How to Avoid Postpartum Depression

Postpartum depression and anxiety are not uncommon. The need for women to wear so many hats can take its toll on our sanity. We feel pressure to “lean in” to our careers, to have perfect bodies, and create pinterest-perfect meals and homes. How can we do it all AND take care of the constant demands of a newborn?

All of these demands can take their toll on us, however, it doesn’t have to lead to depression. You can avoid postpartum depression by maintaining your health and micronutrient stores during and after pregnancy, and supporting your liver and thyroid function.

What’s typical of the postpartum period?

Rapid changes in mood are a normal feature of the postpartum period. Following pregnancy and birth, it is common to feel a combination of bliss and exhaustion. One minute you may feel indescribably happy as you look into your baby’s eyes and in the next minute you may feel overwhelmed with sadness.

This emotional turbulence is generated by the many biochemical and hormonal changes that occur in your body after birth. The fatigue that commonly accumulates as a result of your baby’s irregular sleep schedule is an important contributing factor as well.

The “Baby Blues”

As many as 80% of women have a short bout of the baby blues after delivering the child. This typical phase of uncomfortable emotional turbulence commonly known as the “baby blues” usually subsides within ten days to two weeks of birth.

Postpartum depression

More severe and intense than the “baby blues”, postpartum depression affects about 10% of new mothers. Women with a prior history of depression are more susceptible, but it can affect any woman, regardless of age or number of prior pregnancies.

Signs and symptoms of postpartum depression

Postpartum depression doesn’t become obvious until several weeks after birth. Experiencing the following symptoms for longer than two weeks after giving birth to your baby are a sign to take action and get support:

• Persistent feelings of exhaustion to the point that you’re unable to perform chores or be productive at work.
• Increasing feelings of sadness, guilt, anxiety, or helplessness.
• Inability to care for self
• Sleep and eating patterns are often disrupted
• Lack of interest in baby, or in extreme cases thoughts of harming the baby

The causes of postpartum depression

In western medicine, they don’t really have an explanation for postpartum depression and anxiety.

In Chinese Medicine, however, we attribute it to either the Qi and Bloodloss of pregnancy and childbirth or to what we call “liver qi stagnation” which is our weird way of saying the difficulty the body is having regulating the hormones. Therefore, the way we prevent and treat it is by boosting the qi and blood and supporting the liver and hormonal balance.

There is a rapid drop in estrogen in the first few months after childbirth. Breastfeeding keeps estrogen levels low and can impact your mood. Your body should regulate itself, but sometimes your body needs some support navigating these shifts.

Pregnancy and childbirth are both depleting and taxing on mothers. New moms are often micronutrient deficient. Your body funnels micronutrients to your baby and drains them from you if needed, as making this tiny person is your body’s primary focus during pregnancy.

On top of this, childbirth can often lead to blood loss and an iron deficiency.

Pregnancy and childbirth can often trigger thyroiditis – and hypothyroidism in women that never had hypothyroidism before pregnancy. New moms have to cope with sleep deficiency, which can tax the adrenal and thyroid glands.  Hypothyroidism can masquerade around as postpartum depression because the symptoms are so similar – especially fatigue.

All of these things translate to a “qi and blood” deficiency in Chinese medicine.

Preventing postpartum depression

You can help prevent postpartum depression by nourishing and protecting your Qi and blood during and after pregnancy – making sure you’re eating well, getting enough rest, and getting enough iron.

A little blood loss is normal in childbirth. Plan to build your iron back up after birth. Make sure you continue your prenatal vitamin which should have iron in it, eat lots of red meat, dark leafy greens, and beets – foods that contain iron. Bone broth is also an excellent source of necessary micronutrients – it’s like medicine for a postpartum woman.

Ask your doctor to do labs 6-week after giving birth to check your thyroid levels and iron. Don’t just check TSH, get your T3, T4 and thyroid antibodies checked as well. With this information, you can supplement if needed and often bypass postpartum depression.

The following 5 strategies can help prevent and treat postpartum depression

1. Rest
2. Nourish
3. Blood sugar balance
4. Support your liver
5. Accept support from family and friends

1. Rest

Think rejuvenation and replenishment after birth. Focus on recovering your energy. Protect your thyroid and replenish your qi.

• Take as much rest as possible
• Give yourself permission to let go of cleaning and household errands for a while.
• Slow down and enjoy each moment
• Sleep when your baby sleeps
• Pump if that helps you get more sleep and have your partner give a bottle in the middle of the night, especially if you had a C-section
• Take adaptogenic herbs if needed

In Chinese Medicine, we have a concept called “Zuo Ye Zi” for the postpartum period. It translates to “sitting out a month”. New mothers are encouraged to rest, not leave the house, not cook, not clean, not do anything except care for the baby and herself. They are told not even to wash their hair! That seems a little extreme to me, but it’s a good reminder and inspiration to REALLY let things go and just rest and rejuvenate. It can be tempting to get back at it and many women feel the urge to exercise to get their body back. It may feel counter-intuitive, but you will heal and get your body back way faster if you give it time and rest so it can recover and regulate. Your body goes into a major healing mode after birth, and your body can heal incredibly well if you let it and give it the resources it needs.

2. Nourish

Listen to your appetite when it kicks in. Be gentle with your digestive tract. Favor simple, nourishing, warm foods that are easily digestible like soups, stews, steamed veggies, and casseroles. Eating 4-5 brazil nuts a day will give you a good supply of selenium to support your thyroid. Supplement with:

• Iron (I like liver pills)
• Bone broth
• Fish oil
• Prenatal vitamin
• CoQ10
• Probiotic

3. Blood sugar

Keeping a stable and balanced blood sugar relieves cortisol levels and stress on your adrenal glands as well as supports your liver and your mood.

• Don’t skip meals
• Eat breakfast with protein right when you wake up
• Eat every three hours
• Eat fat and protein every time you eat anything

4. Help your liver

Your body is going through a lot of biochemical and hormonal changes after pregnancy and birth. Your liver has to process and eliminate all the excess hormones coursing through your body, and it’s a big job.

• Milk thistle can support your liver
• Eat a clean diet
• Begin exercising as soon as it is safe – start with leisurely strolls, gradually increasing your level of activity

5. Accept support from loved ones

Set up a support system to help with meals, cleaning, and errands so that you can focus your energy on caring for your baby and for yourself. Take advantage of Amazon and/or Instacart to have groceries and other necessities delivered, so you can stay home and rest.

Your body goes into a major healing mode after birth, and your body can heal incredibly well if you let it and give it the resources it needs.

Don’t be afraid to seek professional help if needed. Women can feel embarrassment over our feelings, there’s so much pressure to be happy and perfect, and this can prevent us from seeking help. Talk to a trained therapist, get acupuncture and herbs, and see a doctor.