Postpartum Depression (PPD)

Although it’s called postpartum depression (PPD), the symptoms associated with this condition can range from mild to severe and include, but are not limited to, mood swings, anxiety, depression, irritability, feeling overwhelmed, crying, reduced concentration, appetite problems, trouble sleeping, fatigue, fear, hopelessness, and thoughts of harming yourself or baby. In stark contrast to the expansive list of symptoms associated with PPD, the causative factors are mostly unknown. Many experts believe a shift in estrogen, progesterone or thyroid hormones plays a role. Although this may be part of the problem, the next question then becomes why don’t all women suffer PPD since every woman who goes through childbirth experiences shifts in hormones? The scope of exploration needs to shift to what makes some women more susceptible to falling victim to these shifts in hormones and symptoms associated with PPD.

As with all health struggles, there is rarely one just a single causative factor. Until recently research done surrounding PPD has taken this a very one-dimensional approach, not only to causes but treatment as well. Now, however, research has begun to take a more holistic approach and look at what role chronic inflammation may play in PPD. Studies have begun to examine an inflammatory biomarker called homocysteine, which if high, can interfere with neurotransmitter production. Likewise, it is believed that immune dysfunction can lead chronic inflammation and elevation in CRP and IL 6, which have also been implicated as a factors in PPD. Another area that is rarely discussed but can have a big impact on mental and emotional health is the state of gut microbiome. Studies have now shown that people with an imbalance in the good and bad gut bacteria (think too many antibiotics, poor diet) can have increased anxiety and depression.

Because I practice Chinese medicine, let me step back and explain PPD through our theory of meridian energetics. The exertion and blood loss occurring in childbirth can cause a state of Blood deficiency and more specifically a Heart-Blood deficiency. Because the Heart meridian houses the Mind and governs Blood, when deficient, the Mind has no place to rest and can become depressed and/or anxious. This can also lead to insomnia, fatigue, inability to cope, tearfulness, loss of libido and feelings of anger and guilt. If this condition deepens into what we term as Yin deficiency or Blood stagnation, the symptoms above will worsen and can even lead to post-partum psychosis.

So now that we know some of the causes of PPD, what can we do to treat it? From a Chinese medicine perspective, we employ the use of acupuncture and Chinese herbs to treat not only the Eastern medicine theories but western medical theories of PPD. There are multiple studies
showing that acupuncture works just as well as pharmaceutical drugs when it comes to treating anxiety and or depression. Research shows that acupuncture works by mediating neurotransmitters such as endorphins, melatonin, GABA and norepinephrine, which are the key players in modulating anxiety and depression. Likewise, acupuncture can treat chronic inflammation by resetting the balance between pro-inflammatory and anti-inflammatory cytokines in the body. Surprisingly, research has also shown that acupuncture can also help restore intestinal microbial balance. The other treatment modality used in the battle of PPD, Chinese herbal therapy, can address the underlying blood deficiency, Yin deficiency or blood stagnation mentioned above and are very safe for both mom and baby.

Other options to consider along with acupuncture and herbs if homocysteine and inflammatory markers are elevated would levels are high would be to take bioavailable B12, B9 and B6, fish oil, vitamin D, magnesium, curcumin and probiotics. Exercise and dietary modifications, of course, is always be extremely helpful, as is meditation. Women suffering from PPD need to know that there are many non-pharmacologic ways to treat PPD. In my 20 years of clinical experience, using acupuncture and/or Chinese herbs can provide one of the fastest resolutions of symptoms associated with PPD.

Dr. Painovich
Thursday, January 14th, 2021

“Just weeks after giving birth to my son, I found myself struggling with postpartum depression and anxiety. My doctor referred me to a psychiatrist who wanted to put me on a fast track to antidepressant medication. I felt strongly that this was not the right path for me or my nursing baby. Thankfully, a friend referred me to Dr. Painovich. After a few weeks of treatment with the doctor and therapy, I began to feel the weight of my PPD/PPA lighten. Dr. Painovich helped me feel more like myself again and was even able to provide some herbal supplements to my baby who was dealing with painful digestion issues. I am so glad that I connected with Dr. Painovich and benefited from her skill with acupuncture and knowledge of eastern medicine.”

– RV