Pregnancy Depression and Postnatal Depression (PND) are the most common complications of pregnancy, with over 15% of women thought to be affected. The signs and symptoms for depression in pregnancy are the same as depression at any other time of life. Importantly, as with many pregnancy complications, there is a great deal of support and means of intervention for those who find themselves suffering from pregnancy depression or post-natal depression. Lifestyle and nutrition influences such as individual nutrient intervention, sleep management, stress management and emotional support can help improve the symptoms of depression during this difficult period.

Diet is the most easily modifiable risk factor for depression, and usually the most successful.  A number of nutrients have strong associations with depression, and over the coming years, the  impact of others will no doubt become more understood.  Women who are anywhere between the pre-conception period and having an infant under 3 years old should consider eating a structured diet to protect against pregnancy and/or post natal depression.

If you feel you are feeling low or depressed at this time, the following advice will help you to make the first steps to feeling better.

Post Natal Depression Risk Assessment:

Pregnancy and lactation are likely to be the most  nutritionally demanding times of every  woman‘s life. Intense nutrient demands, and emotional challenges mean that many women are at risk of depression during this vulnerable period. Many of us have at least one ‘risk factor’, but the risk of you developing depression may not depend on how many risk factors are in your life; stress, for example, is a very undefinable risk factor.   If you instinctively feel that you have a lot on your plate, now is the time to consider making some changes to help protect you from the symptoms of depression. Known high risk factors include:

◊    A personal history of depression or low mood

◊    A history of depression or low mood in your immediate family

◊    Pregnancy complications.

◊    Seasonal Affective Disorder (SAD)

◊    Feeling of Being Unsupported

◊    A Single Parent

◊    Stress- any

◊    Weight Loss over 7lb in the last 3 months

◊    Inadequate nutrition due to illness, or other factors

◊   Eating  a Typical Western Diet.

Signs and Symptoms of Pregnancy and Post Natal Depression

• Persistent sad or ‘empty’ mood
• Loss of pleasure in daily activities
• Sleep disturbance changes
• Feelings of guilt, worthlessness and helplessness
• Difficulty concentrating
• Crying for no reason
• Thoughts of death or self harm.

What to Do if You Feel Depressed.

Step 1: Go and talk to your GP. Your GP will talk things through with you and probably carry out an assessment; in most cases this assessment will be based on the ‘Edinburgh Postpartum Depression Scale’. The assessment is simple; it helps your GP to estimate the severity of your feelings. From there they will decide on how best to help you. They may offer counselling, medication or ask you to come back in a couple of weeks for a review.

Step 2: Take some key supplements. We recommend our Advanced Antenatal Formula to bring up your levels of mood – enhancing key nutrient levels such as folic acid, vitamin B6, vitamin B12, iron, zinc and selenium. Omega-3 fatty acids are important. Improvements in nutritional levels can take up to 3 months to make their full impact so the early you  can start to improve Omega-3 levels, the better. Our DHAPURE Omega 3 fish oil  capsules are a highly concentrated and purified source that will benefit your mood as well as being key in many other aspects of your health during this period.

Step 3: Try to make some dietary changes to incorporate some of the foods that contain the key  nutrients that are known to help combat depression.

Step 4: Sleep. Try a relaxing bath before you go to bed, and a glass of milk which is rich in tryptophan, an amino acid that is known to increase level of serotonin in the brain which is associated with ‘calm’ and sleep.

Step 5: Tell people. Talk about how you feel to your friends and family. Some people will understand better than others, find those that are easier to talk to and let them know how you feel.

Step 6: Get out and about. Try to go for a walk each day, breath in the fresh air and get your circulation going. Exercise releases endorphins, chemicals, in the brain that promote feelings of wellbeing and happiness.

Nutrients that Help Treat Pregnancy Depression and Postnatal Depression.

Omega-3 Fatty Acids and Depression:

Poor omega-3 fatty acid (fish oils) status increases the risk of depression and supplementing fish oils into the diet has been found to successfully treat depression.

Folate (Folic acid) and Depression.

Folate levels are closely correlated with depression as folate is involved in a number of processes that regulate mood.  Not only is folate status linked to the incidence of depression, but the severity of depressive symptoms. There are several factors that can lead to decreased folate status alongside poor dietary intakes which are common. Other factors include use of oral contraceptives, antibiotics, increased nutritional requirements typical of pregnancy, inherited metabolic conditions, mal-absorption syndromes and chronic disease states such as rheumatoid arthritis. Poor dietary intakes are common in the UK, in addition folate is easily destroyed during food preparation and cooking.

In studies only between 5 and 12% of women report taking the recommended 440ug supplement of folic acid, which suggests that very high numbers of women may conceive with low folate status.

Vitamin B6 and vitamin B12 and Depression.

Poor status of the vitamins folate, vitamin B6 and vitamin B12 leads to an elevated level of the amino acid compound ‘homocysteine’. These nutrients are essential for the detoxification of this compound, which if not adequately removed from the brain, can interfere with cognitive function and lead to depression. In one study 17% of mildly depressed women and 27% of severely depression women were found to have low vitamin B12 status. Further studies indicate that over 15% of women of child-bearing age have raised homocysteine levels, which would put them at risk of pregnancy and postnatal depression, and that additional supplementation of B vitamins can reduce homocysteine levels.

Iron Status and Depression

Iron deficiency is the most common single nutrient deficiency in the world with estimates that over 50% of all women of child bearing age are affected. There is a strong association between maternal iron status and anxiety, stress and depression. Post Natal Depression may have strong associations with maternal iron status. Studies also suggest that low iron status may also adversely affect mother-child interactions and infant development.  Iron rich foods include offal such as liver, thyme, twiglets and malt bread.

Zinc and Depression

Even mild zinc deficiency can affect cognitive function and mood. Zinc is an essential component of over 70  enzymes in the human body. In addition it has structural, regulatory and catalytic roles which all in all make it a very important nutrient for our health. Zinc has a role in the storage of neurotransmitters in the brain and the symptoms of zinc deficiency may include irritability and emotional disturbance. Mild zinc deficiency is common in the UK and, in addition, pregnancy increases the requirement for this nutrient, exacerbating the degree of deficiency, which in turn, contributes to mood swings and depression. Zinc rich foods include oysters, beef, lamb and pumpkin seeds.

Selenium and Depression

Depression in European countries such the UK may be due, in part, to diets containing low levels of selenium which is a trace mineral. Low selenium levels in the UK diet are being blamed on the use of  European grain which is deficient in selenium as compared to grain from other continents. This grain which is used, for example, to make flour for bread in the UK is nutritionally inferior to the grain previously obtained from Canada. However the good news appears to be that by eating foods that are  naturally high in selenium such as brazil nuts (one nut contains 20 μg) or by taking a good quality selenium supplement, it is possible to improve mood significantly.

• Other good selenium sources include: brewer’s yeast, offal, meat, fish, shellfish, grains, cereals and eggs.

To further boost selenium levels in your diet it is also recommended you choose unrefined grains (such as wholemeal bread, flour, pasta, rice) because the refining process can reduce the selenium content of food by 50-75%.

Juliet Wilson  Recommended Supplements and Products to Help Combat Depression

1. Advanced Ante-natal Formula;

Compared to many lower quality products on the market, the nutrients  in this formula have been carefully selected for their high bioavailability, which means that your body is better able absorb and use the high percentages of vitamins and minerals from the supplement that you need.  The carefully researched formula contains all the key nutrients for health during pregnancy, breastfeeding and childbirth, in just the right amounts including zinc, iron, magnesium, B12, B6, folic acid and selenium – the nutrient deficiencies most associated with depression. We recommend 2 tablets daily.

2. DHAPURE:

This is a highly purified blend of fish oils, dicosahexaeonic acid and eicosapentanoic acid. Over time these fatty acids are incorporated into the cells of the brain, replacing saturated fats and other less healthy fatty acids, where they are beneficial to brain function, mood and anxiety. We recommend 2 tables daily.

3. Nutrilastin Body Treatment Oil:

Relax! It is important that you find ways to let your body relax as much as possible. This wonderful blend of oils which provides added nutrition to your skin, can be used as massage oil, a moisturiser or as a bath oil. It is truly relaxing and contains pure oils such as lavender, to help relaxation and promote sleep. Formulated from natural oils and rich in oleic and linoleic acids, the nutrients contained within the oil will nourish the skin, ensure maximum suppleness and have active ingredients designed to help prevent the occurrence of stretchmarks.

Foods That Help Treat Low Mood and Depression.

Many foods contain nutrients that will help to combat depression, particularly those that are rich in omega-3 fatty acids, iron, zinc, B vitamins and magnesium. If you already have depression then supplements are the best solution, a known dose of each key nutrient will give you the peace of mind that you are getting what you need, as long as it’s a good supplement that is. As you begin to feel better, dietary changes will ensure that future depressive periods will be kept at bay.

Alongside a good multivitamin and mineral supplement, such as our Advanced Formula Ante-Natal supplement which contains 24 high bio-available nutrients  and a concentrated, highly purified,  fish oil supplement, such as DHAPURE, foods that are rich in the amino acid tryptophan are also useful as they help to increase levels of the neurotransmitter serotonin which regulates mood. Eat plenty of turkey;  milk products which contain high concentrations of tryptophan and salmon are also a good source -although intakes of such fish should be limited because of the potential for high concentrations of toxic contaminants such as mercury and PCBs that exists due to water pollution.

When you need more help.

The links below may be useful if you need to speak to someone or find out more information.

1. Association for Postnatal Illness

A helpline, leaflets and information supported by a network of volunteers who have suffered from PND. Tele 0207 386 0868

2. Depression Alliance

Information and support for people who suffer from depression and relatives who want to help. Tele 0845 123 2320  or email information@depressionalliance.org.

3. Cry-sis

Self-help and support for families with excessive crying and demanding babies. Helpline 08451 228669

4. Family Action

Support and help for families affected by mental illness. Tele 020 7 254 6251

5.   Meet-a-Mum Association (MAMA)

Support and information for all mums and mums-to-be who are lonely, isolated or depressed in pregnancy or after a baby -tele 0845 120 3746.

Sources:

Bread J et al (2005) Maternal Iron Deficency Anaemia Affects Postpartum Emotions and Cognition:  Nutritional Epidemiology . The Journal of Nutrition.

D’Angelo et al (2007) Preconception and interconception health status of women who recently gave birth to live-born infant- PRAMS 2004. MMWR Surveillance Summ 56(10):1-35

Folstein  et al (2007) The Homocysteine Hypothesis of Depression. American Journal of Psychiatry 164:861-867

Leung BM, Kaplan BJ (2009) Perinatal depression: prevalence, risks and the nutrition link – a review of the literature. Journal of the American Dietetic Association 109(9):1566-75

Jonathon et al (1997). Nutrition and Depression: The Role of Folate-  Lead Review Article. Nutrition Reviews 55(5): 145- 150

This entry was posted on Monday, December 13th, 2010 at 10:44 PM and is filed under Pregnancy. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.