Eating To Improve Postpartum Depression b y Dr. Uma Naidoo
Depression is a common, yet serious mood disorder that influences emotions, thought processes and often behaviors. Those who are depressed are characterized as having a low mood, persistent sadness and feelings of hopelessness, worthlessness, irritability, pessimism and fatigue. Depressed individuals are noted to have altered sleep patterns, such that they cannot sleep or they oversleep, appetite changes and/or unexplained digestive problems. Depressed moods can arise throughout the lifespan in response to a variety of conditions, or be chronic, and can affect men, women and children alike. One form of depression that affects a specific population, though, is Postpartum depression (PPD). A condition that is also referred to as Perinatal depression - because it can affect women both during and after pregnancy. Perinatal depression describes a collection of symptoms similar to depressive disorder that includes extreme sadness, fatigue and general fear or anxiety surrounding a pregnancy. Unfortunately, this condition is specifically dangerous for not only mothers, but the baby as well, because it affects the new mother's ability to care for her child and, in some cases, manifests as maternal anger or animosity towards the baby. In extreme cases, PPD can result in suicidal ideation amongst mothers or harmful intent toward their child. This can include postpartum psychosis, which may be due to underlying severe depression.
It is noted that PPD is one of the most common complications of childbirth and affects about 20% of women within the first year of birth and 25% of women beyond the first year.
Given the prevalence and potential danger of this condition, additional and complementary treatment methods are warranted. The field of Nutritional Psychiatry can help to improve symptoms of depression. Some of the pillars of Nutritional Psychiatry can also be used in the perinatal period too. When diet and lifestyle change is implemented, in conjunction with traditional psychiatric treatment, individuals have an increased ability to lead a healthy and happy life! An interesting hallmark of depressive disorders is an altered gut microbiome. One summary of research has shown that those with depressive disorder have remarkably different gut bacteria than those without depression, while another study found that those with depression lack the bacterial species associated with higher quality of life and have higher numbers of inflammatory bacteria in their microbiome. Such evidence tells us that gut health, inflammation and depression are linked. As a Nutritional Psychiatrist, I utilize this relationship, and that of the gut/brain connection, to advise specific dietary changes to help calm inflammation in the gut and build upon the good bacteria to relieve symptoms of depression and promote positive neurotransmitter function, which may similarly prove therapeutic to those with PPD.
Following childbirth, I advise that women be sure to be including the following foods into their diets to promote optimal emotional wellbeing:
Fermented foods such as sauerkraut, kimchi, miso and plain unsweetened dairy or non-dairy yogurt, support a healthy gut and mind! These foods have been shown to feed the healthy bacteria in the gut, essentially offering the reset needed to bring individuals back to a healthy mental state. As discussed above, studies consistently show that those who regularly consume probiotic rich foods report happier moods than those who do not.
Omega-3 Fatty Acids: healthy fats in general help to optimize brain function and reduce depression, but omega-3s specifically are anti-inflammatory powerhouses that promote healthy minds and happy moods! One specific review of the science found that women who regularly consumed omega-3s in the form of fatty fish like wild caught salmon or mackerel showed reduced rates of PPD when compared to those not including such nutrients in their diets. In the perinatal phase women would want to make sure to consume cooked and not raw seafood. Another option to help with omega 3s is an algal oil supplement which is a vegan/vegetarian option that they can discuss with their doctor.
Folate: folate is vitamin B9 and an incredibly important nutrient for those who may be suffering from depression of PPD. Folate supports the synthesis of the neurotransmitters serotonin and dopamine, which are noted to make up happy! The most common symptom of folate deficiency is depression, while those who include plenty of folate-containing foods into their diet, such as leafy greens, broccoli and chickpeas, are less likely to report feelings of depression.
Herbs & Spices: herbs and spices not only make our foods taste better, but they also contain a host of antioxidants that help protect our brain from the damage associated with free radicals and oxidative stress which can lead us to feeling down. Turmeric with a pinch of black pepper, specifically, has been shown to protect brain cells and adjust brain function in a way that significantly reduces depressive symptoms, offering new means of improving mood for those with PPD.
In addition to including these specific foods into the diet as a means of reducing symptoms of PPD, an overall dietary change is necessary for optimal results. Studies continuously show that Mediterranean eating patterns, or more commonly discussed as following a Mediterranean Diet, is associated with reduced prevalence of depression, while Western more processed diets are associated with increased depression. Specifically, a recent systematic review assessing a collection of data found that a balanced maternal diet which included plenty of fruits, vegetables, fish, grains, legumes and herbs (characteristic of a Mediterranean Diet) was associated with fewer PPD symptoms than those consuming more processed, sugary diets. Similarly, another review emphasized the notion that nutrient rich diets, such as those that include plenty of colorful fruits and vegetables, are essential for replenishing the many nutrients that pregnancy depletes for maintenance of proper neurotransmitter function and emotional wellbeing both during and after pregnancy. This study found that women who followed healthy diet patterns with plenty of food sources or supplementation with omega-3s, calcium, vitamin D, zinc and selenium were evidently more protected against developing PPD than women following a lower nutrient diet. In my work as a Nutritional Psychiatrist, one of the pillars I encourage is to “Be Whole, Eat Whole”. When we regularly eat wholesome, nutrient rich foods with plenty of fiber, healthy fats and proteins, we are feeding our best and most wholesome selves. Especially during a time as special as having a new baby, it is important to be nurturing our bodies and minds with healthy foods, to optimize our ability to nurture our children.
DR. UMA NAIDOO is a board-certified psychiatrist (Harvard Medical School), professional chef (Cambridge School of Culinary Arts), best-selling author of This Is Your Brain on Food (Little Brown 2020) and nutrition specialist (Cornell University) whose research provides tremendous insight into the connection between food/nutrition and mental health.