Postpartum depression typically affects anywhere from 10-60% of women in the first years after their child’s birth, and can ‘set in’ within the first 3 months. Depending on the severity, it can affect the mother’s quality of life, the care she is able to provide her child, and strain bonding and relationships. This is no place to lay blame, or feel shame - anyone could be in this position and recognition needs to be given to decrease the stigma so mother's feel safe to seek help. If you yourself feel that you could be suffering with postpartum/ post-abortion depression - I strong advise telling someone you trust who will help you to find the help you need.
This is a good resource for symptoms and a helpline - HERE.
Personal and family history of depression, socioeconomic status/ environment, pregnancy circumstances contribute to the mental health of the mother; although, the hormonal changes undergone in pregnancy/birth/postpartum are highly involved. Li, et al. (2016) reviewed a large number of trials on TCM treatments for Post-Partum Depression (PPD), finding that a combination of traditional herbal remedies and routine treatments (e.g. music therapy, vitamin D drops, Cognitive Behavioural Therapy, relaxation therapy) were most effective. Finding a therapy that works for you and is accessible may take time, but working with your health care providers can help you assess what's working using functional, standarised surveys. One safe place to start is a simple walk with or without your baby outside. Numerous studies have shown the benefit of time in nature, and vitamin D is a regulatory 'hormone' in the body which a scary amount of people are deficient in. 15-30 minutes is a good place to start for mental and physical recovery. You may like to double up with music therapy by listening to music that you enjoy.
Regarding the use of herbal remedies in depression, there is very little research specific to postpartum depression and herbal treatment. This is arguably due to the ethical nature of such trials - who would want to mess around with the mental health of someone providing care to an infant - let alone the impact of any negative outcomes on the mother or child. Naturopathic remedies to treat depression (in non-pregnant individuals) includes: omega-3 fatty acids, saffron, passionflower, chamomile, black cohosh, lavender, and chasteberry show positive results (Yeung, Hernandez, Mao, Haviland & Gubili, 2019; Kendall-Tackett, 2010).
Some of these are not safe or cautioned for consumption in breastfeeding or pregnant women, such as Black cohosh or chasteberry (vitex) as they interfere with HPO axis and may cause unintended effects (Dugoua, et al. 2006).
Meanwhile, herbs such as saffron and lavender (externally only) are gentle anxiolytics and thymoleptics which are safe in pregnancy and lactation (Sadi, et al. 2016; Koulivand, Ghadiri & Gorji, 2013). Chamomile is cautioned in pregnancy due to lack of evidence, though it is safe for use in children (Balbontin, et al. 2019). There may be space to use Chamomile under supervision with experienced pracitioners, but you should always be made aware of any safety issues from your practitioner.
From an alternative adaptogen (= help you deal with stressors better) angle, the commonly used Withania (or Ashwagandha) demonstrated no negative side effects when tested on rats but human studies are limited (Prabu & Panchapakesan, 2015). Braun and Cohen (2015) report that its use in pregnancy should be cautioned, with little supportive evidence, though there is a traditional historic use in Ayurvedic medicine during pregnancy and lactation. Studies on rats show improved pregnancy outcomes (Braun & Cohen, 2015). As such a multifaceted herb with various protective and modulating actions, it’s use in pregnancy and lactation would provide benefit to the patient. Withania is a strengthening tonic, without being overly stimulating like some other adaptogens, this is an ideal recovery and convalescence herb. In combination with other supportive herbs, such as saffron, and other therapeutics, this would support a new/ new again mother through her postpartum period. As always, more research into herbal treatments in pregnancy and lactation are important, as traditional use (excluding if they have been proven unsafe) is often relied upon in such cases.
If a treatment or herb discussed here peaks your interest, please speak to your practitioner before you attempt any self treatment. They may be able to point you in the direction for an effective therapy more efficiently that google.
Safe - meaning there are limited negative outcomes possible.
Cautioned - meaning dosage or indications may be important. Herbs or nutrients cautioned should always be used under supervision and by an experienced practitioner.
Not safe - meaning negative side effects or fatal outcomes have occured in testing (in animals or humans)
References used:
Balbontin, Y., Stewart, D., Shetty, A., Fitton, C. & McLay, J. (2019). Herbal Medicinal Product Use During Pregnancy and the Postnatal Period: A Systematic Review. Obstetrics and Gynecology, vol 133. Issue 5. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485309/#:~:text=Chamomile%20has%20also%20been%20identified,used%20concurrently%20with%20prescribed%20medicines.&text=Considering%20the%20scarce%20evidence%20available,used%20with%20caution%20during%20pregnancy.
Braun, L. & Cohen, M. (2015). Herbs and Natural Supplements: An evidence-based guide Volume 2. [4th Ed.]. Elsevier, Australia.
Dugoua, J., Seely, D., Perri, D., Koren, G. & Mills, E. (2006). Safety and efficacy of black cohosh (Cimicifuga racemosa) during pregnancy and lactation. The Canadian Journal of Clinical Pharmacology, vol 13. Issue 3. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938102/
Kendall-Tackett, K. (2010). Long-Chain Omega-3 Fatty Acids and Women’s Mental Health in the Perinatal Period and Beyond. Journal of Midwifery & Women’s Health, vol 55. Issue 6. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S152695231000070X
Koulivand, P., Ghadiri, M. & Gorji, A. (2013). Lavender and the Nervous System. Evidence Based Complementary and Alternative Medicine, vol 2013. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612440/
Li, Y., Chen, Z., Y u, N., Yao, K., Che, Y., Xi, Y. U& Zhai, S. (2016). Chinese Herbal Medicine for Postpartum Depression: A Systematic Review of Randomized Controlled Trials. Evidence Based Complementary and Alternative Medicine, vol 2016. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059536/
Prabu, P. & Panchapakesan, S. (2015). Prenatal developmental toxicity evaluation of Withania somnifera root extract in Wistar rats. Drug and Chemical Toxicology, vol 38. Issue 1. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/24649920/
Sadi, R., Mohammed-Alizadeh-Charandabi, S., Mirghafourvand, M., Javadzadeh, Y. & Ahmadi-Bonabi, A. (2016). Effect of Saffron (Fan Hong Hua) On the Readiness of The Uterine Cervix In Term Pregnancy: A Placebo-Controlled Randomized Trial. Iranian Red Crescent Medical Journal, vol 18. Issue 10. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285732/#:~:text=However%2C%20it%20is%20believed%20that,9%2C%2021%2C%2022).
Yeung, K., Hernandez, M., Mao, J., Haviland, I. & Gubili, J. (2019). Herbal Medicine for Depression and Anxiety: A Systematic Review with Assessment of Potential Psycho-Oncologic Relevance. Phytotherapy Research, vol 32. Issue 5. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938102/
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