In our previous article, we gave a comprehensive background of perinatal depression and anxiety with a particular focus on postnatal depression (PND), in light of Perinatal Depression and Anxiety Awareness Week from November 12th to 18th. In this update, you will find out why a multidisciplinary approach to PND works, and how best to provide support from a case management perspective.
The food-mood link
The majority of research looking deeper at PND suggests an interplay between hormones, neurotransmitters and environmental factors. When looking at what can be done from a dietary point of view, one study1 identified the following nutrients as important when considering food and mood during this time:
- Folate, vitamin B6, vitamin B12: for their known role in the biochemical processes around mood regulating hormones such as serotonin, noradrenaline and dopamine
- Vitamin D: responsible for boosting mood, particularly if sunlight exposure is inadequate
- Zinc: low zinc status is related to depression in the general population
- Omega-3 fatty acids: particularly important for postnatal depression; omega-3 levels have been found to be lower in women who develop PND than those who do not
The take home message: enquiring about diet is always valid when dealing with mental health conditions, particularly PND, and provide a quick snapshot regarding the overall state of health of a customer
A well-balanced diet ensures a constant supply of these mood regulating nutrients for not only the mother but the baby, and can simultaneously help to keep other health conditions at bay.
New mothers can feel time-poor and might be focusing on their child’s nutrition rather than their own, but as seen above, neglecting key nutrients results in disrupted mental health in the long term.
The role of exercise
The antidepressant effect of exercise has been established across general and clinical populations, and PND is no exception to this. It is worth mentioning that actual antidepressants have some clinical benefit in one small trial, but there is generally reluctance to take a pharmacological option during pregnancy and breastfeeding.
On the other hand, exercise such as regular walking has minimal side effects and can be empowering for a new mother (i.e: they can self-administer the ‘treatment’). A review2 of exercise in managing PND acknowledges that physical activity improves physical and psychological health in the mother simultaneously, and therefore has a positive flow on effect to her children’s health.
The barriers to engaging in exercise after childbirth must be considered, including changes in body weight and fitness, lack of time, low energy and self-efficacy due to PND. Fortunately, an exercise physiologist can use motivational interviewing techniques to work with customers to overcome recognised barriers and bring awareness to other lifestyle factors which may be conducive to wellbeing.
The take home message: while most people know that exercise is good for them, we cannot underestimate the perceived barriers to being active, particularly in the postnatal period.
In summary – pregnancy is an exciting time for many families, however it is also a vulnerable time for the onset of mental health conditions. With the right care in place, the experience of perinatal depression and anxiety doesn’t need to be isolating or overwhelming
Good food, good movement, good social supports and good psychological input can be engaged in a way that mum, dad and baby will all benefit from.
References:
- Leung, B. M., & Kaplan, B. J. (2009). Perinatal depression: prevalence, risks, and the nutrition link—a review of the literature. Journal of the American Dietetic Association, 109(9), 1566-1575.
- Daley, A. J., Psychol, C., MacArthur, C., & Winter, H. (2007). The role of exercise in treating postpartum depression: a review of the literature. Journal of Midwifery & Women’s Health, 52(1), 56-62.