With great pleasure, we introduce to you our newest blog series “Wellness Wednesdays” and our newest guest author Dr. Matthew Perchemlides, ND, FABNO, MSN, BSN from Riverside Natural Health Center. Dr. Perchemlides is here at MiniBury to share information about common medical topics relating to families. Look for his posts once a month! You’ll also find helpful tips for mindfulness, family health and personal wellness ideas each Wednesday here on our blog.
Today, Dr. Perchemlides will discuss a topic near and dear to our heart; Post Partum Depression.
Post Partum Depression, a very common condition that affects between 50-80% of all mothers in the United States.
Let’s just stop right there for a moment. Statistically speaking, you likely know are friends with a mother who has suffered from PPD. To learn more about PPD and learn about Naturopathic interventions, read on. Take it away Dr. Perchemlides.
Medical Disclaimer: This article is not written to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. The information written in this article is intended for general purposes only and is not a substitute for medical or professional care. You should not use this information in the place of the advice of your physician or other healthcare provider. Dr. Matthew Perchemlides is not liable or responsible for any advice, course of treatment, diagnosis, or any other information, services, or product you obtain by reading the information in this article or through this site.
One of the most dangerous attitudes about PPD is that it is “all in your head” or problem of self-control. This incorrect view of PPD is unfortunately what prevents many women from seeking the medical support that can help to stop their emotional and psychological suffering.
I had a professor in medical school who used to say to us in lectures that, after the arrival of her baby, each mother needs not only a detailed and individualized wellness treatment plan from her Naturopathic Doctor but also a full time live-in support person. Postpartum is one of the most challenging times of a woman’s life. The considerable hormonal changes a woman experiences in this time period combined with the lack of sufficient support that many women experience leaves too many mothers vulnerable to Post Partum Depression, a very common condition that affects between 50-80% of all mothers in the United States. If you have recently had a baby and suspect you might have postpartum depression, it is important to understand that this is a real physiological condition that most often requires treatment to bring the body and mind back to health. However, there are many treatment options available for PPD, and not all of them require pharmaceutical intervention.
In general there are three intensity levels of PPD. The first is Postpartum “Maternity Blues”, which typically peaks 24-48 hours after birth. Maternity blues is caused by rapidly elevated estrogen and rapidly decreased progesterone levels. This can cause a hormonal “rollercoaster effect” as the erratic hormonal levels influence the neurotransmitters that are responsible for our thoughts and emotions. Women might feel a sense of loss, irritability, resentment, anger, delayed bonding with infant, insomnia, tearfulness, feelings of inadequacy as a mother, fatigue, and a sense of loss of emotional control. Women experiencing maternity blues can expect a full resolution of symptoms within 10 days when neurotransmitter levels return to baseline, and fortunately this condition usually resolves before any need for medical intervention.
Women experiencing PPD feel mild to moderate depression. Symptoms include a sense of loss, irritability, resentment, anger, changes in maternal feelings towards infant, insomnia, tearfulness, feelings of inadequacy as a mother, fatigue, disordered patterns of eating, and a sense of loss of emotional control.
Postpartum blues are caused by the body’s hormonal response to birth, whereas the next level of PPD, that marked by more pronounced and prolonged symptoms, represent the body’s hormonal and central nervous system response to an individual’s lifestyle and circumstances, which are often extreme for new mothers, especially in many western cultures where an extended family and community support system is often lacking. Persistent stress in the form of pregnancy, labor, vaginal or surgical delivery, breastfeeding, sleep depravation, a high learning curve, changes in family dynamic, professional and financial changes, and a strain on spousal and other relationships all coalesce to create a nearly constant state of maternal stress. The body responds to this stress by producing the “stress hormone” cortisol. Cortisol’s job is to ensure that a mother can stay on her feet to care for herself and her child.
However, the brain and body were designed to respond to cortisol in short, infrequent bursts, and not for weeks, months, or years at a time, as many mothers experience. Over the long term, cortisol provokes epi and norepi, neurotransmitters in the brain that enable the type of rapid and anxious thought often needed in an immediate emergency. But elevated levels of epi and norepi result in severe anxiety and compromise the transmitter serotonin, which is responsible for calm, rational problem solving and a happy, relaxed state. The deficiency of serotonin results in depression, and when experienced over a longer period of time, the depression may worsen, lowering the levels of the neurotransmitter GABA while glutamate rises, a pattern commonly associated with persistent negative thoughts and an inability to pull out of a spiral of anxiety, depression, and worry. The next level of PPD is representative of these extreme biochemical reactions to stress.
The good news is that the ability to measure these imbalances also makes PPD a highly treatable condition with a variety of treatment options.
This level is the one that we typically associate with postpartum depression. It peaks at 6-8 weeks, with full resolution occurring in one year. Women experiencing PPD feel mild to moderate depression. Symptoms include a sense of loss, irritability, resentment, anger, changes in maternal feelings towards infant, insomnia, tearfulness, feelings of inadequacy as a mother, fatigue, disordered patterns of eating, and a sense of loss of emotional control. The CDC reports that this level occurs in 8-19 percent of all mothers in the United States, but physicians acknowledge that PPD is underdiagnosed. Naturopathic interventions for this level of PPD have many advantages over conventional therapies. Long term use of pharmaceutical antidepressants carry the risk of worsening symptoms over time. A naturopathic care plan corrects the underlying problem by supporting the ability of the mother’s brain and body to make those hormones and neurotransmitters that she is lacking. This helps to shorten the duration of symptoms and prevent them from recurring with subsequent pregnancies.
The CDC reports that this level occurs in 8-19 percent of all mothers in the United States, but physicians acknowledge that PPD is underdiagnosed.
Postpartum Psychosis, the third level postpartum depression, is a prolonged and more serious condition, statistically occurring in one out of one thousand births in the United States. This condition is characterized by severe mood disturbance, confusion, disorientation, bizarre behavior, insomnia, hallucinations, and delusions. In the case of postpartum psychosis, conventional therapy with pharmaceuticals and counseling support is necessary to stabilize the condition, at which point a naturopathic care plan can be designed and implemented to help the mother achieve optimal wellness.
Naturopathic interventions can be integrated with conventional care to allow the patient to benefit from both modalities. Naturopathic treatment of PPD is more individualized and multifaceted, aiming to treat underlying causes of the condition. Naturopathic care starts with a comprehensive evaluation of a patient’s medical history and risk factors for PPD.
Women experiencing PPD at any of the above levels often choose to avoid or minimize the use of pharmaceuticals in their healing, especially if they are breastfeeding or have other contraindications to medication. The conventional method of treating PPD most often starts with the use of selective serotonin reuptake inhibitors (SSRI’s). SSRI’s stop the body’s natural process of recycling serotonin so that more serotonin is left on site. Short term this results in very quick symptom relief, but long term it decreases the body’s ability to produce serotonin. A mother’s choice to treat her PPD conventionally for quick symptom relief should always be considered an option. Naturopathic interventions can be integrated with conventional care to allow the patient to benefit from both modalities.
Naturopathic treatment of PPD is more individualized and multifaceted, aiming to treat underlying causes of the condition. Naturopathic care starts with a comprehensive evaluation of a patient’s medical history and risk factors for PPD. A patient is given ample time in a supportive and nurturing environment to explain how she is experiencing her symptoms and to have all of her questions answered. The physician follows up with a comprehensive and individualized treatment plan that includes realistic and achievable recommendations for targeted nutritional supplementation, diet modification, physical exercise, light exposure therapy, psychological support, body work, and self care. Laboratory testing may be recommended and followed by a combination of some or all of the following: targeted nutritional supplements, herbal formulas, homeopathy, neurotransmitter support, and short-term bio-identical hormone replacement. A Naturopathic physician can break down a PPD treatment plan into small, manageable goals and help the patient achieve these goals with follow up care. Naturopathic intervention often takes longer to achieve symptom relief, but once achieved, patients experience success over the long term.
One of the most dangerous attitudes about PPD is that it is “all in your head” or problem of self-control. This incorrect view of PPD is unfortunately what prevents many women from seeking the medical support that can help to stop their emotional and psychological suffering. PPD may be a response to the stress of life as a mother, but it is a biochemical and physiological response, producing real and measurable hormone and neurotransmitter imbalances. The good news is that the ability to measure these imbalances also makes PPD a highly treatable condition with a variety of treatment options.
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Bio
Dr. Matthew Perchemlides, ND, FABNO, MSN, BSN holds a degree in Naturopathic Medicine, as well as a Masters in Human Nutrition from the University of Bridgeport College of Naturopathic Medicine. He also has a degree in nursing from Boston College. Before Dr. Perchemlides became a Licensed Naturopathic Physician, he worked as a Registered Nurse in multiple areas, including pediatrics as well as all areas of adult medicine. After graduating first in his medical school class, Dr. Perchemlides went on to complete a naturopathic oncology residency with Cancer Treatment Centers of America in Tulsa, OK, earning a specialization in naturopathic oncology. Dr. Perchemlides provides primary care to adults and children as well as specialized naturopathic care in the areas of oncology and chronic disease. He practices naturopathic medicine in Middlebury, VT as a member of the natural health cooperative Riverside Natural Health Center.
Medical Disclaimer
This article is not written to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. The information written in this article is intended for general purposes only and is not a substitute for medical or professional care. You should not use this information in the place of the advice of your physician or other healthcare provider. Dr. Matthew Perchemlides is not liable or responsible for any advice, course of treatment, diagnosis, or any other information, services, or product you obtain by reading the information in this article or through this site.