies into this world. Read More About Dr. Zen...