Supporting Your Mood Postpartum - When it is beyond the Baby Blues with Dr. Stephanie Zelembaba, ND

Dr. Stephanie Zelembaba is a naturopathic doctor who primarily focuses on family health — planning a pregnancy, going through it, postpartum and paediatrics. About 23% of new moms in Canada report symptoms consistent with postpartum anxiety or depression. Today, Dr Stephanie will discuss everything you need to know about differentiating baby blues and typical new mom emotions from postpartum depression and anxiety.

1:50

Q. In supporting mood postpartum, what are the symptoms that your patients come in experiencing?

A. Most often in practice, we see the postpartum anxiety trend. I find women are more likely to identify with anxiety than depression. We use the word ‘anxiety’ to explain our stress. Still, I want to help women realise the difference between adjusting to the overwhelming new lifestyle of being a new mom versus postpartum anxiety.

In the first two weeks, once you’ve had your baby, we have the baby blues period. During that time, you experience massive swings in emotion. You can go from being overjoyed to crying at the drop of a hat. The significant shift in our hormones causes this. Typically days three to five are the worst for women, but it can be expected anytime within those first two weeks.

When we differentiate that from what typical postpartum depression and anxiety look like, we see a lot more severe or persistent emotions. So not swinging from happy to sad, but consistently high anxiety or low mood over days to weeks to months.

Many patients who come into the office don’t necessarily realise that it doesn’t have to be the extreme things we see in the movies. Now and then, women can get to the point where they’re suicidal or scared they will harm their baby. But we’re also looking at things like women not being able to fall asleep at night because they’re so anxious about what will happen or having unrealistic fears. Sometimes women feel like they can’t connect with their babies because they have postpartum depression. Additionally, seeing posts on Instagram about how “this is the best time of your life and enjoy every moment” makes it even harder for them. I want women to see that they can fall anywhere on that scale. And any kind of support can be helpful.

6:52

Q. In terms of things that can affect our mood, what foods, nutrients or conditions should women think of in terms of support postpartum?

A. There are three main areas that we start with as naturopathic doctors when it comes to postpartum. Getting bloodwork done is one of the top things I recommend for women. The three main nutrients are vitamin B12, iron (usually run by ferritin), and vitamin D. Deficiencies contribute to low energy and increased risk of mood concerns. For example, women are 66% more likely to experience symptoms of postpartum depression or anxiety if they’re iron deficient postpartum.

Another area is the thyroid. Often there aren’t concerns pre-baby, but postpartum tends to trigger thyroid concerns. There are two main thyroid markers that I recommend testing beyond the typical TSH. One is anti-TPO, a marker of thyroid autoimmunity, and the other is free T4, one of our thyroid functioning markers. A high anti-TPO or a low free t4 level will increase your risk of postpartum depression. Your thyroid function should return to normal after a baby by about four weeks.

The last piece of bloodwork is blood sugar. Insulin resistance can affect our mood. With insulin resistance, we’re getting spikes and crashes from sugar. This can make women feel sucky, for lack of a better term. When a woman has just had a baby, we typically do not see consistent eating patterns. So the other piece beyond bloodwork is ensuring you get calories from protein, fruits and vegetables, especially if breastfeeding. You need about an additional 500 calories to support your baby.

11:26

Q. Can women take vitamin and mineral supplements with medications they may be on?

A. Part of the reason we run the bloodwork is to figure out what supplements are needed so that it’s more targeted. The other part is looking at other supplements. It may not always be about nutrients. There are many different botanical options, like St. John’s wort, which is a great option for mild to moderate depression and is safe for breastfeeding. Passionflower can be used for anxiety. I recommend speaking with a healthcare provider because you want to ensure that that option is right for you and save for you. If you take any medications for postpartum or other reasons, we want to ensure they are not interacting.

12:52

Q. From a prevention standpoint, what are some things that people can do to manage postpartum mood?

A. One of the biggest things I would say is to make sure you have a support system, depending on how many resources you have available and your family and friends. The other one is to seek a counsellor or psychotherapist if you have had a stressful pregnancy or postpartum period. Some of our biggest risk factors for developing postpartum depression and anxiety are significant stressful events during pregnancy postpartum or feeling that you had a traumatic birth experience. We usually recommend seeking support before it has developed into something worse. The last one is nutrition. Getting adequate protein, vegetables, fats, and fibre is just as important for you as it is for your baby.

About Dr. Stephanie

Stephanie Zelembaba is a Naturopathic Doctor and Co-Owner of Abaton Integrative Medicine in Oakville Ontario. Dr. Stephanie focuses in perinatal care (from planning to conceive through the postpartum period), pediatrics and women’s health, particularly mental health. Her goal is to empower individuals and families to take charge of their health. Dr. Stephanie is a Naturopathic Doula, HypnoBirthing Childbirth Educator and Infant Sleep Educator.