This article is intended to be used as a guide for new mothers who may be experiencing symptoms of Depression, Anxiety and Stress. It is not intended as a means to diagnose or replace professional medical advice. If you have suicidal thoughts or are worried about your own or someone else’s safety you can call Lifeline on 0800 543 354 or speak to a licenced professional.
It is not uncommon for new mothers to be experience stress, fatigue, anxiety and depressive states. Postnatal depression affects up to 15% of women in New Zealand alone. Fluctuations in hormones post-birth involve a sudden drop in Estrogen and Progesterone which can cause feelings of sadness, fatigue and lack of energy.
Postpartum Depression usually has an onset within four weeks after delivery
Feelings of depression may be characterised by a persistent sadness, hopelessness and loss of interest in activities. In states of depression, sleep, appetite, libido, energy and self-esteem can all be affected. Depression can be experienced as mild, moderate or severe and this changes the treatment routes. There are also a number of factors which increase the risk of depression, including prior history to depression, living alone, marital conflict, limited social support and a higher number of children.
Anxious states can refer to a temporary and intense episode of worry or fear that subsides and is not frequent. Anxiety disorders are recurrent bouts of anxiety that likely need to be managed in order for it to not impede on one’s life. Generalised Anxiety Disorder (GAD) is defined by excessive worry and anxiety occurring more days than not for more than 6 months, around a variety of different activities.
Whether you are feeling anxious or sad feelings or whether you have been diagnosed with depression or an anxiety disorders, there are some herbal and nutritional options that can help. However, during breastfeeding, substances such as alcohol and drugs (prescription included) enter the breast milk and metabolites of the drug can be passed to the baby. This also applies to herbal medicines and some alternative options, therefore safety is paramount. The safety of the following recommendations has been checked and researched to be deemed safe in breastfeeding. Please note that it is still important to seek advice from a registered Naturopath or Herbalist to find the right product for your own individual needs.
Herbal Medicines for Depression and Anxiety which are safe in Breastfeeding
- Saffron is Known to be the the world’s most expensive spice due to the labour intensiveness of its production, Saffron’s use as a medicinal herb has been documented for over 4,000 years. In December 2017, the journal Phytomedicine published the results of a clinical trial on saffron stigma for treating mothers suffering from postpartum depression. Results showed that the group treated with 15mg twice daily of Saffron Stigma showed a 96% remission rate for post-partum depression, twice that of the placebo group. They concluded that it was a safe and significant treatment for mothers suffering from Post-Partum depression. (Tabeshpour et al., 2017).
- High doses of Omega-3 liquid from Fish Oil has been shown to reduce depression through lowering neuro-inflammation, and can be especially beneficial in the perinatal period (Kendall-Tackett, 2010). It is also one of the most important nutrients for your baby’s brain development. The recommended dose needs to contain approximately 2 grams of EPA per day and will take 3-4 weeks to exert its effects. It is recommended to take before birth to build up stores and to assist in brain development in the infant. It is important to be taking a highly purified fish oil which is tested for heavy metal contamination.
- Curcuminoids derived from Turmeric have shown significant benefits for treating depression and anxiety. In a six week study, 50 individuals diagnosed with depression were randomised to receive 20mg/day of fluoxetine (a conventional anti-depressant) and 25 mg/day of Turmeric individually or in combination. The mean change in scores and remission rates were similar across all three groups, suggesting that Turmeric has an equal effect to fluoxetine for the management of depression. It has been shown to be safe in breastfeeding. Use in late term pregnancy is not advised due to its blood thinning effects and theoretical risk of early labour.
- Vitamin D is especially important as depression has been linked to low vitamin D levels. This is especially significant during the winter months when sunlight exposure is particularly low. It is also one of the nutrients recommended by the Ministry of Health for healthy development newborn babies. An Adult’s recommended doses range from 1000iu a day or more depending on the levels of Vitamin D in the blood.
- Another important yet unknown nutrient for mothers and babies is Inositol. Inositol is the third most abundant carbohydrate found in breastmilk and has been shown to be a vital component for your baby’s brain development. It has also been shown to be very effective for reducing anxiety, panic disorders and Obsessive-Compulsive disorders. It needs to be taken in high doses (12g – 18g daily) so powders are recommended.
- Magnesium has been shown to significantly decrease symptoms of anxiety and supports mood. It also improves quality of sleep. Recommended doses are 300mg of elemental Magnesium once or twice a day.
- B Vitamins are essential for healthy stress response and neurotransmitter balance. It is recommended to take a Vitamin B complex as they will work synergistically with each other to achieve better results.
- A pilot study in 2012 concluded that there were positive effects of using Aromatherapy as an adjunctive treatment for postpartum anxiety and depression. The essential oils most commonly used for anxiety and depression are lavender, jasmine, ylang-ylang, sandalwood, bergamot, and rose.
- Certain strains of Probiotics such Lactobacillus and Bifidobacterium have shown to exert a positive effect on depression, stress and anxiety. It is especially relevant in those who experience stress-related IBS symptoms.
Research shows that Exercise has a strong antidepressant action, even pram-walking has been shown to exert beneficial effects (Daley, MacArthur & Winter, 2010).
Cognitive Behavioural Therapy (CBT) is a psychosocial intervention that focuses on personal coping strategies to improve mental health. CBT has been shown to reduce both anxiety and depressive symptoms in postpartum women (Misri, Reebye, Corral, & Mills, 2004).
The mind-body connection is getting more deserved attention and studies are showing the calming effect of diaphragmatic breathing and other intentional breathing practices on the nervous system as well as reducing feelings of anxiety, depression and stress (Brown & Gerbarg, 2005).
Brown, R. P., & Gerbarg, P. L. (2005). Sudarshan kriya yogic breathing in the treatment of stress, anxiety and depression: Part 1 - neurophysiologic model. The Journal of Alternative and Complementary Medicine, 11(1). Doi:http://doi.org/10.1089/acm.2005.11.189
Daley, A. J., MacArthur, C., Winter, H. (2010). The role of exercise in treating postpartum depression: A review of the literature. Journal of Midwifery & Women’s Health, 52(1), 56-62. Doi: https://doi.org/10.1016/j.jmwh.2006.08.017
Kendall-Tackett, K. (2010). Long-chain omega-3 fatty acids and women’s mental health in the perinatal period and beyond. Journal of Midwifery & Women’s Health, 55(6), 561-567. Retrieved from https://www.sciencedirect.com/science/article/pii/S152695231000070X
Misri, S., Reebye, P., Corral, M., & Mills, L. (2004). The use of paroxetine and cognitive-behavioral therapy in postpartum depression and anxiety: A randomized controlled trial. The Journal of Clinical Psychiatry, 65(9), 1236-1241.