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Preventing and Treating Postpartum Depression

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A baby’s birth is one of life’s most complex experiences, affecting every parent differently. It’s a time of extreme highs and lows, when joy and excitement can quickly give way to nervousness and fear, then surge again as the anxiety subsides. When intense feelings of sadness, confusion, and worry become hard to shake, however, it may be a medical condition known as postpartum depression (PPD). 

According to the Centers for Disease Control and Prevention, one in eight women (about 20%) will experience PPD. Unfortunately, the condition frequently goes undetected for numerous reasons, including social stigma, maternal fear of abandonment, insufficient support, and accessibility challenges. A 2022 analysis found that PPD was underdiagnosed in Black, Asian, Pacific Islander, and Hispanic women.1Liu S, Ding X, Belouali A, et al. Assessing the racial and socioeconomic disparities in postpartum depression using population-level hospital discharge data: longitudinal retrospective study. JMIR Pediatr Parent. 2022;5(4). https://doi.org/10.2196/38879

There is a critical need for increased awareness, support, and culturally sensitive approaches to diagnosing and treating postpartum depression. Intrusive thoughts are common with PPD, but help is available. Acknowledging and communicating complicated thoughts and feelings are the first steps toward healing.

Is PPD the Same as Baby Blues?

The body undergoes extreme physical, hormonal, emotional, and psychological changes during and after pregnancy. The birthing process is an especially vulnerable time, characterized by sweeping shifts in hormonal and physical health. Up to 85% of women and birthing parents experience anxiety, irritability, anger, weeping, and restlessness in the days following childbirth.2What Is Peripartum Depression? American Psychiatric Association. Accessed October 2023. https://www.psychiatry.org/patients-families/peripartum-depression/what-is-peripartum-depression Within a week to two after delivery, these feelings typically dissipate as swiftly as they came. The phenomenon is known as “baby blues,” a self-resolving issue that does not require medical attention.

PPD has more severe symptoms that last longer than two weeks and occur within six weeks of delivery. With PPD, profound sadness or loss of interest is accompanied by five of the following symptoms:3Mughal S, Azhar Y, Siddiqui. Postpartum depression. StatPerls. 2022;Oct 7. https://www.ncbi.nlm.nih.gov/books/NBK519070

  • Insomnia or hypersomnia (difficulty sleeping or sleeping for prolonged periods)
  • Psychomotor obstruction or agitation (difficulty moving or unintentional movements)
  • Feelings of worthlessness or guilt
  • Loss of energy or excessive fatigue
  • Thoughts of suicide, suicide attempt, or recurring thoughts of death
  • Impaired concentration or indecisiveness
  • Unintentional weight changes of 5% in one month

Most new parents will experience one or more of these symptoms—especially a few sleepless nights. However, PPD symptoms are more intense and may affect your quality of life, sense of well-being, and ability to care for yourself and your newborn.

Proactive Prevention

The U.S. Preventive Services Task Force recommends counseling for pregnant patients at risk for PPD. Expecting parents should become familiar with the following risk factors:3Mughal S, Azhar Y, Siddiqui. Postpartum depression. StatPerls. 2022;Oct 7. https://www.ncbi.nlm.nih.gov/books/NBK519070

  • A history of depression, anxiety, premenstrual syndrome/premenstrual dysphoric disorder, or PPD with a previous pregnancy
  • Previous traumatic birthing experience
  • History of domestic violence
  • Lack of social support
  • Smoking during pregnancy
  • Alcohol or drug use during pregnancy
  • Low vitamin B6 levels
  • Lack of physical movement or a high-inflammation diet
  • Insomnia or reduced sleep quantity or quality

Proactive prevention focuses on sleep, nutrition, behavioral health support, and creating a birthing plan with contingencies. Identifying people in your network who will support you before, during, and after pregnancy is essential. A supportive network is vital in PPD prevention and treatment.

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Conventional PPD Treatment

Early diagnosis and treatment of postpartum depression is essential, as untreated PPD can be dangerous for both the birthing parent and child.

Although most cases resolve in a few months with proper treatment, an estimated 24% of women with PPD are still depressed one year after giving birth, and 13% report ongoing depression after two years.4Stewart DE, Vigod SN. Postpartum depression: pathophysiology, treatment, and emerging therapeutics. Annu. Rev. Med. 2019;70:183-196. https://doi.org/10.1146/annurev-med-041217-011106

There are two traditional routes of care for postpartum depression:4Stewart DE, Vigod SN. Postpartum depression: pathophysiology, treatment, and emerging therapeutics. Annu. Rev. Med. 2019;70:183-196. https://doi.org/10.1146/annurev-med-041217-011106

  1. Psychological interventions, including counseling or peer support, where the provider has an experiential understanding of the condition
  2. Pharmacological interventions, like selective serotonin reuptake inhibitors (SSRIs)

The use of SSRIs and other antidepressant medication requires guidance from a healthcare professional trained in managing contraindications. For example, infant exposure during breastfeeding is a concern with some medicines, and switching from one prescription to another can increase the risk of PPD relapse.

Natural Remedies for Postpartum Depression

A naturopathic approach to PPD starts with prevention and provides a comprehensive strategy for expecting parents. Natural treatment incorporates conventional concepts and tools as well as mind–body strategies. Along with a deeper understanding of diet and lifestyle factors, naturopathic doctors (NDs) may recommend herbal and dietary supplements.

Pregnant woman journals on couch

Research shows that mindfulness training can help reduce PPD symptoms among new parents.5Sheydaei H, Ghasemzadeh A, Lashkari A, Kajani PG. The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electron. Physician. 2017;9(7):4753-4758. https://doi.org/10.19082/4753 A 2016 pilot study on yoga and meditation in pregnant women with a history of depression found the yoga–meditation combination just as effective as antidepressants in reducing depression.6Dimidjian S, Goodman SH, Felder JN, Gallop R, Brown AP, Beck A. Staying well during pregnancy and the postpartum: A pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence. J Consult Clin Psychol. 2016;84(2):134-145. https://doi.org/10.1037/ccp0000068

A 2017 analysis of 13 randomized clinical trials demonstrated that exercise could reduce PPD risk and symptoms.7Pritchett RV, Daley AJ, Jolly K. Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis. Br J Gen Pract. 2017;67(663). https://doi.org/10.3399/bjgp17X692525 Researchers also noted the benefits of a Mediterranean diet, with more fruit and less red meat, in managing depression.8Flor-Alemany M, Migueles JH, Alemany-Arrebola I, Aparicio VA, Baena-García L. Exercise, Mediterranean diet adherence or both during pregnancy to prevent postpartum depression-GESTAFIT trial secondary analyses. Int J Environ Res Public Health. 2022;19(21):14450. https://doi.org/10.3390/ijerph192114450

Other natural PPD interventions include light therapy, massage, acupuncture, herbs, and nutrients, such as omega-3 fatty acids, folate, S-adenosyl-methionine, and St. John’s wort.9Deligiannidis KM, Freeman MP. Complementary and alternative medicine therapies for perinatal depression. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):85-95. doi:10.1016/j.bpobgyn.2013.08.007 Individualized homeopathic remedies have also been shown to ease PPD symptoms.10Khanna S. Treating postpartum depression with homeopathy. Int. J. Hom. Sci.. 2021;5(3):248-251. https://doi.org/10.33545/26164485.2021.v5.i3d.430

When considering natural therapies, remember to work with a licensed naturopathic doctor. An experienced ND will help you build a plan that prevents contraindications and effectively incorporates herbal medicine in safe doses. 

Chamomile is an effective herb for calming the nervous system and can help both the mom/birthing parent and newborn baby sleep better. However, breastfeeding moms allergic to ragweed should avoid chamomile. Catnip has similar effects (without contraindications), and it’s safe to use while breastfeeding.

An effective PPD prevention and treatment plan requires education, awareness, and time, especially in high-risk cases. A naturopathic physician can provide primary and behavioral health care post-birth, with frequent checkups and much-needed support. Extended one-on-one time with an ND is part of the treatment process: symptoms are identified sooner, leading to more effective interventions. An ND with advanced training in behavioral health will customize the treatment plan to reflect a patient’s specific health goals and concerns.

Naturopathic physicians also work together with other healthcare providers—like doulas, who guide families during pregnancy, labor, and postpartum care.

Doula Care and Postpartum Health

The doula’s role stems from an age-old tradition where experienced female elders aided home births. Today’s doulas are professionally trained to guide a holistic birth delivery process, providing support during pregnancy, labor, birthing, and the postpartum period.11Meadow SL. Defining the doula’s role: fostering relational autonomy. Health Expect. 2015;18(6):3057-3068. https://doi.org/10.1111/hex.12290

Doulas may also help mitigate health disparities among pregnant people of all genders from different socioeconomic backgrounds and ethnicities. This is critical for Black women, who are more than three times more likely to die during pregnancy or postpartum than white women.12MacDorman MF, Thoma M, Declcerq E, Howell EA. Racial and ethnic disparities in maternal mortality in the United States using enhancing vital records, 2016-2017. Am. J. Public Health. 2021. https://doi.org/10.2105/AJPH.2021.306375

What About the Non-Birthing Parent?

Pregnancy is a life-changing event for everyone involved. Unfortunately, emotional and mental health is often overlooked in spouses and partners.

Caring for a newborn can be overwhelming at times, especially if the non-birthing parent has a history of depression or other behavioral health issues. Many people don’t realize that PPD is also a risk for non-birthing parents.

An estimated 8% to 10% of fathers experience PPD.13Scarff JR. Postpartum Depression in Men. Innov Clin Neurosci. 2019;16(5-6):11-14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659987/?report=reader Men may struggle in silence, as they are less likely to report symptoms of depression. Signs of PPD in men run the gamut and include controlling behavior, insomnia, disengagement, instability, and anxiety that becomes aggressive.

A Holistic Approach to Postpartum Depression

Postpartum depression is a complex condition that affects each parent differently. A naturopathic approach to PPD focuses on the individual and emphasizes stress reduction, nutrition, gentle exercise, rest, and emotional support. NDs work with a team of physicians, doulas, and other healthcare providers to address a mother’s unique needs.

Footnotes

This article is provided by

The Institute for Natural Medicine, a non-profit 501(c)(3) organization. INM’s mission is to transform healthcare in America by increasing both public awareness of natural medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing healthcare systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following initiatives:

  • Education – Reveal the unique benefits and outcomes of evidence-based natural medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

About The Author(s)

Author Guest Author

Gaynel Nave, ND

Dr. Gaynel Nave is an Arizona licensed naturopathic doctor who practices as a naturopathic educator both online and in-person in Grand Rapids, Michigan, as well as a board member of the Psychiatric Association of Naturopathic Physicians (PsychANP). Her practice is focused on facilitating women reconnecting to their identities by addressing the connection between their hormonal and mental well-being.

Author

Institute for Natural Medicine Staff

Our dedicated content team of professional staff writers represents decades of experience covering essential natural health topics in an accessible, evidence-based, and engaging way. Guided by a shared passion for holistic well-being, each and every one of our writers strives to empower our readers to take charge of their health.

Supported by a rigorous fact-checking and medical editing process from licensed naturopathic doctors that examines the latest in peer-reviewed research, our team brings their in-depth knowledge of natural health practices into every piece of content we produce. We strive to be the gold standard for evidence-based natural medicine, providing trustworthy information and inspiring narratives to help you live your best health, naturally.

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