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Archive for the ‘post partum depression’ Category

A Naturopathic Perspective on Postpartum/Perinatal Mood and Anxiety Disorders

Posted on: June 4th, 2021 by TouchStone Health

by Dr. Melanie Reidl, N.D.

The postpartum period can be a transformative, beautiful experience for new parents, however, it is not without a dark side for many. I personally experienced both the euphoric stage of new motherhood, as well as the anxious and depressed state that many women experience. 

Perinatal/postpartum mood and anxiety disorders (PMAD) affect approximately 15 to 20% of new mothers. This may underestimate the prevalence of PMAD; the signs and symptoms may be missed and attributed to being a ‘normal’ part of motherhood, or, mothers may resist acknowledging the signs because of stigma or societal pressures. 

If prolonged and untreated, PMAD’s can be detrimental to maternal health and the child’s development. As such, is important that we work to improve our screening/identification and treatment approaches for this group of women. 

Naturopathic Medicine, with its emphasis on treating root causes and viewing health more holistically, is well suited to support women with PMAD’s. There are many factors or root causes that may be involved in the development of a PMAD, including but not limited to the following: personal history, family history, social support, birth experiences/trauma, stressors, nutritional status, and thyroid/hormonal factors. 

In my experience, the most overlooked factors are nutritional status, stress levels, and thyroid/hormonal imbalances. First, is not uncommon for women to be undernourished during their pregnancy and when a new baby enters the picture. She may have forgotten to take her prenatal multivitamin, have pre-existing nutrient deficiencies, or feel like she doesn’t have the time or energy to nourish herself properly.  

Elevated stress hormones are also common in this group of women. The stress hormone, cortisol, may high be due a variety of factors, including but not limited to: birth trauma, lack of support, financial challenges, relationship stress, and lack of sleep. 

Further, the risk for developing hypothyroidism (an under active thyroid) is greater in the postpartum period. Hypothyroidism may develop due to nutrient deficiencies, prolonged elevation in cortisol levels, and hormonal and immune system changes associated with pregnancy and postpartum. Hypothyroidism is a common cause of depression, anxiety, and fatigue, and must be ruled out in all cases of PMAD.

In my opinion, the treatment approach to PMAD should be collaborative in most cases. Involvement of the woman’s G.P., a Psychologist or Social Worker, and an N.D. would address several facets of the PMAD. In moderate to severe cases medication may be necessary for a period of time. Counselling or CBT is also important to develop healthy coping strategies and to re-frame negative thought patterns. 

My approach as a Naturopathic Doctor would begin with a comprehensive screening of thyroid tests and nutrient levels (ie. Vitamin B12, Iron status, Vitamin D3) in these women in order to better identify and treat any possible physiological underpinnings. Following a careful assessment of patient history and blood work, I work with women to optimize their nutritional status and provide dietary counselling, I encourage healthy lifestyle factors such as exercise, self-care, and mindfulness practices, and provide individualized nutritional or herbal supplement recommendations. 

As an ND who has seen many women with PMAD, in addition to my personal experience, I have developed a deep understanding and empathy for this group of women. They deserve a thorough assessment of their physical, mental, and emotional health, as well as an individualized treatment plan to help them cope, overcome their PMAD’s, and improve their well-being so that they can be more present mothers for their babies and be their best selves.

Getting to Joy Through Sadness  

Posted on: August 24th, 2015 by TouchStone Health

This may seem like a funny title or topic to write about it, but it is one very dear to me. I had written an article awhile back about my Journey with Colic…about my experience with my newborn babe who wouldn’t respond to treatment for her “colic”. She cried the majority of the time (12-18 hours/day) for the first 3-4 months of her life. It was humbling to say the least, as I couldn’t make her better. And what followed these 4 months was not what I anticipated. Once the crying stopped and we discovered we had a wonderful, happy little girl…I got sad…real sad and soon realized that I had post partum depression. I have been reluctant to write about this, as I wouldn’t consider myself completely over it, but I watched a movie that convinced me that it was time to share about my experience.

I used to love movies…I adored them. I enjoyed sitting down and watching the beautiful scenery of somewhere far away, listening to a fantastic music score created specifically for it and appreciating the wonderful acting the supported a story line worth telling. This was when I was younger and since then, I have rarely enjoyed a movie. I guess I’m searching for something that inspires me, encourages me to think about things differently or to be better. But…I got this all back last week when I watched, Inside Out. I was told to watch this film by someone I respect and I was so grateful she did so, as I would not have normally decided to watch a cartoon. Watching Inside Out reminded me of something I forgot in these past few months…sometimes you can’t jump over or crawl under an uncomfortable emotion you are experiencing. Sometimes the only way to get to the other side is to go through it and that has been the best advice with my postpartum depression.

For those of you who haven’t watched, Inside Out, I won’t give it away but simply put, it’s about a young girl growing up and follows her emotions that are trying to guide her through a difficult time. What is most surprising is the focus on all emotions – whether that be joy, sadness, fear, anger, etc…the film helps us understand that all have a place…including sadness.

We often hear we should fake it until we make it. To not focus on anything negative, so as to not attract it…but sometimes that does the opposite of what we hope. By avoiding the uncomfortable or bad thoughts, we aren’t being real with what is and we can’t find the proper support/help.

So – how does this Pixar film relate to my Postpartum Depression? Well, after I found myself crying watching this film until there were literally no tears left to cry, I realized that I had been fighting something that just was. I desperately wanted to be happy, to be joyful, to savour up each and every moment I had with my girls, but sometimes, the Joy was lacking…sometimes it felt like Joy had left all together. The more I pretended or hoped it wasn’t there, the more I felt it. I was Sad. My short maternity leave was everything I didn’t expect it or want it to be – with a crying babe, surprising life stressors and a horribly cold winter that kept me inside. My time with my baby was hard and the truth was, most people didn’t want to hear about that when I tried to share. We live in a culture where the expected answer to “How are you doing?” is, fine, good, great or wonderful. But how often do we feel that? Sometimes we feel rotten, upset, hurt, sad, used up or even angry.

As a Naturopathic Doctor, there is pressure to have it all figured out, to be healthy, fit, optimistic and on it. I was none of those things and the harder I tried to get there the less I experienced them. Inside Out reminded me in a gentle but beautiful way, that sometimes the only way to get to Joy is to allow Sadness in. In doing so, you acknowledge whatever you’re going through instead of pushing it away. Once I did this, I could better support my post partum depression. I could be real with it and find the proper support that I needed to get myself back.

Since then, I’ve had more glimpses of Joy and anticipate that it will continue to grow, as I get myself back.

Sometimes the only way to get to the other side of a difficult situation is to go through it and we are fortunate to live in a time where there are so many options of support to help us get there.

If you are needing support, finding your way to Joy, I’d love to help.

Dr. Amanda Cressman, ND

A Journey with Colic

Posted on: May 22nd, 2015 by TouchStone Health

This is a very difficult article for me to write as my baby has just turned 4 months and is coming out a period where she experienced “colic”. I put the word colic in quotation marks as it’s a very misleading and confusing word. In general terms it is defined as a baby crying for 3 hours a day for more than 3 days a week, for 3 consecutive weeks in a child that is otherwise healthy. The usual onset is 2 weeks of age and it usually lasts until about 3-4 months. But the reasons for colic can be very different and it’s not always due to gas, as the word colic implies.

Some babies have reflux – where it’s noticeable with obvious signs of spit up and pain after eating or silent with no symptoms present at all. For other babies it’s digestive and gas is usually the culprit. For others, they are incredibly sensitive, reacting to any stimulus that is strong, loud or bright. And for others, it is developmental, meaning it is a normal phase, which is now being coined as The Period of PURPLE Crying®. For anyone who has had or known a baby to go through colic…the last word that you imagine being associated with it, is normal.

But this article will not focus on the causes and treatments of colic…that will be for another article, which I will soon publish. This article is about the stress and impact it has on those caring for the crying child and talking about options of support. This article is hard to write, as this experience of having a colicky baby has been one of the hardest I have been through and I feel very passionate about helping anyone who is or will be going through it. It’s a vulnerable place to write about one’s own experience, but I feel there will be value in sharing, as this topic is a difficult one to speak about with others. Let me tell you a bit about my past 4 months.

When my baby was born, she screamed for her first 90 minutes of life. The midwives and myself found it a bit odd, but she was deemed healthy and normal and went home soon after her birth. I had hoped her screams were just signs of her strong vitality but as the days came and went her crying increased. At 2 weeks it was bad – lasting close to 12 hours/day…at 4 weeks it was worse, lasting 12-16 hours/day and at 6-8 weeks it was horrible, lasting upwards of 18+ hours/day. She was gaining weight, peeing and pooing as expected and considered healthy with no other underlying causes for the crying.

With each week, I hoped the next would be better but my heart sunk further and further as it kept worsening. I would rock her most nights from 11 pm-4 or 5 am while she screamed in my arms. Sometimes I may have cried just as much as she did, as the screaming was what I call, ‘crazy making’ for me. Sometimes she slept in the day due to exhaustion, but there was always more crying than not and the kind of crying that breaks your heart as it seemed it did not matter what we did, it remained.

Leaving the house was awful, as the crying was worse in the car, in the stroller or in anyone else’s arms. Everytime we went grocery shopping I’d literally have 5 or 6 people come up and ask me if she was ok or worse yet, they’d tell me what I should do to make it better. I realize everyone was trying to be helpful, but it generally did the opposite.  Having people over was stressful, as no one likes listening to a baby crying and I would feel the need to try to entertain or try to hold a conversation, even though it felt more like a burden than a gift of having a visitor. As the days came and went, my babe and I found no routine that we could latch onto…we just got by and I hoped the next day would be better…but it usually wasn’t.

I would feel embarrassed and ashamed that I couldn’t make my baby stop crying, especially being a Naturopath.  My babies colic wasn’t due to gas or reflux which there are natural supports that can sometimes help dramatically.  For her the best medicine was time which was the hardest medicine for me to swallow.

I had hoped to exercise, to eat clean, to get my former body back in shape and strength, just like I had after my first daughter was born. But with time, the weight kept staying on, eating clean foods no longer was a priority or possible and I had no desire to exercise, take supplements or do anything good for myself. I tried…I really, really tried, but I was burnt out in every aspect of my being and I had nothing left for myself.  What was worse, was that I knew how to do all the “right” things but I had nothing left in my tank.  My body and emotions reflected how burnt out I was.

So many women that I see in my practice who have had colicky babe, difficult babes or post partum depression often suffer in silence. Speaking for myself, I’ve felt it inappropriate to complain or share about this struggle, as I know many others struggle with their own journey’s…whether that be infertility, miscarriage or the loss of a child.

Now, I need to preface this article, with saying I am and always was grateful for my daughter and don’t take it lightly, how fortunate I am to have a babe. I know many women would love to have babes who can’t…that some women would gladly have a colicky baby. The reason I share this, is I feel it is important to keep perspective. But it’s also important to be honest about where you’re at and this article is written with the hope that if you’re suffering from exhaustion, anxiety, depression, loneliness or lack of will to look after yourself…that you’re not alone.

Whatever your journey has been, please know that if you’re wanting or needing support, you have options. Your emotions need a place where they can express what you have gone through, your mind needs a place to make sense of your experience and encouragement to shift perspectives if you’re ready for that and your body needs a place to rebuild its depleted stores and get strong again.

I lost myself in the care of my colicky daughter. I lost the drive to prepare healthy foods, I lost the drive to run and be outside which helps my body and mind, I lost the drive to connect with life and ultimately myself. I’m in the process of rebuilding myself and it’s taking work and love and care on many fronts…but I’m getting myself back and grateful that there are natural supports to do so.

The process of rebuilding takes time and needs nurturing care but is the most important thing you can do.  I’m in this process myself and if you’re needing a place to help rebuild yourself, I’d be honoured to a be a part of that. Know you have options and that you’re not alone.

Amanda Cressman, ND.

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