Postpartum Depression (PPD)
It’s estimated that 1 in 7 women experience postpartum depression and most suffer in silence. I’m hoping this post will open the doors for more women to seek help and support if they’re are feeling exhausted, overwhelmed, and/or depressed after having a baby.
What’s the difference between Postpartum Depression (PPD) and the normal fatigue, brain fog, and perhaps sadness and isolation experienced by new moms?
PPD usually lasts longer and is more debilitating than the common fatigue of a new mom. It can hit immediately after giving birth and last as long as 12 months. AND it can change its stripes: first appearing as anxiety and a feeling of complete overwhelm then moving into depression.
PPD is not necessarily new but there’s been a rise in the number of moms affected and when that happens, it’s always good to ask why.
Factors That Contribute to PPD
- Isolation and lack of support
- High expectations
- Greater hormonal imbalances lasting for longer periods of time
- Nutrient deficiencies
- An increase in Hashimoto’s thyroiditis
1.Isolation and lack of support: Moms kind of get the boot once they give birth. They receive their 6 week check-up and then they’re supposedly good to go.
Unfortunately, mom is too often not good to go. She can feel isolated and overwhelmed, inadequate, and ashamed that she’s not able to feel joy caring for her new baby.
Many moms no longer have families close by to show them what to do, take some of the load off, or just let them know that everything they’re feeling is normal. And it’s often hard to establish relationships with other new moms to compare notes and receive support.
2.High Expectations: Countries in Europe and Asia have paid maternity leave ranging from 16 weeks to 18 months, while the U.S. offers no paid leave, putting pressure on both moms and dads. In the U.S. and probably nowhere else in the developed world, women are expected to return to work within 6-12 weeks after giving birth.
At the 12 week mark, let alone at 6 weeks, mom is still trying to allow her hormones to level out, adapt to 5-6 hours of interrupted sleep, pumping or nursing every 3-4 hours, and giving tons of needed attention to a new little person. That’s a lot to deal with, without attempting to add work, especially full time, into the mix.
Even if you feel ready to return to work and you’re in a position to have great support and help, remember that your body is still adapting to being in a non-pregnant and possibly nursing state and your hormones have NOT settled down yet.
If you jump back in all the way, just be aware that you’re possibly setting yourself up for a rebound of low hormones and moods. If that happens, honor it, back off, and take care of yourself.
3.Hormones: Once baby and the placenta are delivered, estrogen and progesterone levels take a deep dive. To compound things, your brain and ovaries haven’t been talking to each other for about 10 months and it takes a while for that communication to get back online.
The significance of this when talking about PPD is that both estrogen and progesterone affect your neurotransmitters. Estrogen affects serotonin-think depression and sleep, while progesterone, your calming hormone, affects your GABA neurotransmitters-think anxiety, racing thoughts, and sleep again.
Stress (caused by feeling alone, inadequate, and exhausted, or going back to work too early) along with nutrient deficiencies can exacerperate low hormones levels for a longer time period which in turn can cause a much longer and deeper emotional roller coaster.
4. Nutrient deficiencies: Postpartum moms often have nutrient deficiencies due to what is lost during the birthing process compounded with little time or energy to prepare good nutritious food for themselves. I don’t know about you but when I’m super tired, I want to reach for something quick and sweet to boost my energy and moods which is probably not going to have much nutrition. Thus, a vicious cycle begins.
The most common nutrient deficiencies we can expect during this time are low iron and iron stores (aka ferritin), B-12, and folate, which all contribute to feeling greatly fatigued, inadequate, and moody.
Low B-12 levels can be the underlying reason for brain fog and low energy. Folate, along with B-12 is needed to make both RBC (energy) and neurotransmitters. Remember that low levels of neurotransmitters cause depression, anxiousness, and difficulty sleeping .
5. Hashimoto’s Thyroiditis: 1 in 12 women worldwide, after giving birth, suffer from a thyroid condition called Hashimoto’s. Hashimoto’s often mimics signs of PPD and can occur even if you’ve had no apparent thyroid issues prior to becoming pregnant.
What is Hashimoto’s? It’s an autoimmune disease where the body attacks the thyroid gland, reducing thyroid hormone production, causing hypothyroidism. It’s a disease that is very manageable through diet and lifestyle changes, detoxification, supplementation, and medication if needed. Unfortunately, it’s often ignored and not adequately screened.
Hypothyroidism and PPD are linked because thyroid hormones regulate the metabolism of all of your cells and if you don’t have enough of these hormones, it feels like you’ve been hit by a sledge hammer. You have no energy, are graced with dry skin and hair, and milk production diminishes. Your body goes into hibernation mode and it doesn’t matter how much sleep you’re getting, you’re still exhausted.
It’s easy to be screened for hypothyroidism with blood work but you may have to be a bit insistent with your request or obtain an order from an online source. I highly recommend that women who can’t seem to shake excessive fatigue and low moods to have a complete thyroid panel done.
The Best Ways to Prevent And Get Help With PPD
- Look into introducing a doula into your life prior to giving birth and for 3-6 months after. A doulas mission is to completely support mom. Check out this link for Doulas of Orange County
- Build a community with other moms. Check out joining a mom’s group prior and after pregnancy. Pregnancy yoga is a great place to start even before you become a mom. I like Ra Yoga studios.
- Lower your expectations of what you can and should do by at least 25-30%.
- If possible, delay going back to work, especially on a full time basis, for a minimum of 6 months.
- Take supplements to support your neurotransmitter production while your hormones are trying to find their way back: 5HTP, GABA, L-theanine, glycine, B-6, folate, B-12. You may want to consult with a practitioner (like me) who specializes in prenatal care to help guide you.
- Continue on your prenatal vitamin for 6 months to a year after birth.
- Conserve your time and energy by shopping for quality food and nutritious meals online and having food delivered to your doorstep. I recommend Thrivemarket for dry goods, Butcherbox for grass-fed/organic meats and poultry, and CSA or Farm Fresh Direct to have fruits and vegetables delivered to your doorstep.
- Packaged organic meals by Sunbasket are also a time, thought, money, and energy saver.
- Have a complete thyroid panel done 6-8 weeks postpartum. (include TSH, Free T4, Free T3, reverse T3, and TPO antibodies. You can request this from your OBGYN or order from online labs.
It’s very helpful to look at the first six months to a year after giving birth as your fourth trimester. Be gentle and kind to yourself during this year and if you’re finding it hard to cope, reach out and get help. It’s all fixable and no one should suffer needlessly.
Being a mother is one of the hardest and most joyous jobs we will ever have. We were not meant to do it alone!
P.S. Don’t miss The Pregnancy Summit coming up September 10th-16th. It covers preconception through postpartum and addresses a multitude of topics including infertility, hypothyroidism, PPD, pelvic floor prolapse, etc and it’s free! I’ve checked out the list of interviewees and think we’ll be in for a treat. Click here to opt in.