Postpartum Progress

Dosing Information for Omega-3s

If you're interested in using Omega-3s to help combat your depression and are unsure of the dosing, here is a link to a very useful handout that Karen Kleiman (author of "This Isn't What I Expected: Overcoming Postpartum Depression) has posted on her blog.  It was created by Kathleen Kendall-Tackett.

Guest Author: Aliza Sherman of Babyfruit

Below is a blog post about experiencing postpartum depression that first appeared in Aliza Sherman's Babyfruit blog:

When It Hit Me, It Hit Hard

     I ended up with knock down drag out post partum depression around 4 months [postpartum] but even before that, there were signs.
     Maybe the time I threw a dirty plate from the dinner table up in the air because I was so angry could have been a clue. Or when I screamed at my husband to "give me the baby, you can't keep her from me!" then ran through the house slamming doors and cursing at him to leave me alone. Or the time I ran from the house screaming with the car keys, thinking I'd drive away (where? somewhere, anywhere) and he had to chase after me, wrap his arms around me tightly, lead me back into the house.
     When it hit hard, it wasn't depression in the way I had thought about depression. I wasn't sad. I was angry. I was seething. I was absolutely furious. Everything set me off. In my mind, as long as I didn't want to hurt my baby, then I would be okay. But I didn't think twice about wanting to hurt myself.
     When it looked like I was going to be put on anti-depressants, I couldn't go there. I had heard too many stories about people who went on them and then committed suicide and knowing how sensitive I am to anything I put into my body, I feared that they'd send me over the edge.
     So I turned to a naturopath and in one 2 hour visit, she pinpointed exactly what I needed. She said that the hormone imbalance I was feeling included large amounts of adrenaline and epinephrine pumping into my system sending me into "fight or flight" mode. This definitely explained my state of constant panic. The only way I could describe it was that I was screaming inside, constantly.
     She gave me supplements to help my adrenal glands to not overproduce adrenaline and an amino acid to spray under my tongue when I would start to feel panicky. Within a few days, I felt...as normal as one can feel after having a life changing and body changing event happen at age 41 (having a baby, of course).
     I can't say normal because I'm not who I was before baby. I'm another person, totally changed, and half the time I'm not sure who I am. I've seen a therapist a few times to explore this aspect of motherhood. Nobody told me I would lose my identity and have an identity crisis that would only add to my PPD.
     In the 2 months since I started getting treatments for my PPD, I haven't had any out of control, irrational outbursts. And I'm not screaming inside. When I feel something creeping in, I spray the amino acid under my tongue a few times and then take a deep breath, letting it out slowly. I have only had to do that one time in the last 3 weeks.
     I still don't know who I am, although when I went to a friend's birthday party last month with my husband and baby, we had to wear name tags. I put my name, then under it, I wrote "NG's Mom." After the party, I stuck it on the inside of my coat and it is still there, a little worn around the edges, but there to remind me at least who I am in part. I need that reminder.

And here is Aliza's update, as of this month:

     About 5 months after I wrote this blog post, my naturopath sent me to a colleague - a nurse practitioner - who muscle tested me for an antidepressant. She determined that Effexor would be right for me. I started on the lowest dose - 37.5 mg - and immediately - and I mean immediately - felt different. I slept soundly and deeply the first night and woke up the next day refreshed. Within a few days, I felt calmer. The jagged edges of anxiety were smoothing out. Within a week, I felt...like me. Like the me I remembered me to be.
     Because the effects were so immediate and positive, I have remained on the lowest dose and am only supposed to take it for 3 months. Life at home is so much more calm. I feel capable of coping with everything, including being a mom. I'm trying not to worry too much right now about getting off the medication. I'm just enjoying having a normal life, something that I thought I'd never have again.

Reluctance to take Meds: What If It Was Diabetes or High Blood Pressure Instead?

I get so many comments and questions from women who want to know how to get over postpartum depression without taking medication.  I'm NOT judging them or questioning their reluctance one bit, because truthfully I didn't want to take medication either.  But all these concerns have led me to wonder what our reluctance really is.  As I said in an email to one of these women earlier today, if I was diagnosed with diabetes I wouldn't think twice about taking medication prescribed to me.  If I was told by my doctor that I had high cholesterol or high blood pressure, I'd take the medication prescribed to me.  Sure, I'd need to change my lifestyle as well to address the underlying problems causing the high blood pressure or cholesterol -- I'd exercise more, I'd eat better, I'd develop better coping mechanisms for stress -- but I'd also take the medication to address the current crisis until my other activities kicked in and my blood levels were safe enough that I could discontinue the meds.   

Isn't it the SAME THING with postpartum mood disorders?  Aren't meds ok to help resolve the immediate crisis, while at the same time we can use exercise and/or talk therapy and support gropups and whatever else works to resolve any contributing underlying factors and to recover and get back to our old selves?  And when we do recover, we can reduce them until it's okay to stop taking them altogether. 

It seems to me that psychiatric medication, where appropriate and prescribed by an experienced professional, is simply addressing a physical medical crisis.  Our bodies don't differentiate between psychiatric illnesses and other physical illnesses.  Only society does.  It's society, and the damn insurance companies, that make us feel like psychiatric illnesses are some how different and highly questionable.   Who the hell is some insurance person to tell me how many damn doctor visits I'm allowed to have to get better from postpartum depression?  Are you kidding?  ... sorry ... it just incenses me that we're given hard limits on what treatment we can have to get better as if (wink, wink) we're probably not really sick in the first place, now are we??

Anyway, I'm sure there are people who have recovered from postpartum mood disorders without taking medication.  And I say more power to them, seriously.  Potentially, through continued research into various hormones and brain chemicals and genes and levels of various things in our blood we may get to a point where there is a more direct treatment for these illnesses which may or may not involve medication.  Until then, I can only tell you that I, myself, would not have recovered without the medication I took.  As Oprah says, that's one thing I know for sure.

P.S.  On the same topic, click here to go over to The Perinatal Project blog to read about some recommended changes in the way mental illnesses are covered by insurance.

Supplements for Depression

Here's more info on using Omega-3 fatty acids as supplements for depression.  There are actually several pre-natal vitamins out now that include Omega-3s, as well as a supplement for nursing moms that has DHA.  I'm taking one of the new pre-natal vitamins and so far, so good.

"Omega-3 fats could be a missing link that brains need to be happy. In a recent study, six out of 10 people suffering from depression got relief after taking fish oil supplements rich in omega-3 fats (Amer. Jour. of Psychiatry, Mar 2002).

'These results were huge, and the improvements were obvious,' says psychiatrist Andrew Stoll, MD, of Harvard Medical School. Those who got the supplements slept better and felt less worthlessness and guilt. 'We think omega-3s help your brain use a feel-good chemical called serotonin,' says Dr. Stoll. 'All cell coatings are made of fats, and when those fats are omega-3s, the serotonin receptors on the surface of brain cells seem to function in a healthier way.'"

The above information came from this article in Prevention magazine.

Tag: postpartum depression supplements

Omega-3

In the new book "YOU: The Owner's Manual" by Dr. Michael F. Roizen and Dr. Mehmet C. Oz, I happened upon the following factiod:

Essential fatty acids -- like omega-3 fatty acids found in fish -- can help prevent postpartum depression.  When the mother doesn't have enough of these essential fats, the baby borrows from the mother -- leaving the mother with a depleted supply of fatty acids.  Research shows that omega-3s are essential for normalizing moods, and consumption of fish correlates with lower rates of depression, and especially postpartum depression.

I get emails all the time from people who think they've found the answer to what causes PPD or the answer to what will prevent it.  Usually I don't write about that stuff here because I am not a doctor.  If I can't verify that it is true, then I don't want to send hundreds of mothers off on a wild goose chase for something that isn't really effective. 

What I can tell you is that I didn't really eat fish when I was pregnant because I was so afraid of the warnings about mercury.  I'd be interested to see what some of the doctors who specialize in postpartum mood disorders think of this quote.  If it is indeed true, than how do mothers balance the dangers of mercury with the benefits of omega-3s?

Maybe I Should Have Eaten More Spinach

I thought you'd be interested in this article from CNN.com about a study released today on the subject of iron-deficiency and postpartum depression: "Low Iron May Impact Mom-Baby Bonding"

This is interesting news, although as I recall I took my OB's prescribed vitamin supplement religiously, so I can't imagine I would have been iron deficient. Unless there wasn't much iron in it. Come to think of it, I have no idea what was in it ...

Fish Food for Thought

Darlene Gray sent me this story on the benefits of eating fish during pregnancy. Interesting, considering how much coverage has been given by the general media to the importance of avoiding certain fish during pregnancy due to high levels of mercury. I avoided fish like the plague when I was pregnant (although I doubt that's why I ended up with PPOCD). Why must it all be so confusing?!

Check out this story, but remember, as is always the case, there is no magic remedy for avoiding postpartum mood disorders. Link: KeepMedia | Psychology Today: Eating fish during pregnancy and lactation may benefit mother and child.