Postnatal depression is multi-factorial, so taking a holistic approach is essential, says dietician Ashleigh Caradas.
For some moms, the period after birth is pure bliss, but it’s estimated that up to 80% of women feel overwhelmed, anxious and sad. What’s more, the guilt associated with these feelings can send you into an even more depressive state. If these feelings last longer than two or three weeks, what you’re experiencing could be more than the “baby blues”, you could have postnatal depression.
The emotional and psychological demands of pregnancy and raising a child are significant – especially for women who have multiple responsibilities. Postnatal depression includes symptoms of deep fatigue and hyper-vigilance that can start immediately after birth and last for up to 10 years if not treated effectively. But there’s plenty you can do to remedy the situation.
Clinical psychologist, Jeanine Lamusse explains having postpartum depression does not make you a defective mother. “As you will see as your child grows, in order for you to parent her effectively, you have to confront many parts of yourself. Sometimes, it means understanding that in order to parent effectively, you need to take care of your own health. Also, as your child grows, her experiences will awaken memories and emotions around your own childhood. This can be difficult, but gives you the opportunity to heal those parts of yourself. If you avoid this process, you risk harming your child emotionally – a sad and harsh truth to digest.”
It’s essential that moms understand they don’t have to be the best in the world, they just need to be good enough and do the best they can. “A good-enough mother is a thoughtful one; a mother who can set aside some time to be fully present to the needs of her child,” explains Jeanine.
Medical, psychological and nutritional interventions can work together to help lift your mood and improve your coping skills if you’re suffering with postnatal depression.
Here’s a look at some of the options.
The best way towards a solution is to find the root of the problem, but depression can be tricky to investigate. Researchers have tried to pin down the cause of depression and postpartum depression, but while chemicals, hormones and inflammation are at play, the “cause” is unknown.
However, Jeanine’s clinical experience has revealed many possible links including:
- High expectations, which are unchecked and not realistic of yourself as a parent
- Perceptions and experiences of childhood, and the belief systems they might have created
- Battling with a sense of vulnerability
- Whether or not you’re in touch with your inner child
- Temperament differences between mother and child
- Environmental stressors
- Hormonal imbalances
- Sleep deprivation
- Not feeling supported in your relationships.
Psychological counselling can help uncover the areas that need attention and help you better understand your behaviours and feelings so you can better equip yourself with coping skills and a sense of resilience. Jeanine says, “I look at all aspects of self-care, the support structure around the woman, and explore how she understands her journey to see if there are any beliefs or expectations that need to be explored. I would do a thorough history of her childhood, and help her identify patterns she may be re-enacting unconsciously. In this way, she can develop an understanding of herself, and practise healthier ways of being. I would also refer her for parent/infant or parent/child therapy if the child is displaying concerning behaviours. Very often, a large part of my work is getting women to be informed by their bodies, in touch with their feelings again and learning how to use their feelings as tools rather than being blinded by them. I take a very systemic approach and consider all things that may be impacting the mother-child system.”
Medication and supplements
Antidepressants are often the first line of treatment for women with postnatal depression and many will do well on SSRIs (selective serotonin reuptake inhibitors). Medication can help correct the chemistry that causes low mood, but does not address the root cause on a holistic level. Also, for women who are breastfeeding, SSRIs may be contraindicated. Some doctors give Sulpiride, an anti-psychotic drug that’s also used to increase milk supply, but this often comes with unwanted side effects, as with most medications. According to Jeanine, “Some clients don’t like psychiatric medication so for milder cases, I have seen surprising results with homeopathic and herbal interventions.”
Natural remedies are a good option for mothers who are not nursing, but if you’re breastfeeding, medical supervision is always necessary as safety of these medicines during breastfeeding is still a grey area.
A commonly prescribed alternative to SSRIs is 5-hydroxytryptophan (5-HTP), an amino acid-like precursor to serotonin (the feel-good neurotransmitter). For women battling with anxiety more than depression, supplementation with the neurotransmitter gamma-Aminobutyric acid (GABA) is an option due to its stress-relieving and calming effects. Adaptogens like ginseng and ashwaganda are also options, but safety during breastfeeding is questionable.
Supplementation with a high-dose vitamin B supplement (especially vitamins B1, B6 and B12) and magnesium can also help the body better deal with stress. Vitamin D deficiencies and deficiencies of omega-3 fatty acids have been linked to postnatal depression. Fortunately. supplements of B vitamins, magnesium, vitamin D and omegas are all safe during breastfeeding.
Being depressed can interfere with the way we eat and our food choices. When you’re down, you tend to go for instantly gratifying foods, like starchy or sugary meals; or reduce your food intake due to low appetite. Having a healthy relationship with food and a nourishing diet is essential to help not only deal with stress but also create a sense of self-care, which is important in the healing process.
The role of diet in combatting depression and boosting mood is often overlooked. The first port of call is to treat any underlying deficiencies or boost levels of nutrients known to help with depression. Magnesium can be obtained from most things that grow in the ground, and keeping plant intake high will help boost magnesium levels. Besides direct sunlight (20 minutes per day is recommended), food sources of vitamin D include eggs, oily fish and mushrooms. Omega-3 fatty acids from oily fish (like salmon or sardines) as well as flaxseeds, chia seeds, hemp seeds and walnuts are good additions to the mood-boosting diet. Protein is also essential for neurotransmitter production, and a good protein source should be included with every meal.
A diet that contains adequate protein, is mostly plant based and includes essential fatty acids can help provide additional protection against a depressive mood.
Ashleigh Caradas is a Johannesburg dietician with almost 15 years’ experience in private practice. She holds a bachelor’s degree in Science from the University of the Witwatersrand and a Medical honours degree in Nutrition and Dietetics from the University of Cape Town. Her practice is dedicated to clearing up misconceptions about popular diets and helping her clients find the right fit for their particular body type, preferences and goals.