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Natural Postpartum Depression Support

April 18, 2013 Written by JP       [Font too small?]

According to a survey by the Centers for Disease Control and Prevention, up to 19% of women report frequent postpartum depressive symptoms. Postpartum depression or PPD describes a broad set of symptoms which often include feelings of anger, hopelessness, inadequacy and overwhelment. The onset of PPD can occur almost immediately after giving birth and may extend as long as one year. Changes in hormone levels (estrogen, progesterone, thyroid) and various emotional and lifestyle factors, such as difficulty breastfeeding, poor sleep quality and psychological stress, have also been noted as probable contributors. In the conventional medical system, antidepressants, counseling and hormone replacement are the mainstay treatments. However, there are also several alternative and complementary options that ought to be considered.

Diet and the judicious use of dietary supplements is a good starting point for addressing the “baby blues”. Studies appearing in peer reviewed medical journals report that eating a nutrient dense diet centered around dairy, fish, fruits, nuts, olive oil and vegetables may reduce the incidence of PPD. Likewise, omega-3 fatty acids and select nutrients (selenium, Vitamin D and zinc) have been singled out in terms of importance. Fish, flaxseeds, grass fed meat, omega-3 enriched eggs and walnuts are the best sources of dietary omega-3 fats. Since many fish are contaminated with lead and mercury, opting for “cleaner” fish, like freshwater trout, sardines and wild salmon, is recommended. Some of the best food sources of selenium are Brazil nuts, lamb and shrimp. Zinc can be found in menu items such as pumpkin seeds, scallops and turkey. Coupling a high potency prenatal multivitamin/mineral with a whole food diet is a common sense approach to attaining the nutritional goals outlined in the scientific literature. In addition, limiting intake of omega-6 fats, commonly found in refined foods and vegetable oils (corn, soybean, sunflower seed), may further improve mood by lowering ones omega-6/omega-3 ratio.

Apart from nutrition, clinical trials reveal that postpartum exercise is an invaluable tool for alleviating a depressed mood. Even home-based exercise interventions have shown very promising results. Therefore, unless there’s a medical rationale to avoid exercise, anyone with PPD needs to get moving. This, of course, may require the assistance and support of family, friends and/or medical professionals. Other, non-pharmacological means of improving PPD include aromatherapy and massage. Inhaling a combination of two essential oils, rose otto (rose oil) and lavandula augustifolia (English lavender), twice-weekly for 15 minutes at a time provided “significant improvements” in a group of 28 women with PPD. Frequent massage therapy is also of value because it confers an antidepressant and calming effect by decreasing cortisol (a stress hormone), while increasing dopamine and serotonin. Massage therapy can be applied professionally and/or by informed loved ones.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Emerging Risk Factors for Postpartum Depression: Serotonin (link)

Study 2 - High Dietary Ratio of Omega-6 to Omega-3 Polyunsaturated Acids During … (link)

Study 3 - Nutrition and the Psychoneuroimmunology of Postpartum Depression(link)

Study 4 – Effect of Supplementation with Selenium on Postpartum Depression … (link)

Study 5 - Antepartum/Postpartum Depressive Symptoms and Serum Zinc (link)

Study 6 - Elevated Serum Copper Levels in Women w/ a History of Post-Partum (link)

Study 7 – Dietary Patterns During Pregnancy and the Risk of Postpartum (link)

Study 8 - A Randomized Clinical Trial of Exercise to Alleviate Postpartum (link)

Study 9 - The Effects of Clinical Aromatherapy for Anxiety and Depression in (link)

Study 10 - Cortisol Decreases and Serotonin and Dopamine Increase Following (link)

Supplementing with Omega-3′s Improves the Omega-6/Omega-3 Ratio

Source: Depress Res Treat. 2011; 2011: 467349. (link)

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19 Comments & Updates to “Natural Postpartum Depression Support”

  1. liverock Says:

    The problem can be due to high copper levels in the brain.
    Pregnant women absorb more copper from their diets when estrogen levels are high to enable the fetus to form the arterial and heart system. The copper levels are particularly high during the third trimester when the baby is nearly full grown.

    After delivery most women will find the copper levels slowly returning to normal but in some cases the copper stays high and eventually is stored in the liver and brain, which causes most of the depression.

    The Carl Pheiffer institute have carried out substantial research in the field of the effects of copper on the mind in OCD and Autism and have found that reducing the copper levels in PPD cases by zinc,B6 and molybedenum can help alleviate the problem.

    http://www.ncbi.nlm.nih.gov/pubmed/17317521

  2. JP Says:

    Liverock,

    Thank you for your valuable comment. I attempted (and thought I succeeded) to post a reply on Friday via my IPhone. But, alas, it’s not here!

    I actually included the same paper in my link section at the bottom of the column (Study 6). Fortunately, some of the better formulated prenatal multis don’t contain a lot of copper and provide at least some B6, molybdenum and zinc. I suspect that consciously eating more zinc-rich foods and/or supplementing additional zinc may be enough to tip the balance away from copper excess.

    Be well!

    JP

  3. Shari J. Ryan Says:

    PPD had a chokehold around my life for too long. For eight months I was in denial, and I had confused the overwhelming feelings of being a new mom with postpartum depression. While it took me a long time to ask for help, the type of help I received had an instantaneous effect. I had been afraid of taking a medication after hearing all of the bad side effects, and while it was necessary for a little while, the therapeutic advice that came along with it will stay with me for a lifetime. It’s so simple, yet most moms forget how important it is to find something that’s just for you—something that doesn’t involve your children or even your spouse in some cases. My escape is writing. It takes my mind out of the current and puts me in a place where I can breathe. Since the solid advice I had gotten four years ago, I have written three novels (Schasm Series). While I enjoy sharing my books with others, the meaning behind them is my pride. It is my reward for overcoming one of the hardest obstacles I’ve ever faced. It’s so important to always make time for yourself. You never know what could come out of it! :)

  4. JP Says:

    Shari,

    Thank you for sharing your healing journey with us! That’s wonderful!

    Be well!

    JP

  5. JP Says:

    Update 04/12/15:

    http://www.ctcpjournal.com/article/S1744-3881%2815%2900025-0/abstract

    Complementary Therapies in Clinical Practice – Published Online: April 01, 2015

    Efficacy of yoga for depressed postpartum women: A randomized controlled trial

    Highlights: •Yoga as a complementary therapy for postpartum depression was examined. •57 depressed postpartum women were randomly assigned to yoga or WLC group. •Significant change in depression, anxiety, and HRQOL in yoga, relative to WLC. •Clinically significant change detected in 78% of women in the yoga group. •Replication studies are warranted to examine efficacy and mechanisms of change.

    Background: Up to 20% of women experience postpartum depression (PPD). PPD is associated with anxiety and poor health-related quality of life (HRQOL). Efficacious treatments are critical; many women with PPD prefer complementary therapies. Thus, the current study examined yoga as a complementary therapy for PPD.

    Methods: Fifty-seven postpartum women with scores ≥ 12 on the Hamilton Depression Rating Scale were randomly assigned to a yoga (N = 28) or wait-list control (N = 29) group. The yoga intervention consisted of 16 classes over 8 weeks. Outcomes were depression, anxiety, and HRQOL.

    Results: The yoga group experienced significantly greater rate of improvement in depression, anxiety, and HRQOL, relative to the control group with moderate to large effects. Reliable Change Index analyses revealed that 78% of women in the yoga group experienced clinically significant change.

    Conclusion: These findings support yoga as a promising complementary therapy for PPD, and warrant large-scale replication studies.

    Be well!

    JP

  6. JP Says:

    Update 05/18/15:

    http://www.maneyonline.com/doi/abs/10.1179/1476830513Y.0000000105

    Nutritional Neuroscience – Volume 18, Issue 4

    Objective: Previous studies have shown a positive effect of zinc as an adjunctive therapy on reducing depressive symptoms. However, to our knowledge, no study has examined the effect of zinc monotherapy on mood. The aim of the present study was to determine the effects of zinc monotherapy on depressive symptoms and serum brain-derived neurotrophic factor (BDNF) levels in overweight or obese subjects.

    Methods: Fifty overweight or obese subjects were randomly assigned into two groups and received either 30 mg zinc or placebo daily for 12 weeks. At baseline and post-intervention, depression severity was assessed using Beck depression inventory II (BDI II), and serum BDNF and zinc levels were determined by enzyme-linked immunosorbent assay and atomic absorption spectrophotometry, respectively.

    Results: The trial was completed with 46 subjects. After a 12-week supplementation, serum zinc and BDNF levels increased significantly in the zinc-supplemented group compared with the placebo group. BDI scores declined in both the groups at the end of the study, but reduction in the zinc-supplemented group was significantly higher than the placebo group. More analysis revealed that following supplementation, BDI scores decreased in subgroup of subjects with depressive symptoms (BDI ≥ 10) (n = 30), but did not change in the subgroup of non-depressed subjects (BDI < 10) (n = 16). Moreover, a significant inverse correlation was observed between serum BDNF levels and depression severity in all participants. Interestingly, a significant positive correlation was found between serum BDNF and zinc levels at baseline.

    Conclusion: Zinc monotherapy improves mood in overweight or obese subjects most likely through increasing BDNF levels.

    Be well!

    JP

  7. JP Says:

    Updated 10/22/15:

    http://onlinelibrary.wiley.com/doi/10.1111/jan.12836/abstract

    J Adv Nurs. 2015 Oct 20.

    Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial.

    AIM: The purpose of this study was to evaluate the effects of chamomile tea on sleep quality, fatigue and depression in postpartum women.

    BACKGROUND: Sleep quality is a significant issue for postnatal women. Chamomile is widely used as a folk remedy for its presumed sedative-hypnotic effects.

    DESIGN: A pretest-post-test randomized controlled trial was used.

    METHODS: A total of 80 Taiwanese postnatal women with poor sleep quality (Postpartum Sleep Quality Scale; PSQS score ≧16) were recruited from November 2012-August 2013. They were systematically assigned, with a random start, to either the experimental group (n = 40) or the control group (n = 40). The participants in the experimental group were instructed to drink chamomile tea for a period of 2 weeks. The participants in the control group received regular postpartum care only. The PSQS, Edinburgh Postnatal Depression Scale, and Postpartum Fatigue Scale were used to assess outcomes. Two-sample t-tests were used to examine the mean differences in outcome variables between the two groups.

    RESULTS: Compared with the control group, the experimental group demonstrated significantly lower scores of physical-symptoms-related sleep inefficiency (t = -2·482, P = 0·015) and the symptoms of depression (t = -2·372, P = 0·020). However, the scores for all three instruments were similar for both groups at 4-week post-test, suggesting that the positive effects of chamomile tea were limited to the immediate term.

    CONCLUSION: Chamomile tea may be recommended to postpartum women as a supplementary approach to alleviating depression and sleep quality problems.

    Be well!

    JP

  8. JP Says:

    Updated 11/10/15:

    http://chp.sagepub.com/content/early/2015/11/05/2156587215614703.abstract

    J Evid Based Complementary Altern Med. 2015 Nov 5.

    Omega-3 Fatty Acids and Cholesterol Have a Main Role in Antidepression Diet of Iranian Traditional Medicine.

    Depression is one of the major health problems of our world. Recent studies have revealed the relationship between diet and depression. In Iranian traditional medicine, there is a therapeutic diet that is recommended in melancholic diseases like depression. One of the main components of this diet is meat. Meats are divided into 2 groups: recommended and abstinent. The aim of this study was to clarify the logic of this diet through comparing nutritional elements of the 2 groups with each other. For this purpose, prominent books on Iranian traditional medicine were searched for abstinent and recommended meats traditionally prescribed for depressed patients. The results of each group were compared with the other by using Mann-Whitney Test (SPSS version 16). The results showed that recommended meats contain higher amounts of polyunsaturated fatty acids (P = .01) especially omega-3 (P = .03). Both groups contain high amounts of cholesterol. Iranian traditional medicine recommends consumption of meats that contains cholesterol with omega-3 fatty acids in depression.

    Be well!

    JP

  9. JP Says:

    Updated 12/17/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26665746

    Harefuah. 2015 Sep;154(9):568-72, 608.

    [THE ADDED VALUE OF ART THERAPY FOR MOTHERS WITH POST-PARTUM DEPRESSION IN ARABIC SOCIETY IN ISRAEL].

    INTRODUCTION: Post-partum depression (PPD) is a neurotic condition, which appears usually within two months after the delivery. This is the most common complication of pregnancy and puerperium, affecting about 15 to 20% of the mothers. In Israel, with some 150,000 deliveries annually, this relates to about 20,000 women each year. Routine treatment with psychotherapy (PT), helps about two thirds of these women. Continuation of the maternal symptoms affects the baby’s development, and the rest of the family as well.

    OBJECTIVES: The purpose of this study was to evaluate the additional value of art therapy (AT), compared to standard therapy, with PT alone, to eradicate symptoms of depression.

    METHODS: A prospective, randomized controlled study was conducted. During the period 2011-2013, a total of 141 Arab mothers with symptoms of PPD, from the Um-El-Fahem region, were included in the study. A comparison was made between two groups: The control group receiving routine treatment with PT and the intervention group which received, in addition, AT.

    RESULTS: Both groups demonstrated a reduction in the level of depressive symptoms. In the intervention group, however, the reduction in the level of depressive symptoms was statistically more significant (p < 0.05).

    CONCLUSIONS: In our study, the combination of standard PT with AT enabled the vast majority of the mothers to recover from the depressive state. In a health care system with chronic budgetary constraints, the addition of some cardboard and plasticine to the “Health Basket”, coupled with a few hours with a trained therapist, is probably a worthy alternative, considering the scope of the problem and its influence on the mother, the baby, and the family as a whole.

    SUMMARY: The appearance of PPD symptoms is a common and significant medical condition. These attributes make this phenomenon a significant problem from the public health perspective. Routine treatment with PT, helps a lot of women. Many, however, remain symptomatic. The addition of AT enables most of them to resume a normal and healthy course of life.

    Be well!

    JP

  10. JP Says:

    Updated 03/18/16:

    http://www.ncbi.nlm.nih.gov/pubmed/26984349

    Eur Arch Psychiatry Clin Neurosci. 2016 Mar 16.

    Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial.

    Given that antidepressants (ADs) work slowly, there is interest in means to accelerate their therapeutic effect and to reduce side effects. In this regard, thiamine (vitamin B1) is attracting growing interest. Thiamine is an essential nutrient, while thiamine deficiency leads to a broad variety of disorders including irritability and symptoms of depression. Here, we tested the hypothesis that adjuvant thiamine would reduce depression, compared to placebo. A total of 51 inpatients (mean age: 35.2 years; 53 % females) with MDD (Hamilton Depression Rating Scale score (HDRS) at baseline: >24) took part in the study. A standardized treatment with SSRI was introduced and kept at therapeutic levels throughout the study. Patients were randomly assigned either to the thiamine or the placebo condition. Experts rated (HDRS) symptoms of depression at baseline, and after 3, 6, and 12 weeks (end of the study). Between baseline and the end of the study, depression had reduced in both groups. Compared to placebo, adjuvant thiamine improved symptoms of depression after 6 week of treatment, and improvements remained fairly stable until the end of the study, though mean differences at week 12 were not statistically significant anymore. No adverse side effects were reported in either group. Results suggest that among younger patients with MDD adjuvant thiamine alleviated symptoms of depression faster compared to placebo. Importantly, improvements were observed within 6 weeks of initiation of treatment. Thus, thiamine might have the potential to counteract the time lag in the antidepressant effects of ADs.

    Be well!

    JP

  11. JP Says:

    Updated 04/22/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815377/

    Iran J Nurs Midwifery Res. 2016 Mar-Apr;21(2):197-201.

    Effect of lavender scent inhalation on prevention of stress, anxiety and depression in the postpartum period.

    BACKGROUND: Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women.

    MATERIALS AND METHODS: In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA), and post hoc tests. Level of significance was set as 0.05 for all tests.

    RESULTS: The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (P = 0.012, P < 0.0001, and P = 0.003, respectively) and stress, anxiety, and depression scores at time points of 1 month (P < 0.0001) and 3 months after delivery (P < 0.0001) were significantly lower in the study group compared with the control group.

    CONCLUSIONS: Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth.

    Be well!

    JP

  12. JP Says:

    Updated 08/04/16:

    http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0988-7

    BMC Pregnancy Childbirth. 2016 Aug 3;16(1):203.

    Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study.

    BACKGROUND: Vitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults. We performed this study to evaluate whether low maternal vitamin D levels are associated with depressive symptoms in pregnancy.

    METHODS: This study was a secondary analysis of a randomized trial designed to assess whether prenatal omega-3 fatty acid supplementation would prevent depressive symptoms. Pregnant women from Michigan who were at risk for depression based on Edinburgh Postnatal Depression Scale Score or history of depression were enrolled. Participants completed the Beck Depression Inventory (BDI) and Mini International Neuropsychiatric Interview at 12-20 weeks, 26-28 weeks, 34-36 weeks, and 6-8 weeks postpartum. Vitamin D levels were measured at 12-20 weeks (N = 117) and 34-36 weeks (N = 112). Complete datasets were available on 105 subjects. Using regression analyses, we evaluated the relationship between vitamin D levels with BDI scores as well as with MINI diagnoses of major depressive disorder and generalized anxiety disorder. Our primary outcome measure was the association of maternal vitamin D levels with BDI scores during early and late pregnancy and postpartum.

    RESULTS: We found that vitamin D levels at 12-20 weeks were inversely associated with BDI scores both at 12-20 and at 34-36 weeks’ gestation (P < 0.05, both). For every one unit increase in vitamin D in early pregnancy, the average decrease in the mean BDI score was .14 units. Vitamin D levels were not associated with diagnoses of major depressive disorder or generalized anxiety disorder.

    CONCLUSIONS: In women at risk for depression, early pregnancy low vitamin D levels are associated with higher depressive symptom scores in early and late pregnancy. Future investigations should study whether vitamin D supplementation in early pregnancy may prevent perinatal depressive symptoms.

    Be well!

    JP

  13. JP Says:

    Updated 08/22/16:

    http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-1024-7

    BMC Pregnancy Childbirth. 2016 Aug 20;16(1):239.

    A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers.

    BACKGROUND: Mood disorders in pregnancy and post-partum period are common and considered as a public health issue. Researchers have studied the relationship between low serum vitamin D concentration and perinatal depression, although no clinical trial has been conducted on vitamin D’s effects on depression related to childbirth. This study evaluated the effect of vitamin D3 supplementation on perinatal depression scores.

    METHODS: This randomized clinical trial was done in pregnant women who were under prenatal care in a teaching hospital in Shiraz, Iran. The inclusion criteria were: being 18 years or older, no history of mental illness and internal diseases, a singleton live fetus, without any pregnancy complications, gestational age of 26-28 weeks upon enrollment, and depression score of 0 to 13. The Edinburgh Postnatal Depression scale was used to evaluate depression scores. A total of 169 participants were assigned to the two groups of placebo and vitamin D through block randomization design. Vitamin D group received 2000 IU vitamin D3 daily from 26 to 28 weeks of gestation until childbirth. Maternal serum 25-hydroxyvitamin D concentrations were measured at baseline and childbirth. Besides, depression scores were evaluated four times: at 26-28 and 38-40 weeks of gestation, and finally at 4 and 8 weeks after birth.

    RESULTS: The two groups were similar in relation to baseline 25-hydroxyvitamin D concentrations. However, at childbirth, the vitamin D group had significantly higher 25-hydroxyvitamin D concentration in comparison to the control group (p < 0.001). At baseline, no correlation was observed between 25-hydroxyvitamin D concentration and depression score (r = 0.13, p = 0.09). There was no significant difference between the two study groups in relation to the baseline depression score. While, the vitamin D group had greater reduction in depression scores than the control group at 38-40 weeks of gestation (p = 0.01) also, at 4 and 8 weeks after birth (p < 0.001).

    CONCLUSIONS: The present trial showed that consuming 2000 IU vitamin D3 daily during late pregnancy was effective in decreasing perinatal depression levels. We suggest further clinical trial in pregnant mothers who are at risk for postnatal depression.

    Be well!

    JP

  14. JP Says:

    Updated 10/21/16:

    https://www.ncbi.nlm.nih.gov/pubmed/27763932

    Holist Nurs Pract. 2016 Nov/Dec;30(6):368-378.

    Effects of Reiki on Pain and Vital Signs When Applied to the Incision Area of the Body After Cesarean Section Surgery: A Single-Blinded, Randomized, Double-Controlled Study.

    This study was conducted to determine the effects of Reiki on pain and vital signs when applied for 15 minutes to the incision area of the body after cesarean section surgery. The study was single-blinded, randomized, and double-controlled (Reiki, sham Reiki, and control groups). Forty-five patients, equalized by age and number of births, were randomly assigned to the Reiki, sham Reiki, and control groups. The treatment, which was applied to the patients in these 3 groups, was applied for 15 minutes to the incision area of body in the first 24 and 48 hours after the operation within 4 to 8 hours of the application of standard analgesics. The study data were collected using a patient follow-up form and a visual analog scale. Mean visual analog scale measurement values were significantly different from each other according to groups and times (P < .05). A reduction in pain of 76.06% was determined in the Reiki group patients between day 1 pre-tx and after application on the second day (day 2 post-tx) measurements. Mean breathing rate and systolic blood pressure measurement values were significantly different from each other according to groups (P < .05). The Reiki group was observed to use fewer analgesics throughout the study and to need them after a longer time than the sham Reiki and control groups (P < .05). It was concluded that Reiki applied for 15 minutes to the incision area after a cesarean operation had the expected effects on pain and the need for the use of analgesics, but it had no effect on vital signs.

    Be well!

    JP

  15. JP Says:

    Updated 10/29/16:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5068252/

    Iran Red Crescent Med J. 2016 Jun 7;18(8):e34270.

    The Effect of Slow-Stroke Back Massage on the Anxiety Levels of Iranian Women on the First Postpartum Day.

    BACKGROUND: Anxiety disorder is common during the postpartum period. Back massage relaxation techniques are one of the most important nonpharmacological interventions to prevent and control postpartum-related anxiety.

    OBJECTIVES: To determine the effectiveness of slow-stroke back massage on the anxiety levels of primiparous mothers in the first days after delivery.

    MATERIALS AND METHODS: This single-blind controlled clinical trial consisted of 100 primiparous mothers with normal deliveries. The mothers were randomly allocated to interventional (n = 50) or control (n = 50) groups using binary blocks. Both groups were followed up just before, immediately after, and the morning after the intervention. Data were collected using a demographic questionnaire and Spielberger’s state anxiety inventory (STAI) questionnaire.

    RESULTS: The mean age of the mothers was 22 years. There were no significant between-group differences in age (P = 0.333), education (P = 0.427), and medication during labor and the postpartum period (P = 0.412). There was no statistically significant difference between the mean anxiety scores of the experimental (6.66 ± 35.48) and control groups (9.05 ± 37.42) before the intervention (P = 0.268). Immediately after the massage and the next morning, there was a significant between-group difference in the anxiety scores (P < 0.001).

    CONCLUSIONS: The findings demonstrate that slow-stroke back massage is a simple, inexpensive, noninvasive, and effective method to reduce the anxiety levels of primiparous women during the first postpartum day.

    Be well!

    JP

  16. JP Says:

    Updated 01/23/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28110159

    J Affect Disord. 2017 Jan 15;211:124-129.

    Manganese intake is inversely associated with depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    BACKGROUND: One epidemiological study in Canada has addressed the association between zinc intake and depressive symptoms during pregnancy while another epidemiological study in Korea has examined the association between iron intake and depressive symptoms during pregnancy. The present cross-sectional study in Japan examined the association between intake of zinc, magnesium, iron, copper, and manganese and depressive symptoms during pregnancy.

    METHODS: Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, employment, household income, education, body mass index, and intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, calcium, vitamin D, and isoflavones.

    RESULTS: In crude analysis, significant inverse associations were observed between intake levels of zinc, magnesium, iron, copper, and manganese and the prevalence of depressive symptoms during pregnancy. After adjustment for confounding factors, only manganese intake was independently inversely associated with depressive symptoms during pregnancy: the adjusted prevalence ratio between extreme quartiles was 0.74 (95% confidence interval:0.56-0.97, P for trend=0.046).

    LIMITATIONS: Information was obtained between the 5th and 39th week of pregnancy.

    CONCLUSIONS: The current cross-sectional study of Japanese women demonstrated higher manganese intake to be independently associated with a lower prevalence of depressive symptoms during pregnancy.

    Be well!

    JP

  17. JP Says:

    Updated 04/07/17:

    http://www.pnas.org/content/114/13/3509.abstract

    Proc Natl Acad Sci U S A. 2017 Mar 28;114(13):3509-3514.

    Selective dietary supplementation in early postpartum is associated with high resilience against depressed mood.

    Medical research is moving toward prevention strategies during prodromal states. Postpartum blues (PPB) is often a prodromal state for postpartum depression (PPD), with severe PPB strongly associated with an elevated risk for PPD. The most common complication of childbearing, PPD has a prevalence of 13%, but there are no widespread prevention strategies, and no nutraceutical interventions have been developed. To counter the effects of the 40% increase in monoamine oxidase A (MAO-A) levels that occurs during PPB, a dietary supplement kit consisting of monoamine precursor amino acids and dietary antioxidants was created. Key ingredients (tryptophan and tyrosine) were shown not to affect their total concentration in breast milk. The aim of this open-label study was to assess whether this dietary supplement reduces vulnerability to depressed mood at postpartum day 5, the typical peak of PPB. Forty-one healthy women completed all study procedures. One group (n = 21) received the dietary supplement, composed of 2 g of tryptophan, 10 g of tyrosine, and blueberry juice with blueberry extract. The control group (n = 20) did not receive any supplement. PPB severity was quantitated by the elevation in depressed mood on a visual analog scale following the sad mood induction procedure (MIP). Following the MIP, there was a robust induction of depressed mood in the control group, but no effect in the supplement group [43.85 ± 18.98 mm vs. 0.05 ± 9.57 mm shift; effect size: 2.9; F(1,39) = 88.33, P < 0.001]. This dietary supplement designed to counter functions of elevated MAO-A activity eliminates vulnerability to depressed mood during the peak of PPB.

    Be well!

    JP

  18. JP Says:

    Updated 05/11/17:

    http://insights.ovid.com/crossref?an=00006250-900000000-98405

    Obstet Gynecol. 2017 May 5.

    Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period: A Meta-analysis.

    OBJECTIVE: To examine the influence of exercise on depressive symptoms and the prevalence of depression in the postpartum period.

    DATA SOURCES: A structured search of MEDLINE, EMBASE, CINAHL, Sport Discus, Ovid’s All EBM Reviews, and ClinicalTrials.gov databases was performed with dates from the beginning of the databases until June 16, 2016. The search combined keywords and MeSH-like terms including, but not limited to, “exercise,” “postpartum,” “depression,” and “randomized controlled trial.”

    METHODS OF STUDY SELECTION: Randomized controlled trials comparing postpartum exercise (structured, planned, repetitive physical activity) with the standard care for which outcomes assessing depressive symptoms or depressive episodes (as defined by trial authors) were assessed. Trials were identified as prevention trials (women from the general postpartum population) or treatment trials (women were classified as having depression by the trial authors). Effect sizes with 95% confidence intervals (CIs) were calculated using Hedges’ g method and standardized mean differences in postintervention depression outcomes were pooled using a random-effects model.

    TABULATION, INTEGRATION, AND RESULTS: Across all 16 trials (1,327 women), the pooled standardized mean difference was -0.34 (95% CI -0.50 to -0.19, I=37%), suggesting a small effect of exercise among all postpartum women on depressive symptoms. Among the 10 treatment trials, a moderate effect size of exercise on depressive symptoms was found (standardized mean difference-0.48, 95% CI -0.73 to -0.22, I=42%). In six prevention trials, a small effect (standardized mean difference-0.22, 95% CI -0.36 to -0.08, I=2%) was found. In women with depression preintervention, exercise increased the odds of resolving depression postintervention by 54% (odds ratio 0.46, Mantel-Haenszel method, 95% CI 0.25-0.84, I=0%). The trials included in this meta-analysis were small and some had methodologic limitations.

    CONCLUSION: Light-to-moderate intensity aerobic exercise improves mild-to-moderate depressive symptoms and increases the likelihood that mild-to-moderate depression will resolve.

    Be well!

    JP

  19. JP Says:

    Updated 12/05/17:

    http://www.sciencedirect.com/science/article/pii/S0944711317301447?via%3Dihub

    Phytomedicine. 2017 Dec 1;36:145-152.

    A double-blind, randomized, placebo-controlled trial of saffron stigma (Crocus sativus L.) in mothers suffering from mild-to-moderate postpartum depression.

    INTRODUCTION: Numerous adverse effects of antidepressants as well as the attitudes of breastfeeding mothers, who prefer to consume herbal medicine rather than chemical drugs, encouraged us to assess the effects of saffron (Crocus sativus L.) on mothers suffering from mild-to-moderate postpartum depressive disorder.

    METHODS: A double-blind, randomized, and placebo-controlled trial was conducted on 60 new mothers who had a maximum score of 29 on the Beck Depression Inventory-Second Edition (BDI-II). They were randomly assigned to the saffron (15 mg/Bid) or placebo group. The primary outcome was a change in the BDI-II scores 8 weeks after treatment compared to the baseline. The response and remission rates were considered to be secondary outcome measures.

    RESULTS: Saffron had a more significant impact on the BDI-II scores than the placebo. The mean BDI-II scores decreased from 20.3 ± 5.7 to 8.4 ± 3.7 for the saffron group (p < .0001) and from 19.8 ± 3.2 to 15.1 ± 5.4 for the placebo group (p < .01). In the final assessment, 96% of the saffron group were in remission compared to 43% of the placebo group (p < .01). The complete response rates were 6% for the placebo group and 66% for the saffron group.

    CONCLUSION: When administered to treat minor PPD in breastfeeding mothers, saffron had a more significant impact on the BDI-II than the placebo.

    Be well!

    JP

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