March 25, 2010
How Your Diet Can Raise The Risk of Postpartum Depression
The MGH Center for Women's Mental Health has written a great analysis of recent research into the impact of diet and nutrition on mental health.Â They take a look at two different studies, one published in the Archives of General Psychiatry and the other in the American Journal of Psychiatry, that show that the foods we eat and our weight can lead to higher risk of depression and anxiety.
"These findings suggest that a diet rich in processed food leads to higher rates of depressive illness.Â This has practical implications for our patients, suggesting that it may be prudent to provide nutritional information and ...view middle of the document...
Â You wanted to know what type of effective complementary or alternative treatments exist for postpartum depression.Â I asked Kelly Brogan, MD, to help educate us all and she was kind enough to share her expertise with the following post.Â Dr. Brogan is an integrative reproductive psychiatrist with her own practice in New York City.
Navigating the ever-evolving risks and benefits of psychiatric treatment during pregnancy and postpartum remains a challenging endeavor.Â Perhaps it is in response to this complexity that many women express an interest in alternative or complementary treatments.Â Treating an expecting or new mother is treating an entire family, and the decisions involved require consideration of the woman as a whole, her preferences, history and the nature of her current symptoms.Â Given the prevalence of significant mood symptoms during pregnancy and postpartum, and the risks of untreated maternal mental illness (low birth weight, prematurity, pre-eclampsia, childhood psychiatric pathology, etc.) women must be proactive about management of emerging symptoms.
For moderate to severe symptoms, a careful discussion of risks and benefits of medication treatment must be explored with an expert psychiatrist.Â Many complementary interventions enhance standard treatment, and may even limit the dosages required to treat to remission, and for mild symptoms they may even be considered as first-line interventions.
Per Dr. Marlene Freeman, the American Psychiatric Association is poised to release results of a taskforce on integrative treatment approaches, and future research is likely to further substantiate complementary and alternative medicine (CAM) interventions which may hold special appeal for a population concerned about the risks of medication exposures.Â Currently, there are several interventions with a significant evidence base despite the fact that CAM studies are often limited by challenges to controls (exercise, acupuncture), as well as limited in terms of funding for large-scale, placebo-controlled trials.Â In my practice, I routinely recommend omega-3 fatty acids, SAMe, light therapy, folic acid, exercise and cranial electrical stimulation, and refer to qualified acupuncturists for management of antepartum and postpartum illness.
At a recent Integrative Mental Health conference, Dr. Freeman discussed the available evidence on this subject.Â Meta-analysis of Omega-3 fatty acids (EPA and DHA from fish sources) have demonstrated benefit over placebo for mood support, although some outcome heterogeneity can be attributed to insufficiently powered studies (Su, Parker, Freeman, Nemets).Â [This means that some studies show it works, and some studies show it doesn't, but that may be because the trials weren't big enough.]Â Because of depletion of maternal fatty acids by the fetus during pregnancy and lactation, in addition to insufficient dietary consumption, Omega-3 used at therapeutic doses represents a potential benefit...