Natural Treatments for Postpartum Depression
UPDATED: FEBRUARY 2024
Did you know that almost 96% of polled healthcare practitioners in Canada believe that perinatal mental health services are insufficient? I work with many postpartum moms in my practice, and I often ask them how their 6 week check-in/discharge went with their pregnancy care provider - and if they were screened for postpartum depression. Many aren’t. I wasn’t.
Naturopathic Doctors are equipped to support moms experiencing postpartum depression, but I would caution that acting in a complementary capacity - where a mom may also be doing CBT or using medication as needed, may more beneficial to mom.
If PPD is not treated properly, it may have several impacts to both mom and baby. Maternal impacts of not treating PPD: physical, psychological, relationship & risky behaviours. Infant impacts of not treating PPD: anthropometry, physical, sleep, motor, cognitive, language, emotional, social, & behavioural development. Mother-child interactions: bonding, breastfeeding, & maternal role
Many moms are reluctant to seek help when it comes to PPD because they're unable to recognize their own mental health symptoms, and accessing care can be difficult. An easy screening tool that will help you determine is PPD is affecting you is the Edinburgh Postnatal Depression Scale.
When I work with women who have PPD, my treatments are evidence-based and can range between dietary and lifestyle changes, counselling, acupuncture, botanical medicine, and more! I like to provide my clients all the information, to allow them to make an informed decision as to what will fit best during this period in their life.
Holistic Treatment of Postpartum Depression
Nutrition and Postpartum Depression
Overall foods that may be helpful for PPD are fruits, vegetables, fish, grains, legumes and herbs.
Saffron and Postpartum Depression
While research is limited, saffron may be helpful for mild-to-moderate postpartum depression. If starting treatment in the postpartum, benefits may be able to be seen around 4 weeks. Adverse effects may include: headaches, dry mouth, nausea, daytime drowsiness, constipation, sweating, bleeding gums, GI disorder, oversleeping, lack of sleep, and low milk supply.
Iron and Postpartum Depression
Many women go into pregnancy with low iron levels. It's not a surprise considering that an iron deficiency is the most common nutritional deficiency in women. When someone is pregnant, their body needs more hemoglobin (as your blood volume is increasing), so it shouldn't be a surprise that more iron is needed! Blood loss after birth (ex. postpartum hemorrhage and c-section) may also cause iron stores to decrease.
A recent review examined the effect of iron deficiency and postpartum depression. Eight out of ten studies found higher risk for PPD in anemic women. Women who had low ferritin in the postpartum period (not pregnancy) was associated with an increase risk in PPD. Giving iron in the postpartum decreased PPD risk.
Having your ferritin levels checked throughout pregnancy is key (especially in the second and third trimester), so it can be determined if you need extra iron supplementation (aside from what’s in your prenatal vitamin).
Vitamin D and Postpartum Depression
If you’re going to pay for any piece of blood work during pregnancy and the postpartum - vitamin D is it! Serum vitamin D lower than 50 nmol/L, was associated with a more than 2x increased risk of postpartum depression.
If I’m working with someone during their pregnancy, I encourage them to have their vitamin D levels tested. I’m based in Toronto, Canada and while it’s automatically assumed that most Canadians are vitamin D deficient, we should really test our levels to determine if this is going to be a risk factor for postpartum depression. Pregnant and lactating mothers may need to keep their Vitamin D levels around 90-100 nmol/L to reduce the risk of postpartum depression.
Thyroid and Postpartum Depression
Did you know that increased thyroid antibodies (anti-TPO and anti-TG) are associated with postpartum depression? In addition, a TSH of over 4 mU/L is a risk factor for postpartum depression.
Your Naturopathic Doctor should be able to requisition a full thyroid panel to determine your risk factors, and if treatment would be warranted.
Omega-3 and Postpartum Depression
To help decrease PPD, omega 3 may helpful in the postpartum as an adjunctive support, not monotherapy. Studies are conflicting about the amount of omega-3 fatty acids needed, as well as the EPA/DHA ratio.
Acupuncture and Postpartum Depression
New evidence is showing that acupuncture can be helpful when it comes to PPD. I personally love acupuncture for everything, but huge barrier is carving out the time to get a 30 minute treatment. Nevertheless, it's an option and perhaps something to have done if you have help with childcare.
Acupuncture is more than just inserting needles in different areas in the body. It's thought to influence your neuroendocrine and immune systems through regulating different neurotransmitters like serotonin, dopamine, endorphins and glucocorticoids. It can regulate gene expression and new research is suggesting that it may actually have antidepressive effects.
While we don't know the true cause of PPD, it's thought that a drop in hormones, specifically estrogen, can lead to depressive symptoms. A 2018 review showed that in 4 studies, estrogen levels increased after acupuncture.
If acupuncture is something that you might consider trying, book an appointment with a Naturopathic Doctor or Licensed Acupuncturist. The way they use acupuncture, may be a bit different than a Chiropractor or Physiotherapist.
Sleep and Postpartum Depression
In case you are reading this before you give birth, now is the best time to rest and get all your sleep in. A study showed that prenatal sleep disorders in pregnant women may actually increase the risk of developing postpartum depression. There are many remedies out there that can help with sleep for instance acupuncture, magnesium, and even balancing your blood sugar before bed!
When dealing with lack of sleep post pregnancy, you may want to consider supporting your adrenal glands, evaluating your breastfeeding expectations (especially as your baby gets older), and seeking help when needed (ie. partner, family, doula).
Exercise and Postpartum Depression
Exercise can help treat mild-moderate PPD as a third-line treatment (CBT and medication being first and second respectively). Most exercise recommendations begin after 6 weeks postpartum (you should also get assessed by your pelvic floor physiotherapist before resuming moderately intense physical activity).
The goal is ≥150min per week of moderate intensity aerobic exercise. Keeping in mind that benefits are seen at ≥ 12 weeks. Finding something enjoyable, where a consistent routine can be created may go a long way at helping to reduce PPD symptoms.
Yoga and Postpartum Depression
Yoga has been shown to be a complimentary therapy for mothers experiencing PPD. Depressive symptoms were assessed using the Hamilton Depression Scale. Mothers in the yoga group practiced twice a week for 8 weeks and improved at a significantly faster rate on measures of depression, anxiety, well-being, and health-related quality of life.
Cognitive Behavioural Therapy (CBT) and Postpartum Depression
Cognitive behavioural therapy is the first-line treatment for PPD and will identify negative thinking patterns and assess the link between thoughts, feelings, and behaviour. When you experience depression, you might experience negative thoughts that carry significant meaning. This meaning might be relation to the past, future, about yourself or your world.
CBT helps you change negative thoughts, so ultimately you can change how you view and feel about yourself, and your behaviour.
A review looked at CBT in moms with PPD and found that 7 practices were commonly used in treatment - pyschoeducation, thought restructuring, problem-solving, behaviour management, goal setting and achieving, stress management, and relaxation. The most common were psychoeducation and challenging negative thoughts and beliefs. While CBT was found to be an effective treatment for PPD it can be time consuming and may require adjunctive childcare.
Next Steps
You don't need to go through PPD alone! Check out the Canadian Mental Health Association website for more information about PPD, or book an appointment with a Naturopathic Doctor start implementing the best therapies for you, so you can feel great again!