Prenatal (Antepartum) and Postpartum Depression

Pregnancy can be a difficult change for women. Their body is growing, they can't do many things they enjoyed, and their hormone levels are fluctuating. These changes may be why 10% of women suffer from depression during or after pregnancy.

Prenatal and postpartum depressions are depressive disorders that occur during or within a year after pregnancy. A woman may be fine during pregnancy but then become depressed after delivery. However, most women with prenatal depression will suffer after birth as well. Many women report that this depression is unlike anything they have experienced before.

Prenatal & Postpartum Symptoms

An expectant or new mother may experience some of the following symptoms:

Sluggishness, fatigue, exhaustion
Feeling sad, worthless or hopeless
Feeling tense, anxious or 'on edge'
Mood swings, emotional outbursts or unexplained crying
Irritability, anger, short temper or argumentative
Sleep problems; either too much sleep, sleep at the wrong time, or insomnia
Changes in appetite
Loss of concentration, memory problems or confusion
Feeling overwhelmed or thoughts of suicide
Overprotective or overly concerned for the baby
Fear of harming the baby or yourself
Lack of interest in sex

Prenatal and postpartum depressions are among the most serious mood disorders for women because they impact the health of the fetus and newborn. An expectant mother will not take as good care of herself, which may harm the fetus. Studies also show that depressed mothers don't care for their babies as well as other mothers. They talk less, show less affection and don't' respond as well. As a result, their babies have more problems socially; they withdraw, and are less animated than other babies. Commenting on the long-term consequences, Dr. Barbara Parry, Women's Health researcher at UCSD states:

"Children of depressed mothers are at increased risk for anxiety disorders in childhood, major depression in adolescence, and alcohol dependence in early adulthood. Furthermore, depressed offspring of depressed parents have a longer duration of episodes, more impairment, more medical problems and receive less mental health treatment. In addition to having more serious and recurrent depression, they are more socially and vocationally impaired. Thus, to reverse these adverse consequences of maternal depression, treatments need to be instituted early in the course of the illness." - Barbara Parry, M.D., Journal of Affective Disorders, 60 (2000) 201-212

Why expectant and new mothers become depressed

Pregnancy and delivery causes hormone levels in some women to be too low. During pregnancy, the body clock releases hormones that increase the body's ability to deal with the added stress of having a baby. These hormones take their toll though, by depleting reserves of serotonin, the hormone associated with wellness and mood. During the third trimester and just after birth, serotonin levels are as low as those found in people with major depression. This is why over 70% of new mothers experience the "blues,' and 10% suffer from depressive illnesses.

In postpartum depression estrogen levels fall after birth, which may also be a cause for depression. Estrogen and serotonin replacement have been helpful in improving symptoms of this depression.

Pregnancy and postpartum depressions affect the body clock

Researchers have also noted a strong connection between circadian rhythms and pregnancy related depressions. Symptoms are generally worse in the morning time, and the sleep problems are a result of disrupted circadian rhythms. Since light is known to produce serotonin as well as reset the body clock, researchers at Yale and UCSD have had success in treating women with pregnancy related depressions. In this case, the specialized light is used in the morning time. News that morning bright light is helpful is important because anti-depressant medication is undesirable during pregnancy and nursing.

Wake Therapy

Women who suffer from severe depression symptoms should consider wake therapy as a viable option to anti-depressant medication. Scientists believe that depression may cause the body clock to 'shut down', and wake therapy is just like rebooting a computer. 'z`Wake therapy' means waking the patient early, from about 2:00am on, when the body clock is most active. Since the body clock doesn't get the sleep feedback it needs, it reboots its system.

Adding morning bright light keeps the circadian system from shutting down again. Several clinical studies now confirm that using bright light with wake therapy produces an immediate and lasting antidepressant response. Research also shows that when wake therapy is combined with traditional medications, the effect is even more pronounced.

"It appears that bright light combined with wake therapy and medication might produce a much better antidepressant response much more rapidly than our available antidepressant drugs." - Bright light augments antidepressant effects of medication and wake therapy , Depression and Anxiety, 16: 1-3 (2002).

Apollo Health Tips

BRITEWAVE Therapy 15-30 minutes in the morning can help produce serotonin and reset your body clock. Resetting your body clock will also allow you to fall asleep easier and sleep better throughout the night. BRITEWAVE light is specially designed to produce the active hormone, serotonin and suppress melatonin. Melatonin is often called the 'hibernation hormone' and is thought to restrict other hormones that promote a healthy menstrual cycle. Your body produces higher levels of melatonin during the winter, and when you don't get enough bright light. PMDD is also worse in the winter.
Wake Therapy has been used successfully with women for stronger symptoms of postpartum depression. With the guidance of a physician, try waking up early, around 2:00 am (for one morning only) before your period starts, and use BRITEWAVE light each morning through the first week of your next cycle.
Increase Serotonin Levels . Low levels of serotonin are related to depression, mood, irritability, low concentration and pain. Women are more vulnerable to serotonin deficiency than men. In addition to BRITEWAVE therapy, Apollo's Harmony™ works with BRITEWAVE to balance your serotonin levels.
Increase vitamins and minerals . Since post pregnancy is marked by a deficiency in several vitamins, calcium and magnesium, Apollo has developed a high-quality supplement to restore a natural balance. Apollo's Vitality™ and Neutralize™ work with your circadian rhythm to restore this essential balance of vitamins and minerals.
Healthy lifestyle . Caffeine, alcohol, and tobacco all increase depression symptoms such as irritability, stomach problems and insomnia. Salty foods help retain water and contribute to blood pressure problems. Refined sugars and carbohydrates increase insulin, which depletes serotonin.
Exercise moderately . A consistent exercise plan increases energy and mood and cuts down on cramping and body aches. Late afternoon is the best time to exercise; less cortisol is in your system, which means less risk to your heart. Your body burns energy better, and muscles respond quicker in the afternoon & evening. Don't exercise within 4 hours of bedtime, though. This may make it difficult to sleep.
Reduce Stress. Post partum depression may often be the cause of stress, because of the discomfort and emotional problems it causes. Make sure to review the main stress section in our web page.

Bright light and pregnancy:

In addition to light being used for prenatal depression, light may help pregnant women sleep better. 8 out of 10 women have disrupted sleep during pregnancy, partly because of circadian rhythm hormone changes and partly because of the moving fetus. Light can help with sleep by strengthening the circadian rhythm.