Breaking The Taboo of Postpartum Depression
It took me a couple of years to acknowledge the fact that I had been suffering from postpartum depression. I was in denial. Even though I knew I didn’t have the instant connection to my son that new mothers always talk about, I thought “well, I just met him, I’m sure it will come soon”. I never told anyone, because the thought of a mother not being able to connect with her own child seemed preposterous, selfish, and frankly hard to explain. How do you begin to confess your inability to connect with your infant? Especially when everyone who meets your little one lights up in pure delight and rambles on about all the similarities you two have.
Denial is one of our first responses as we find comfort in telling ourselves that this is just a passing phase. If I were to Google search “why can’t I bond with my baby?” then it becomes real.
In the meantime, we drag the symptoms around like extra heavy baggage in an airport – not knowing which terminal to take, and not knowing our final destination.
What is Postpartum Depression (PPD)?
Postpartum depression is an utterly debilitating condition. I was shocked to find that it affects up to one in seven women in America. On its own, that’s a very high number – but what about all the cases that go undiagnosed every year and are omitted from this statistic? I had personally never told anyone about my experience until a few months ago when my son turned four years old. I’d venture to guess the prevalence of PPD is much higher than one in seven.
After I began to speak more openly about my struggle with postpartum depression, I realized that most women in my community had experienced some degree of this condition. Through my journey, I’ve learned just how important it is for us to have freedom to speak about PPD, offer each other support, and assuage the more severe cases including postpartum psychosis, and at times, suicide. A recent study identifies postpartum suicide as a “public health priority.” One in five postpartum deaths come as a result of suicide, positioning it as the second leading cause of death amongst new mothers.
Even though there has been a recent increase in the amount of studies focusing on PPD, the treatment protocol still mirrors that of general depression, which often leads to suboptimal outcomes. Women are prescribed anti-depressants and other pharmaceuticals that merely mask symptoms and frequently have detrimental side effects.
Compared to a more general form of depression, there is a specific symptom of PPD that makes this illness stand out. It is the “inability to bond” – specifically as it pertains to bonding with your child.
This begs the question: what is it that makes us bond to people in the first place? What makes us have pleasant feelings when we see a loved one rather than a stranger?
OXYTOCIN: THE LOVE HORMONE
Significant research in this field is now focusing on oxytocin, the hormone associated with the transition into early motherhood. It’s simply referred to as the “love hormone” or “cuddle hormone” – responsible for bonding you with your partner, your pets, and most importantly, your newborn. In the past two decades, there has been a surge of clinical trials evaluating oxytocin’s therapeutic potential in treating PPD.
On a chemical level, oxytocin is produced in the hypothalamus part of the brain, then released into the pituitary gland. Oxytocin is a nanopeptide composed of 9 different amino acids. The body uses oxytocin not only in the brain, but also in different organs like ovaries, testes, eyes, adrenals, placenta, thymus, and pancreas – all organs known to store high concentrations of vitamin C. This is where it gets exciting; let’s dive deeper.
Breastfeeding and oxytocin: The link
I was not surprised to learn that women who suffer from postpartum depression tend to have difficulty breastfeeding. I was one of them. I couldn’t produce enough milk for my son, and my depression and frustration eventually stopped me from trying. I stopped breastfeeding when my son was 3 months old and received no shortage of shame from family and friends for this decision, only furthering my anxiety and depression.
Oxytocin is directly involved in the milk-ejection reflex. When a baby sucks at the breast of its mother, the stimulation leads to oxytocin secretion into the blood, which then causes milk to be released into the breast.
What causes the disruption to oxytocin?
Studies have found a relationship between depression symptoms and low oxytocin levels with mother’s experiencing postpartum. Oxytocin also works along side your inflammatory stress hormones such as cortisol during times of stress so you can maintain homeostasis.
It is easily disrupted by a deficiency in vitamin C, magnesium, vitamin D, and lack of a good night’s sleep. To some people this is enough to get out of depression but to others there’s more to that. I had PPD for two years, and even after getting good quality sleep, supplementing the necessary vitamins and minerals, and increasing time in the sunshine, I was still having trouble bonding with my toddler.
It comes as no surprise that the routine procedures that take place in a hospital setting can increase stress and lower oxytocin. The combination of frequent nurse visits to scan your wristband, bright mercury-powered fluorescent lights, unhealthy food, antibiotics (also used as ointment in your baby's eyes) — and if you've had a difficult birth, a whole lot of medications, can greatly increase your body's stress response.
How do we stimulate oxytocin?
Below is a brief list of vitamins, minerals and herbs that have shown promising results in postpartum women who wish to turn to natural sources.
Vitamin C: One of the most important vitamins involved in the stimulation of oxytocin is vitamin C, which can be found in citrus foods and a variety of vegetables. Broccoli, cauliflower, chili peppers and oranges are all rich in vitamin C. If you wish to incorporate nutrient-dense superfoods, and consume powdered versions of vitamin C-rich foods in your smoothies, then I recommend acerola cherries (which are known to have the highest concentrations of this vitamin), rose hip tea (used in Chinese Medicine as a potent source of vitamin C), and black currants. You can also add herbs rich in vitamin C to your recipes, including thyme and parsley. Do not supplement with ascorbic acid, or lab made Vitamin C, most of it comes from GMO Corn made in a lab in China. Whole food vitamin C is a source of bioavailable copper with tyrosinase at the core.
Magnesium: For oxytocin to function properly, your body requires magnesium. At least 80% of the population is magnesium deficient today, and constant stress further depletes magnesium levels. Any foods high in chlorophyll contain high levels of magnesium. This includes seaweed, algae, spirulina and chlorella. These ingredients can be purchased in powder form and added into your smoothies, soups, or sprinkled over food. Wheatgrass and barley grass also contain high levels of magnesium and are simple foods to incorporate into your daily routine. Quality salt can be a great source of magnesium as well. Icelandic sea salt from Crucial Four has 3x more magnesium than regular sea salt!
But your main source of magnesium should be in your water. Here's a recipe for making your own magnesium bicarbonate concentrate for your water.
Lactobacillus reuteri: This species of probiotic bacteria is available in supplement form. It is shown to improve levels of oxytocin after giving birth, especially if you were prescribed a round of antibiotics. Antibiotics are known to lead to microbiome dysfunction as they destroy good gut bacteria.
Herbs: Sage, anise seed, and fenugreek have all been shown to increase oxytocin in pregnant women. Adding this to your diet can be a fun way to incorporate new flavors into your recipes, and at the same time will help elevate your levels of this critical hormone.
Vitamin D: It’s important to make sure both you and your baby get enough sunshine each day. Requirements vary depending on your skin color. Studies estimate that darker-skinned people may need anywhere from 30 minutes to three hours of sunlight daily compared to fair-skinned people who might only need 10-15 minutes outdoors to get enough vitamin D. This is a major reason why darker-skinned people have a higher risk of deficiency from vitamin D. The pigment on your skin works as a natural sunscreen, and the darker you are the more pigment (melanin) you have.
Melatonin: This is when things can get tricky as a new mom: lack of sleep can lower oxytocin levels, and a lack of oxytocin can have a negative impact on sleep. Thus, oxytocin and melatonin work in synergy. Quality of sleep is dependent on both NREM and REM sleep. Levels of oxytocin peak approximately 5 hours after sleep onset when REM sleep predominates.
The best way to stimulate the secretion of melatonin in the evening is by getting sufficient sun exposure during the day. Sun exposure increases the brain’s release of serotonin. When the evening comes, the serotonin in your body will be converted into melatonin. The most important component involved in this conversation is light exposure; when it’s nighttime the body will naturally release the melatonin. If you have a bright room at night, lights on in the house, and have the TV on, then this prominent light exposure will inhibit the secretion of melatonin. Your brain thinks it’s still daytime.
For this reason, I always make sure my house is very dark about 4 hours before I go to bed. I like to use incandescent lights and Himalayan salt lamps for subtle light. I replaced the light bulb of my bedside lamp to an incandescent red light bulb.
They provide enough light to see around the room without disrupting melatonin conversion. This minimal nighttime light exposure is great for your baby as well. Too much light stimulation will disrupt their sleep just as much as yours.
Sleepless nights, linked to stress and depletion of oxytocin
So now you know how the levels of melatonin, serotonin, and oxytocin affect your sleep. This is a very important subject for new mothers as a common denominator is the need for sleep.
I remember when trying to get my son to go to sleep, sometimes the only way that worked would be to walk around the room with him in my arms. One time, I was so sleep deprived that while I was walking with him in my arms, I too fell asleep, and went crashing on to a wall. Luckily nothing happened to either of us, but it was definitely (and literally) a wake-up call.
Without sleep, no healing can be done in the body. Sleep deprivation increases recovery time and weakens the immune system. According to additional studies, sleep loss also causes social withdrawal. The brain networks that warn of human approach are reduced during periods of sleep deprivation, causing the sleep-deprived to frequently withdraw from social activities.
Lack of sleep brings its own set of symptoms. Don’t sleep for one day and the result will feel like a hangover. Prolong that lack of sleep for days, even weeks or months, and the detriment to your health is heavy. Your body transitions into survival mode, and the sympathetic nervous system kicks into full throttle. This tends to make you feel on edge, experience heightened mood swings, withdraw from people, and generally feel what most people would call “crazy”.
Don’t worry, there is liberation below; I will get to this.
STRESS HAS A STRONG LINK TO POSTPARTUM DEPRESSION
There is an inverse relationship between oxytocin and the stress hormone cortisol, meaning that when cortisol goes up, oxytocin goes down.
Giving birth is a physical, mental and emotional rollercoaster. Your body has just created another human being, and this is not even remotely similar to baking a cake. We can’t just gather ingredients, mix together and wait until the baby comes out so we can enjoy. The body must go through a series of major changes – it took approximately 9 months to make this human, and it will take at least the same to recover. Organs must move to make room for a growing belly, and your body is constantly sharing nutrients with the baby so if you were already nutrient deficient, sharing with a baby will further deplete you.
Along with the physical stress comes the emotional stress, which is something we rarely speak about. Overnight, there is someone in your life that is far more important than you. Your baby depends on you to survive, and you are wholly responsible for the life of this helpless being. And not only are you responsible for its physical health, but you are responsible for its emotional and mental health. That’s a lot to take in, a lot to think about, and a lot to do. Suddenly all your needs are put on the back burner, and somehow you need to come up with the energy to be a supermom.
I recall when I was unpacking the gifts from my baby shower, the first thing I noticed on all the items was a bright orange or yellow labels with huge warning signs and illustrations of dying babies. The cute beach bucket with a toy shovel had a sticker with an image of a baby going headfirst into a water bucket, and the big sign read: “Warning, children can fall into bucket and drown.” The car seat showed a baby being squished by an airbag. These warning signs were plastered onto the baby crib, baby chairs, strollers, even support pillows.
How can you sleep at night knowing that any of these everyday products can somehow kill your baby? Try going to sleep with these labels staring at you. Can we rip off the labels? Sure, but the thought of them existing doesn’t go away – unless you learn how to better channel stress and cortisol. This is something I learned from talking to athlete – something I noticed they excel at. Let’s dive a little deeper into this. Grab some more tea or take a bathroom break because we are getting closer to the root cause.
Do genes cause an impact?
In 2015 a study showed a significant interaction between the oxytocin receptor protein rs53576 genotype and the presence of postpartum depression. Further detail showed that women who do not display depression in pregnancy, but who harbor the rs53576 GG genotype and display high methylation in the oxytocin receptor (OXTR) are nearly three times as likely to develop postpartum depression, in comparison to women of lower methylation levels or carrying the rs53576 A allele.
Another study was also able to predict postpartum depression based on the support and interaction of the father. Father support was a stronger predictor of post partum depression symptoms than mother or family support. It also showed that father support was most protective and had a stress-buffering effect amongst women with the GG genotype. You can find this information yourself. If you have previously done the ancestry DNA test like 23 and me, you can download your raw data and search for the genotype rs53576. This can give you a better idea and get you closer to putting the puzzles together.
Stress-buffering is a big one, and if you keep reading, you'll learn how to buffer just right.
How does stress work? Meet the parasympathetic nervous system
One of the primary jobs of our brains is to predict the future. It is constantly scanning the surrounding environment in search of threats to your safety. Some people’s brains are more responsive to pending threats, even in neutral situations. The moment you begin to feel stress, the body will prepare itself for any dangerous situation – whether a lion is chasing after you at full speed, or your baby keeps crying through the night. Within seconds of the perceived threat, the blood vessels in your body constrict so you bleed less when wounded. Less blood flows to the brain, and the adrenal gland releases cortisol which floods your body with energizing glucose so you can run even faster.
This leads to both heart rate acceleration and increased blood pressure. This visceral response to any threat shuts you down and prepares you for pain. People with chronic stress constantly see common life events as major threats, generally feel uncertain, and can at times feel shameful and inadequate. The series of events surrounding childbirth can be seen as quite threatening, and dare I say “stressful,” especially for first time mothers.
Not all stress is evil
The question then becomes, how do we learn to better channel stress, and see incidents as challenges rather than threats? High adrenaline sports (triathlons, heavy lifting competitions) are all stressors to the body. But the athletes that compete in these environments have a knack for seeing these stressors as challenges rather than obstacles. It’s all in the way we choose to see things. And as a new mother, this ability to reframe our stress and keep our cortisol levels in check becomes crucial in our recovery from childbirth, and even from postpartum depression.
That said, not all stress is evil. There is another side of stress that we need to familiarize ourselves with. It is the type of stress that actually helps us and gives us a sense of challenge. Exercise is inherently a stressor, but it actually helps you further develop your resources. When you exercise, your heart rate increases and blood becomes oxygenated, allowing this vital element to flow exactly where it is needed in your body – especially to the heart and the brain. During this process, the adrenals give you a shot of cortisol for energy, but the brain knows how to shut it down when it is no longer needed.
The “challenge response” to stressful situations is often associated with improved problem solving and critical thinking. Athletes are shown frequently to have a “challenge response” to stressors. Studies show that highly successful people also routinely view problems as challenges to be conquered (similar to the response of athletes), rather than as dangerous threats.
So the next time you begin to feel the stress signals in your body like heart rate increase, muscle tension, and rapid breathing, you can quickly reframe it by telling yourself “This is good stress, my body is giving me energy so I can perform well.” Or simply tell yourself “I choose to see this as a challenge, and I know my body is strong enough to solve this.” Another helpful thing I frequently ask myself is, “in 5 months, will I be thinking about this?” Most of the time, the answer is no.
This perspective will train the body to respond with feeling more energized, more dilation to the vessels, more blood flow to the brain. It will help you successfully manage cortisol levels which in turn effect the love hormone oxytocin. And as we now know, this hormone is an essential component in the life of a new mother, especially one experiencing any degree of PPD.
Become aware of your body, recognize the onsets of stress, and control your response as much as possible.
What can you do now?
Separating the YOU from the beautiful stuffed animal and baby powder rubble. What does taking care of YOU look like?
After speaking with several new mothers in my community, one theme seems to be very common: loss of identity. It’s challenging to segment the various factors of your new identity – the you, the relationship between you and your kids, and the kids themselves. It all becomes a big cluster.
When we’re on an airplane, the flight attendant repeatedly instructs us to put our oxygen masks on first, before assisting others. Why is this crucial for survival? Because if you run out of oxygen, you can’t help anyone else put on their masks. Put on your oxygen mask and you can help a lot more people.
Begin by scheduling 15 minutes of time for yourself each day. Forget about the chores that need to be done around the house, and the paperwork that might be piling up. Take these 15 minutes to nurture your spirit, body and mind daily. (Social media doesn’t count.)
The Self-Compassion Challenge
I also ask that during this sacred time you practice being kind to yourself. I challenge you to say 5 things that you love about yourself every day. Five things you’ve done throughout your life that made someone smile or made someone feel good. Don’t call yourself negative names. If it helps, think of yourself as a small child; would you go up to that precious child and call it dumb and stupid? Be compassionate with yourself, because when there is a stressful situation, you are going to be able to get out of it, challenge yourself, and grow stronger.
Meditation can be an extremely powerful tool for stress management and self-compassion. If you’ve never done it, that’s okay! There are plenty of apps that can help you get started (Insight Timer, Calm, Headspace).
Even simply gardening – planting some seeds, connecting with the ground around you, touching the soil, feeling the sunshine – is an easy method for feeding your spirit.
Breathwork is another crucial component in stress management. When we feel stress, we don’t breathe properly, and at times hold our breath altogether. Our organs need a lot of oxygen to properly function. Specifically, the brain needs oxygen to help you think, and the liver needs oxygen to transform glucose into energy. Take 5 minutes a few times a day to breathe deeply in and out and let the oxygen flow through your system.
There are so many ways we can learn to connect better with our bodies: take a moment to think about the emotions that run through you when you are stressed, happy, sad, angry. We feel these intensely on a physical level. It’s okay to feel these emotions. Most of the time when people are crying or sad, the first thing we tell them is “don’t cry”. If you feel like crying, cry, cry loud and let it out. If you feel angry, use a cushion as a punching bag and let all of the energy out. If you are happy, share that happiness with others and magnify those feelings. And when you are stressed, channel it and use the stress as your best friend, because stress can be positive if channeled properly. See these emotions as part of your journey, and you will become a witness to your body feeling superhuman.
It’s important to also do things daily that feed your mind. Think about the 8-year-old version of yourself. What was her passion? Being outside? Climbing trees? Maybe reading about dinosaurs? Your mind is naturally curious and constantly wants to learn and explore. Let your mind guide you and take you where it wants to go. Take these 15 minutes to yourself each day to connect with you.
Getting Emotional and Physical Support:
1. Let’s talk about this
People are more likely to help if we actually ask them to, and if we aren’t afraid to open up about what we’re feeling. People naturally want to help. Don’t hesitate to reach out to others and develop a plan to better help you. Instead of having your sister spend all day admiring the baby, you can ask her to help you meal prep for the week so you have more nutrient-dense dishes waiting for you in the kitchen. It’s easy to reach for cookies and bread when you are hungry, but these foods simply won’t give you the nutrients your body requires to heal.
2. Sign up for classes
Explore the community around you. There are likely classes and groups near you that are designed to help you connect with new mothers going through similar experiences. Mommy-and-me classes are great options for connection and support and are available in most cities.
3. Have a network of mothers
Get to know other mothers around you. They have gone through similar experiences and are likely able to provide support. I’m one of them. I frequently offer babysitting to friends that seem to need it, because I know what it’s like not to have support and to feel alone.
4. Have a routine
Human beings thrive on routine. Try as hard as you can to make a schedule for yourself and for your baby. Babies can be unpredictable, but you can develop a routine that works for you, allowing you to maintain some sense of organization. Begin by scheduling your regular stroller walks, feedings, and skin-to-skin time (this is also another stimulator of oxytocin).
5. Sleep training your baby
Oh! Talking about sleep again? Yes! Sleep is the most important part of pretty much everything we’ve covered so far – from oxytocin, to stress, to depression. There is a blog I follow religiously that has a few entries rich with sleep training information. Wee Bee Dreaming. The schedule looks like this. https://www.weebeedreaming.com/my-blog/routines-for-baby
6. Hydrate. Hydrate. Hydrate.
Water is life, and is the one thing we need most to survive. We are comprised of 70% water. Unfortunately, chronic dehydration has become very common. The liver – the organ that serves as your filter – needs a lot of water. Think about your dishwasher. What happens if you fill it with dirty dishes without first rinsing them? And cut its water usage in half? Yep. The filter would be a nasty mess and would likely not clean any of the dishes at all. That’s your liver when you’re dehydrated.
7. Nutrient-dense meals
It’s all too easy to reach for that bag of cookies, a frozen pizza, or the bag of potato chips when you’re exhausted and hungry. However, the amount of nutrients in these foods is essentially nonexistent. They contain primarily preservatives which are known to kill your good gut bacteria and negatively impact your ability to make serotonin (the happy hormone for a happy gut). Contrary to popular belief, 95% of serotonin is created in the gut.
Healing from childbirth takes time, but your body has an impressive ability to recover. Help your body help you. Assign a friend or relative to help with weekly meal prep. Make sure everything you eat is nutrient-dense and nourishing. You can even meal prep for a whole month, store everything in the freezer, and just pop dishes into the oven when you’re ready.
Our smoothies take less than a minute to make, they have all the necessary polyphenols, antioxidants, prebiotics, probiotics, and digestive enzymes to get your through the day.
Exercise is a great way to help your body make more energy. At the same time, it helps you avoid losing calcium from sitting or laying in bed for extended periods of time. Start with short walks around the neighborhood. Any stairs nearby? Go up and down the stairs a few times, then gradually do it for longer. Follow YouTube videos specifically designed for low intensity, easy 10-minute workouts.
I can tell you my son is 5 years old now, and it has been such a mission for me to continuously connect and bond. I assure you that it does get easier. Find things that you can enjoy together. We are currently into Pokemon: we watch the episodes together and go to the forest to “find” them. It’s a good way to bond and to get him out of the house to explore his surroundings. Maybe you’re into cooking? Teach him/her how to make cookies or scrambled eggs. Into painting? How about some finger painting? There are so many things you can do to continue the oxytocin bond throughout your child’s life.
This whole article in a simple recipe
And as usual with most of my posts, I try to incorporate a functional recipe based on the nutrients that were discussed in the piece. This recipe is designed with a focus on Vitamin C content, chlorophyll, magnesium, and foods that stimulate the hypothalamus – the part of the brain responsible for making oxytocin. Drink it first thing in the morning so you can get back to being supermom!
Oxytocin Boosting Smoothie
- 1 Cup of Frozen Blueberries
- 1 Cup of Frozen Spinach
- 1 Teaspoon of Spirulina
- 1 Coconut Water or Organic Oat Milk
- 1 Probiotic Capsule, open take out powdery content, I prefer probiotic spores here.
- 1 Teaspoon of Bee Bread this honey contains, royal jelly, honey, bee pollen, bee superfoods shown to help balance your hormones. I like this brand here.
- 1 Cup of Ice
- 1 Teaspoon Chaga powder (We love this brand: Wild Chaga Powder of Maine )
- 1 Teaspoon Lion’s Mane (KOS Organic Lion's Mane Powder)
Mix all the ingredients together in your blender, blend and enjoy the bliss!