& Alan Titchenal Tuesday ,April 3, 2012
Postpartum depression common, cause unknown
Postpartum depression is more common than many people think. Estimates vary but generally indicate that 10 to 20 percent of women today experience serious depression after giving birth. At this point in time, the cause remains unknown, but it is being studied by biomedical and psychological researchers. Ironically, these two groups of researchers do not appear to be reading each others’ research adequately.
QUESTION: What is postpartum depression?
ANSWER: It is the most common psychiatric disorder experienced by women within weeks of giving birth. Its symptoms are the same as major depression. The condition typically lasts from a few weeks to six months, sometimes longer.
Q: What are the usual consequences of postpartum depression?
A: Without proper treatment, postpartum depression can have a substantial detrimental effect on the family and, of course, on the mother and child. Mother-infant interactions can be abnormal and adversely affect infant development. In addition, the financial costs for the family and to the health care system can be substantial. In extreme cases of postpartum depression, women are at risk of harming themselves or even their infant.
Q: What are the major theories regarding the cause?
A: Proposed causes include nutritional deficiencies, hormonal changes and psychosocial problems such as stressful life events, marital conflict and lack of social support. Most likely, not all cases of postpartum depression have the identical combination of causes, but some of these may actually be caused by the condition.
For example, iron deficiency is a well-known cause of depression. Depression can trigger marital conflict and lead to isolation and result in a loss of social support. Which came first?
Q: What is known about nutrient deficiencies and postpartum depression?
A: Nutritional deficiencies that have been studied in relation to postpartum depression include the minerals iron, zinc, selenium and calcium, the B vitamins and the omega-3 fatty acids. Any of these nutrients, if deficient, could contribute to altered brain function. Among these the most thoroughly documented nutrient deficiency in pregnant women is iron deficiency.
The iron needs of women nearly double during the second and third trimesters of pregnancy due to increases in the mother’s blood volume and meeting the iron needs of the developing fetus. If a woman starts pregnancy without adequate iron stores, brain functions that depend on normal cellular iron levels could be compromised.
Q: Is it possible to prevent postpartum depression?
A: It may be possible to use iron supplements to prevent postpartum depression if deficiency is the cause. Since excessive iron intake may be detrimental in someone with normal iron status, experts recommend tests shortly before or early in pregnancy by measuring levels of an iron-containing protein called ferritin.
For pregnant women with no inflammatory health problems, when serum ferritin levels are below 30 micrograms per liter, a daily iron supplement of 80 to 100 mg is recommended. When ferritin is between 30 and 70, a supplement of 40 milligrams per day is recommended, and if ferritin is over 70, no supplement is recommended.
Joannie Dobbs, PhD, CNS and Alan Titchenal, PhD, CNS
are nutritionists in the Department of Human Nutrition, Food and Animal Sciences,
College of Tropical Agriculture and Human Resources, UH-Manoa.
Dr. Dobbs also works with the University Health Service
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