To Your Health

Outside of antidepressants, what are the best ways to treat postpartum depression

Q. I have a bad case of "new baby blues" but I don't want to take antidepressants because I am still nursing my baby. What else might help, especially among the nutrients?

A. Since it's so obvious that postpartum depression is strongly connected to changes in hormone levels, most of the interest focuses on hormones and there is scant research into the involvement of nutritional deficiencies. The burden that pregnancy places on the nutritional reserves of mothers should be a clue that nutrient deficiency could play a role in PPD.

Although controlled studies are still lacking, the latest study, using higher amounts of omega-3 fatty acid supplements (2.8 grams per day) than previously used, did show a 50% drop in depression score. Without supplements, in a few months time, the omega-3 fatty acid levels in breast-feeding mothers drop by about 30%. In addition to reducing the chances of PPD, omega-3 fatty acid supplements for the mother improve the neurological development of breast-fed infants, who perform significantly better on standard neurological tests.

Because pregnancy and lactation are major drains on a mother's folic acid stores, and because folic acid has been used successfully to treat depression from other causes, folic acid supplements have been suggested as a treatment for PPD. To date, research has always combined folic acid supplements with other important nutrients such as iron and vitamin B12, so the benefits of folic acid alone, while likely, are not known.

Subclinical hypothyroidism, usually defined as abnormal thyroid test results in the absence of symptoms, is now generally recognized as worthy of treatment, or at least a "trial run" of thyroid medication to see if there is improvement in the many subtle symptoms of low thyroid. Although they have improved over the past few years, tests for thyroid problems are notoriously unreliable. Some specialists go so far as to rely on symptoms instead of what they call the "tyranny" of test results in order to diagnose hypothyroidism. The close association of ovarian hormones with thyroid hormones makes a link between PPD and thyroid disorders quite plausible. If you should choose to have thyroid testing, ask for more than just the routine T3, T4, and TSH. A mirror-image molecule of T3, called reverse T3, is sometimes present and interferes with the action of normal T3. Also, certain antibodies that can now be detected will dramatically interfere with thyroid function if present. As a result, even though the routine test results are normal, you may be suffering from thyroid-hormone deficiency.

Nutrients that are called "methyl donors," such as S-adenosylmethionine, or SAMe, are found to be comparable in effectiveness with prescription anti-depressants but with far fewer side effects. SAMe is a prescription anti-depressant in Europe but available here in America without prescription. Clinical trials of SAMe are currently under way. It is not specifically recommended for PPD but appears a relatively safe and fast-acting anti-depressant, though at this time its impact on breast-fed babies is unknown.

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