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DESCRIPTION
Postpartum depression is related to the rapid readjustment of hormones in a woman's body following the birth of a baby. Emotional changes affect almost half of all new mothers. Baby blues are most common 3 to 10 days following delivery (but can occur anytime in the first year) and usually last anywhere from 48 hours to 2 weeks. In some women, the depression is more pronounced, and, rarely, there is extreme depression.
FREQUENT SIGNS & SYMPTOMS
The symptoms vary in intensity, but can include:
- Feelings of sadness, hopelessness or gloom.
- Appetite and weight loss (sometimes a weight gain).
- Sleep disturbances or frightening dreams.
- Irritability; anxiety.
- Loss of energy, fatigue.
- Slow speech and thought.
- Frequent headaches and other physical discomfort.
- Confusion about one's ability to improve life.
- Fears about personal health and infant's health.
CAUSES
It's common for mothers to experience some degree of mild depression during the first weeks after birth. Pregnancy and birth are accompanied by sudden hormonal changes that can affect emotions.
Additionally, the 24-hour responsibility for a newborn infant represents a major psychological and lifestyle adjustment for most mothers, even if it is not the first child.
These physical and emotional stresses are usually accomplished by inadequate rest until the baby's routine stabilizes, so fatigue and depression are not unusual.
RISK INCREASES WITH
Stress and lack of sleep.
Poor nutrition.
Postpartum blues following a previous pregnancy.
Lack of support from one's partner, family or friends.
Unplanned, non-prepared and intensely unpleasant birthing experiences and outcomes (e.g., a planned homebirth or birthing center birth developing risk problems that may have resulted in cesarean delivery or high-tech interventive delivery in a hospital).
Pre-existing mental health problems.
PREVENTIVE MEASURES
Cannot be prevented, but can be minimized with rest, an adequate diet and a strong emotional support system.
See Baby Blues by Elizabeth Pantley for some suggestions.
EXPECTED OUTCOME
This depression is usually very short-lived. With support from family and friends, mild postpartum depression disappears quickly.
POSSIBLE COMPLICATIONS
Lack of bonding between mother and infant, which is harmful to both.
If depression becomes more severe, a mother may not be able to care for herself and the baby, and hospitalization may be necessary (rare). Medication, counseling, support, nutritious diet, adequate restful sleep usually will cure even severe depression in 3 to 6 months.
Serious depression that may be accompanied by aggressive feelings toward the baby, a loss of pride in appearance and home, loss of appetite or compulsive eating, withdrawal from others or suicidal tendencies.
TREATMENT
GENERAL MEASURES
Diagnosis is usually based on a history of symptoms. There are no specific diagnostic tests.
Don't feel guilty if you have mixed feelings about motherhood. Adjustment and bonding take time.
Don't feel guilty about negative birthing experiences. Sometimes things happen and adjustments are made accordingly. Experience is knowledge. Learn from the experience and leave the emotional residue behind. If you are planning on subsequent children, make plans to have the birth take place in a setting with a birth attendant that corresponds with your particular desires for a positive birth experience. Healing can take place with time, counseling and emotional work.
Schedule frequent outings, such as walks and short visits with friends or family. These help prevent feelings of isolation.
Some professionals suggest that you have your baby sleep in a separate room so that you may sleep more restfully. However, others suggest that the baby be allowed to sleep with you in the family bed to build strong bonding ties and prevent the constant waking and getting up required for nighttime feedings (it is easy to breast-feed your baby while sleeping together and the baby usually can find the nipple without problems). Either way, try and use what works for you.
If you feel depressed, share your feelings with your partner or a friend who is a good listener. Talking with other mothers can help you keep problems in perspective.
Severe postpartum depression requires professional help and the mom should be given a referral to a qualified therapist by either the midwife or by a health care provider.
MEDICATION
A mild sedative may be prescribed temporarily.
Antidepressant drugs may be recommended for more severe symptoms. These are effective when used for 3 to 4 weeks. Don't stop taking them too early.
Any medication use must be carefully considered if you are breast-feeding.
HERBAL & HOLISTIC RECOMMENDATIONS
DEPRESSION
Breast-feeding is probably the best cure for postpartum depression. The process helps moderate hormonal swings, increases the endorphin level and allows your body to regain hormonal balance slowly and evenly.
Lemon Balm leaves. Considered a specific for helping new mothers to cope with changing life situations that are difficult to adapt to and accept, such as the many unexpected changes a new baby brings to its parents. Melissa is a favorite for depression, melancholy, and hysteria. One or two cups of the tasty infusion, mellowed with milk and/or honey, every day for a week or two will be sufficient to aid postpartum blues.
Increase intake of foods rich in the B vitamins and iron, such as alfalfa, blackstrap molasses, brown rice, eggs, enriched whole-grain cereals, fish, green leafy vegetables, kidney beans, oats, poultry, soy products, and wheat germ. Inadequate iron intake causes anemia, which can make you feel tired, irritable, and unhappy.
Blessed Thistle leaves. The intensely bitter Milk Thistle has a wide reputation for alleviating many postpartum problems, including severe depression. Use a cup or two of the infusion daily, or up to 80 drops per day of the equally effective, but not so bitter, tincture.
2 Parts Red Raspberry Leaf
1 Part Nettle Leaf
1 Part Alfalfa Leaf
1 Part Peppermint Leaf
Mix dried herbs thoroughly and use a portion to make up a half gallon to a gallon of tea. This blend makes a nice sun tea that can them be refrigerated for a refreshing iced tea to be consumed throughout the day. It provides red raspberry leaf for hormonal balance and uterine toning, Nettle and Alfalfa are high in blood building vitamins and minerals, and the peppermint leaf is good for soothing the digestive system and getting it back to normal as well as giving the tea a nice minty flavor. It tastes fine unsweetened, but if the mom would like a little sweetener, use honey. Honey is high in nutrients and digests easily. A great tea blend for not only pregnancy, but postpartum recovery. It makes a great tea blend for adding recovery tinctures to, if needed, since the flavor of the tea will help "hide" some of the flavors of the tinctures (not all of them taste good). Bulk herbs are available through Mountain Rose Herbs (see banner ads at the bottom of the page or click on the herb above. They have a nice selection of organic bulk herbs for a reasonable price).
Postpartum Herbal Bath. Start up a big pot of hot water for steeping herbs for a postpartum bath soon after birth. Strain the tea before adding to bath water. Steeping in glass gallon jars is very effective, then strain directly into bath through cheesecloth placed in a plastic colander.
For the bath combine:1/4 cup Sea salt
1 ounce Uva ursi (bearberry)
1 - 2 ounces Comfrey
2 ounces Shepherd's purse
1 crushed fresh Garlic bulb (can be obtained from your local supermarket)
Place a bath towel in the bottom of the tub for comfort and to prevent slipping. Let the mom enjoy the bath until she asks for baby, at which time the baby can be introduced to the bath slowly, feet and legs first, then bottom. The salty garlic is astringent and mildly antiseptic so immersing the baby's cord is okay.
Since the bath is quite warm (102-104°F), have the mom drink three cups of a strong infusion of shepherd's purse at room temperature soon after birth and before entering the bath.
The following are criteria for using the herbal bath soon after birth:
- Mom's uterus has good tone.
- Any source of significant bleeding has been identified and repaired.
- The baby has been assessed and is fine.
- Mom is able to walk to the tub with minimal assistance.
- Mom and babe are not left alone in the bath.
Postpartum Blues Herbal Cocktail
This brew is delicious and effective for not only postpartum blues but for fortifying breastmilk. The tea is made from red clover, great for purifying the blood and helping improve breastmilk; lemon balm, which works wonderfully for lifting the spirits; red raspberry leaf, which helps the uterine walls contract so the uterus can shrink back down to size; and nettles, which contains vitamin K, important for clotting. Nettles also is a good source of iron which is important for breastfeeding babies. Steep a teaspoon of each per cup of tea for about five minutes. It is best fresh! It is hard being a new parent, especially if you have never done it before. Be patient and make sure to get as much fresh air as you can.
Postpartum Depression Brew.1/2 ounce dried, shredded Licorice root
1 ounce dried, crumbled Raspberry Leaf
1 ounce dried, finely cut Rosemary Leaves
1 ounce dried, cut Skullcap
Mix the dried herbs thoroughly together. Use two teaspoons per cup of boiling water to prepare this strongly scented and interesting tasting tea.
Licorice favorably affects the hormonal balance and cheers the spirits. Raspberry leaf tones the uterus and ovaries and increases available calcium, making life seem easier. Rosemary increases the milk flow, adds calcium, tones the liver, and is a Wise Woman favorite for depression. Skullcap is also a source of calcium and is a superb nerve strengthener and soother; prolonged use establishes emotional calm.
The usual dose is two or more cups daily for several weeks to two months.
Jasmine Essential Oil bath. Run a relaxingly warm bath and add a few drops of Jasmine. It will begin to work almost as soon as you step into the bath and afterward use a drop of Jasmine oil on the edge of your pillow. If Jasmine Essential Oil is not available, use Ylang Ylang or Clary Sage essential oil. These are almost as effective.
Jasmine Essential Oil, NOW Foods, 1 fl. oz.
Ylang Ylang Essential Oil, NOW Foods, 100% Pure, 1 fl. oz.
Clary Sage Essential Oil, NOW Foods, 100% Pure, 1 fl. oz.
EXHAUSTION & TENSION
Chamomile flowers. The popularity of German or Garden Chamomile testifies to its potency as a calming sleep inducer, pain-killer, and mental relaxer. Brew the flowers briefly, a teaspoon to a cup of water, and drink the pleasantly aromatic tea freely. Several cups of hot tea with milk and honey may be necessary to induce sleep.
Motherwort herb. Clear-minded, non-drowsy relief from the tension and confusion of overwhelming emotions is the promise of Motherwort tincture. Use 5 drops in a glass of water, repeated as needed. CAUTION: Excessive use of Motherwort tincture (more than four doses a day for several weeks) may cause you to become dependent on it.
Skullcap herb. The tincture, not the infusion, is used to sedate and bring on sound sleep. Use three drops of homemade fresh-plant tincture in a glass of water should bring on immediate sleep. Five drops of tincture may bring on extended sleep. There are no side effects from overdoses of Skullcap, so start small but don't be afraid to repeat or increase the dose, especially when using commercial tinctures made from dried Skullcap. Skullcap is not habit forming.
Hops flowers. Humulus lupulus is a strong seducer of sleep. Insomniacs will slump on the kitchen table with half a cup of Hops infusion still sitting beside them. Hops is also an excellent herb for increasing and enriching breast milk. It is helpful in relieving afterbirth pains. Unfortunately, the taste of Hops is acrid and unpalatable to many and the tincture does not seem to be as effective.
Herbal information and Postpartum Depression Brew has been obtained from Susan Weed's Wise Woman Herbal for the Childbearing Year. Aromatherapy information is obtained from Aromatherapy for Women by Maggie Tisserand.
BENEFICIAL DIETARY SUPPLEMENTS
Motherwort Tincture, 100% Organic, 2 fl. oz. - Research has shown that Motherwort is able to calm palpitations and irregular heartbeat. It is used as a specific remedy for tachycardia caused by anxiety, and for all heart conditions that produce anxiety and tension. The glycosides in this herb have the short-term ability to lower blood pressure. Motherwort seeds are effective in stimulating a suppressed or delayed menstruation, and can ease dysmenorrhea, especially when there is anxiety or tension involved. It has also been used to ease false labor pains, and when taken as an infusion after childbirth, helps restore the uterus and reduce the risk of postpartum bleeding. Suggested Dosage or Use: Take 6-12 drops in liquid or under tongue, 1-3 times a day.
Ultimate B (Vitamin B Complex Formula), Nature's Secret, 60 Tabs - Superbly formulated, Ultimate B, vitamin B Complex Formula, is a synergistic blend of herbs, superfoods, and enzymes made of 33% food ingredients for easy absorption. B Vitamins relieve stress and depression.
Royal Jelly, NOW Foods, 1000 mg, 60 Softgels - Royal Jelly and Bee Pollen increase energy. Royal Jelly is a natural source of may nutrients and is the only food for the Queen Bee, and it enables her to outlive worker bees thirty fold.
Ginseng, Hops, Sarsaparilla and Blessed Thistle, when consumed in tea form, help rebalance hormones.
Red Panax Ginseng Ultra Strength (10 ml Vials), 30 Vials - Red Panax Ginseng is often used to increase energy. This extract is made from 6 year old Red Ginseng roots plants which are a precious natural product growing in the Mountains of Chang Pai in northern China. Considered by traditional herbals as the king of herbs, ginseng's adaptogenic properties (how it helps and balances and restores the body and mind when dealing with stress related conditions) are prized by many. If you are nursing or pregnant, consult with your midwife or health care provider before taking ginseng.
Hops Herb Tincture, 100% Organic, 2 fl. oz. - The use of hops is recommended for discomfort due to restlessness or anxiety and sleep disturbances. Hops has been used to improve appetite and digestion and has a mild sedative effect.
Blessed Thistle (Cnicus benedictus) Powder, 4 oz. Bulk - Modern uses of Blessed Thistle (Cnicus benedictus) include increasing milk supply for nursing mothers, memory improvement, increasing appetite and generally preventing sickness. Four different ways of using Blessed Thistle have been recommended.
Sarsaparilla Tincture, 100% Organic, 2 fl. oz. - Sarsaparilla is used for sexual impotence, rheumatism, and skin disorders such as acne, dermatitis, eczema, and psoriasis. As a tonic, Sarsaparilla is used for physical weakness, for enhancing the male reproductive system, and it aids in relieving low mood and debility associated with menopause. Sarsaparilla is also a cleansing remedy for skin and joint problems.
Lemon Balm (Melissa officinalis) Powder, 4 oz., Bulk - Lemon Balm tea is recommended to relieve fever due to cold and flu, and to ease menstrual cramps, insomnia, headaches and nervousness. Lemon Balm helps fight depression.
Just An Ounce Calcium & Magnesium, Almond Flavor Liquid, 16 fl. oz. - Just An Ounce, Calcium and Magnesium Liquid can help with the development of strong bones and teeth, also prevents muscle cramping, risk of colon cancer, maintain regular heart beat, protects against osteoporosis and helps relax the central nervous system. Calcium and Magnesium aids restful sleep and calms the body.
Scullcap (Skullcap) Powder (Scutellaria lateriflora), Certified Organic, 8 oz. - Skullcap calms the nerves. Traditionally been used internally for nervousness and convulsions, irritability, insomnia, and neuralgia. Scullcap may act as a sedative, to relax spasms, lower fever and stimulate the kidneys, and has anti-toxic effects. Scullcap is an excellent tonic for the nervous system. It is good for treating anxiety, insomnia, and nervous headache.
Licorice Root (Glycyrrhiza glabra) Powder, 4 oz. Bulk - Licorice Root aids hormone balance.
After Baby Mood Support Wellness Oil, for Post Partum Depression, 2 fl. oz. - Pregnancy and nursing safe. After Baby Mood Support is an absolute must have for any new mother.
Relaxing Blend Tea with Valerian & Chamomile, 20 Tea Bags - This soothing Tea, with a blend of Black Cumin Seed with Chamomile, Valerian, Passion Flower and other herbs, will help you relax and put your worries to rest.
ACTIVITY
No restrictions. Resume your normal activities as soon as possible. Avoid getting too fatigued.
Exercise regularly (as your recovery from childbirth permits). A casual walk in the fresh air can help bring spirits up.
DIET
Eat a normal, well-balanced diet for breast-feeding mothers. Avoid alcohol and caffeinated beverages.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or your family member has symptoms of postpartum depression and additional life changes occur, such as divorce, career changes, or moving.
Postpartum depression does not improve after 2 weeks or the symptom level increases.
You have suicidal urges or aggressive feelings towards the baby. Seek help immediately!
MoonDragon's Postpartum Holistic & Herbal Recommendations
MoonDragon's Client Handouts about nutrition and diet for pregnant and breastfeeding mothers are available at the links below. Examples of sample diets and menus are given, including some holistic suggestions. Nutritional analysis for various foods and nutritional therapy information is also available.
POSTPARTUM CARE INFORMATION
Postpartum Care: Index
Postpartum Care: Weight
Postpartum Care: Diet
Postpartum Care: Bowel Movements & Urination
Postpartum Care: Bathing
Postpartum Care: Breasts & Breastfeeding
Postpartum Care: Perineal Care
Postpartum Care: Vaginal Bleeding (Lochia) & Menstruation
Postpartum Care: Exercise & Back Care
Postpartum Care: Sexual Intercourse
Postpartum Care: Contraception
POSTPARTUM VISITS
PostPartum Visit: Day One
PostPartum Visit: Day Three
PostPartum Visit: Day Seven
PostPartum Visit: 4 to 6 Week Visit
POSTPARTUM CONCERNS
Baby Care & Concerns
Fatigue & Exhaustion
Postpartum Depression (The "Baby Blues")
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