Top 5 Natural Ways to Prevent Postpartum Depression

How to prevent postpartum depression is a frequent topic that comes up when I am talking to patients and other providers. To help squash some of the myths out there on the internet, and to provide some evidence-based education, I have put together a list of the top 5 natural ways to prevent postpartum depression. Keep in mind though, if someone has a history of two or more periods of depression in their past or has a history of bipolar disorder, the risk of those symptoms coming up again during pregnancy or postpartum is greater than 60% (higher for bipolar disorder) if they are no longer on medication. Because mental illness symptoms in pregnancy and postpartum have significant risks for baby, it is important to take the necessary steps to prevent mental illness from coming up during this important time. For some people, the safest option might be to continue their medication. For everyone, though, using these 5 natural tools to prevent mental illness will help keep both mom and baby healthier!

  1. Support Network

    Postpartum depression rates have increased over the decades, and one likely culprit is the change in our society structure. Women are more present in the workforce, and are working until they are older. This likely means a woman doesn’t live near other family, and that other family and friends also have jobs that take them away from helping when baby comes. 

    As humans, we have evolved as very social creatures though. We depend on social and emotional connections to thrive. This dependency on connection is even more imperative around the time of pregnancy and postpartum, as a woman’s brain is changing in many ways to prepare her for motherhood. Multiple studies have shown the importance of a woman’s support network during the postpartum period, and this makes sense logistically. If a woman has help with cooking, cleaning, working, and taking care of her other children, she is bound to have less stress, and, therefore, is less at risk for postpartum mental illness. Similarly, if she has someone to confide in about her struggles or fears, or someone to give her some time away from her newborn to rest, she is also going to fair better mentally and physically than a woman who does not have those opportunities. There was also a recent study that showed a baby’s IQ was directly correlated with the number of people in the mom’s support network. This isn’t surprising though. Many studies confirm that if mom does better mentally, then baby also thrives more in developing mentally and physically. 

    Take time to plan your postpartum period. Utilize the people who offer to help. Decide who will bring which meals, who can help out with other children, who can clean, and who can give mom and dad a needed break. Consider hiring a postpartum doula or a night nanny if friends or family are scarce. There are so many resources out there to help you plan for this time, including this Postpartum Workbook. PPHA is a local Austin organization that offers a doula voucher program so that families who would not otherwise be able to afford a doula, can. Visit pphatx.org to learn how to apply.

  2. Food

    Food and exercise are two lifestyle modifications that frequently show up as prevention tools for illnesses. It is no different with mental illness. Let’s not forget that the brain is an organ in our body, just like our heart, liver, kidneys, etc. And just as other organs benefit from a healthy lifestyle, so does our brain. 

    Eating a diet high in sugar and other processed ingredients increases the amount of oxidative stress on neurons, or the cells that make up our brain. Oxidative stress is a term that refers to chemicals our body makes in response to certain environments that harm the cells in our body. This makes it much more difficult for our neurons to function optimally, which increases our risk of developing mental illness. Eating a diet with a lot of vegetables, fruits, legumes, beans, and fish has shown to decrease this oxidative stress. Given this information, it is no surprise that The Mediterranean Diet has specifically been studied for its health benefits, and has shown to improve mood in some people. Overall, it serves as a great guideline for healthier eating habits. There are also psychiatrists who specialize in Nutritional Psychiatry, which studies how foods impact mental health. Dr. Drew Ramsey is one of the well-known psychiatrist in this field, and has published several books to help people eat foods that better brain health.

  3. Exercise

    Exercise is another tool to help prevent mental illness. There are several ways this possibly helps our brain to be healthier, but we still have not completely figured out why exercise decreases our risk of mental illness. We know exercise has many benefits on our body that impact mental health such as improving deep sleep quality, regulating stress hormones, increasing endorphins, and improving access to oxygen throughout the body. There is evidence showing that moderate exercise for 30 minutes a day, 5 days a week can improve depression, and that yoga is an effective adjunct treatment for anxiety.

    Women have come up with some pretty creative ways to exercise with a baby, and you can find many of these exercise regimens on YouTube. There are even stroller meet up groups and yoga classes with baby here in Austin.

  4. Sleep

    There is a lot of research about sleep and its impact on the body, especially on the brain. As many people know from personal experience, a night of bad sleep can really change your mood or make you feel more anxious the next day. Even small amounts of sleep deprivation can add up over time to impact how the brain functions, making it more prone to mood instability and anxiety. Sleep problems in pregnancy have shown to increase the risk for postpartum mental illness, and those with more severe sleep deprivation postpartum, are also more likely to develop postpartum depression or anxiety. It is so important for the brain to get a minimum of 4 to 5 hours of uninterrupted sleep each night, but this can be impossible when you’re the only one caring for an infant at night.

    Some strategies to help improve sleep after baby comes include, dividing up night duties with your partner (one person takes the first half of the night, and the other person takes the second half), hiring a night nanny for a few nights a week, sleeping in a different room than baby as (s)he gets older, using sound machines or ear plugs, and keeping it as dark as possible at night (this will help baby sleep too). It is very important to practice “sleep hygiene” techniques as well.

    If you find that you are having trouble sleeping at night - whether it’s falling asleep or staying asleep - it is important to talk to a psychiatrist or therapist about this. The most validated way to improve sleep is by using a technique called CBT-I, or cognitive behavioral therapy for insomnia. This is the first-line approach to insomnia, and is much safer and more effective than medication. There are online programs for CBT-I for those who cannot afford therapy or cannot find a therapist who offers it. One such program is Slumber Camp. If you notice you are having trouble sleeping when baby is asleep, this is also a red flag that you may be suffering with postpartum mental illness.

  5. Therapy

It can seem unrealistic to some, but going to therapy weekly can actually be as effective as medication at improving mild depression and anxiety symptoms. Weekly therapy has also been shown to help prevent postpartum mental illness in some studies. There are two types of therapy that specifically show evidence in postpartum mental illness treatment: cognitive behavioral therapy and interpersonal therapy.

This blog post was written by Kristin Yeung Lasseter, MD who is the current Medical Director of PPHA and Psychiatrist at Reproductive Psychiatry Clinic of Austin

What Language Is That?

It’s not uncommon that clinicians throw around acronyms and words that others don’t understand. Just like other professions, the healthcare industry has its own terminology that can be difficult to follow if you’re not trained in it. In fact, there are even courses available to receive a Medical Terminology Certificate.

To further complicate terminology in medicine, different medical specialties use acronyms and phrases that those within other specialties are not familiar with. In the perinatal mental health world, we often throw around a lot of terminology that even other mental health providers are not privy to. This is one of the many reasons we believe it is imperative for all mental health providers involved in treating perinatal patients to receive specific training in this realm.

We thought it might be helpful for others to clear up what some of the phrases, words and acronyms mean around perinatal mental health, as well as the various levels of care. Don’t know what perinatal means? No worries, we’ve got that one covered too.


Levels of Care in Mental Health:

  • Outpatient treatment

This refers to the lowest level of care and takes place in an office setting. Typically outpatient therapy appointments last 40 minutes to 60 minutes and occur anywhere from 2-3 times a week to once a month. Outpatient psychiatric treatment appointments last less than an hour, as well, and occur weekly to annually.

  • IOP (Intensive Outpatient Program)

    This refers to therapy that is occurring multiple hours a day for multiple days a week. These programs usually take place in an office setting, but can sometimes be located at hospitals. It is more frequent than outpatient therapy, but less frequent than PHP. Patients usually see a psychiatrist who is involved with the IOP once or twice during the program, but will see a therapist in a group setting during the program days.

  • PHP (Partial Hospitalization Program)

This refers to treatment that occurs for the majority of the day, 4-5 days a week. The setting is usually at a hospital, but patients do not stay the night in the hospital. While in a PHP, patients are usually seen by a psychiatrist associated with the program a few times, in addition to the therapists they work with during the program days.

  • Inpatient treatment

This is the highest level of care. While a patient is inpatient, they are staying in a hospital all day and usually unable to leave the hospital grounds. Inpatient hospitalizations typically last 3-5 days on average; however, it can range from less than 24 hours to months. Long-term hospitalization is a different type of hospitalization that is much more rare, where patients spend months to years in the hospital.

Terminology:

  • Perinatal - usually refers to the period of time from conception to one year after delivery, or one year postpartum.

  • Prenatal - the period of time from conception until labor, also known as antepartum.

  • Peripartum - the period of time around birth. This is less well-defined, but usually refers to the few weeks leading up to birth, and the few weeks following birth.

  • Antepartum - the period of time from conception until labor, also known as prenatal.

  • Intrapartum - the period of time from the onset of labor until delivery of the infant and placenta.

  • Postpartum - typically this is the period of time from delivery until 12 months after delivery; however, others may define it as being from the time of delivery to anywhere from 6 weeks after delivery to 2 years after delivery.

  • Gestation - refers to the period of time during pregnancy starting from the first day of the last menstrual cycle. Often used to describe the age of the fetus.

  • Preterm labor - labor prior to 38 weeks gestation.

  • PMAD - perinatal mood and anxiety disorder

  • PPD - postpartum depression

  • PPA - postpartum anxiety

  • PPND - paternal perinatal depression

  • PND - perinatal depression

  • PMD (vs PMDD) - perinatal mood disorder. PMDD is an acronym for premenstrual dysphoric disorder, which is unrelated to pregnancy.

  • EPDS - Edinburgh Postnatal Depression Scale

  • CBT - Cognitive Behavioral Therapy

  • DBT - Dialectical Behavioral Therapy

  • CPT - Cognitive Processing Therapy

  • EMDR - Eye Movement Desensitization and Reprocessing

  • IPT - Interpersonal Psychotherapy

  • IOP - intensive outpatient program

  • PHP - partial hospitalization program

  • DSM-V - Diagnostic and Statistical Manual of Mental Disorders, fifth edition

  • LBW - low birth weight. Refers to the weight of a newborn.

  • LGA - large for gestational age. Refers to the size of a fetus

  • SGA - small for gestational age. Refers to the size of a fetus. The acronym, SGA, is also used to refer to a class of medications, called second generation antipsychotics.

  • MCM - major congenital malformations

  • NAS - neonatal adaptation syndrome

  • PPHN - persistent pulmonary hypertension of the newborn

  • SSRI - selective serotonin reuptake inhibitor

  • SNRI - serotonin-norepinephrine reuptake inhibitor

  • TCA - tricyclic antidepressant

  • ECT - electroconvulsive therapy

This blog post was written by Kristin Yeung Lasseter, MD who is the current Medical Director of PPHA and Psychiatrist at Reproductive Psychiatry Clinic of Austin


Why You Should Donate to PPHA

No mother in the midst of a perinatal mood disorder should feel alone. No parent experiencing anxiety, depression, or crippling grief from pregnancy or infant loss should feel they have nowhere to turn. The feelings that 1 out of 7 mothers experience in the perinatal period can cause them to feel isolated and filled with shame. These feelings are made worse by a systemic lack of support in a country that does not guarantee paid paternal leave and access to healthcare. Not to mention that the United States is the most dangerous nation to give birth in the developed world. This statistic is more alarming for women of color, who are three times as likely to die from complications of child birth.

As cases of mental illness and complications from birth continue to rise, birthrates among this generation of potential parents is sinking. Though it can be attributed to a variety of factors, the statistic speaks for itself. Mothers, fathers, babies, families, and communities are more in need of advocacy and support than ever. And if we are to be a thriving nation, we must begin with helping families to thrive. This will take legislative progress on the part of family services and benefits. It will take an increased awareness around mental health and perinatal mood disorders. Most of all, it will take supporting new families and being there for them in their time of need.

This is where PPHA comes in. The Pregnancy and Postpartum Health Alliance of Texas was created in 2010 in Austin, Texas, by mothers and mental health professionals who saw a disabling void in the maternal health care system. Families in Austin were in need of resources, so that they could easily find health care providers who could help them through the depths of perinatal mood disorders like postpartum depression. They were in need of a community, that could help erase any negative stigma around mental illness and parenthood. Under-served and low income families were in need of services that were not available to them, because of a lack of health insurance or financial resources. The founders of PPHA saw this need, and they came together to create solutions.

Since then, countless mothers and families have been impacted positively by the work of providers, doulas, and volunteers through PPHA. But although non-profit organizations like this one create great strides in progress for their communities, they often do so without funding. PPHA relies chiefly on donations from benefactors who are passionate about supporting moms and families. Luckily for PPHA and for those experiencing perinatal mood disorders, the call for help has been heard by a vast community of benefactors from Texas and all over the world.

As we continue to expand our reach, aiming to serve more families each year, we ask for donations. This time of year is especially important, as it’s our annual drive for fundraising through Amplify Austin. All day on February 28th, we’ll be asking for donations to reach our $15,000 goal. With your help, we’ll be able to continue to answer the call for help from all affected families. Our impact is lasting and life-changing. Together, we can continue to create a community that supports moms and families in some of their darkest periods of need. To schedule a donation, go to https://www.givegab.com/nonprofits/pregnancy-postpartum-health-alliance-of-texas-ppha

Thank you!