| published in: Taste for Life magazine; January, 2002 | |
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BEYOND BABY BLUES By Marcia Zimmerman, M.Ed., C.N.
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Giving birth can be as exhilarating as it is life changing. But the abrupt shift in the hormones that regulate childbirth and the postpartum period delivers a major shock to a woman's body. And many emotional and physical problems common in new mothers may intensify after a second or subsequent births. Uzzi Reiss, MD, a Beverly Hills gynecologist, finds that 20 to 30 percent of his postpartum patients experience mild depression. An additional 2 to 5 percent experience major depression. "The problem is major depletion of hormones," he says, "In some women this drop is drastic - from Mt. Everest to the Dead Sea - and creates depression." Nutrient Depletion Repeated pregnancies spaced closely together may deplete a woman's body of the nutrients needed to maintain emotional and physical stability. Even a strong, healthy woman can be brought down by the demands of pregnancy and childbirth that rob nutrients from her body. Moreover, the risk of depression increases with each new baby because nutrient depletion, induced by pregnancy, is only slowly reversed, especially among women who breast-feed. Compounding the problem new mothers may hesitate to seek help because they don't believe they should be depressed. Hence, postpartum depression often goes unrecognized and untreated. "The mother may become biochemically so distraught that she rejects her new baby," says Joan Mathews Larson, PhD, executive director of the Health Recovery Center in Minneapolis. Physicians who recognize postpartum depression often prescribe antidepressant drugs, which cannot correct underlying hormonal imbalances and nutritional deficiencies. That's why a number of depressed mothers do not respond to these medications if, indeed, they take the drugs at all. "Many women with this disorder come to me because they are unwilling to take the medications that have been prescribed," says Hyla Cass, MD, author of St. John's Wort, Nature's Blues Buster. "These drugs not only have unpleasant side effects but are also transmitted to their babies during breast-feeding." "Believe it or not, postpartum depression is not a Prozac deficiency," says Dr. Cass. She pointedly asks, "Why give a drug when the problem may be an easily remedied chemical imbalance?" |
Natural Solutions Dr. Cass believes that the usual underlying factors are low levels of progesterone and fatty acids. Certainly, when she prescribes them for her patients, they improve. Other physicians blame plunging levels of estrogen after childbirth. Antti Ahokas, MD, PhD, of Helsinki University, the lead author in a new study in the Journal of Clinical Psychiatry, notes that giving sublingual estrogen quickly reverses severe depression in women who are deficient in that hormone. While estrogen can quickly alleviate postpartum depression, its use would not seem advisable as a long-term solution, especially if blood levels of copper and zinc have not been evaluated. Mineral imbalances or deficiencies also contribute to postpartum depression. Dr. Larson points out that high copper levels can cause what looks like mental illness: extreme fears, agitation, sleep disturbances, depression, paranoia and even hallucinations. She explains that "ceruloplasmin, a copper-containing protein, is produced much faster in the presence of estrogen," which is plentiful during pregnancy. "This condition occurs during late pregnancy," she says, "leading to elevated copper levels." High levels of copper deplete zinc and vitamin B6, both of which may be low anyway in a new mother due to the nutritional demands of her pregnancy. Physical of zinc deficiency include stretch marks, white spots on fingernails, impaired wound healing, loss of appetite and diminished sense of smell. Dream recall is reduced or absent when B6 is low.
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Different Shades of Blue Nearly half a million women in the US will experience a postpartum mood disorder this year.Yet postpartum depression (PPD) is easily misunderstood, because many people think new mothers can't be anything but overjoyed. No wonder women have a hard time opening up about this condition to their doctors. At the University of Connecticut, Cheryl Beck, DNSc and Robert Gable, EdD, have come up with a new Postpartum Depression Screening Scale to detect moms in jeopardy. "Healthcare professionals need to encourage mothers to open up about PPD so they can get the help that they need," says Dr. Beck. Although she says this test is not a diagnosis, Dr. Beck notes that it has proved highly accurate. "It's a quick and easy means to catch women at risk before the condition escalates," add David Herzberg, PhD, at Western Psychological Services, which holds the copyright on the quiz. And although it doesn't replace a detailed clinical interview, the test can help healthcare providers determine where a woman falls on scale ranging from mild to severe depression, according to Dr. Herzberg. Below are some sample questions from the test, which consists of 35 questions dealing with seven categories
The mother indicates how much she agrees or disagrees with each statement during the past two weeks, using a scale of 1 to 5, with 1 meaning "strongly disagree" and 5 meaning "strongly agree." |
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| I got anxious over the littlest things that concerned my baby. | 1 | 2 | 3 | 4 | 5 |
| I was scared that I would never be happy again. | 1 | 2 | 3 | 4 | 5 |
| I felt like I had to hide what I was feeling towards the baby. | 1 | 2 | 3 | 4 | 5 |
| I started thinking that I would be better off dead. | 1 | 2 | 3 | 4 | 5 |
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If you or someone you know feels overwhelmed or depressed after childbirth, this screening may be useful. |
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Copyright©, 2001 by The Zimmerman Group, Inc. All rights reserved. Except as permitted under the Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. |
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