I would like to start this article on Post-Partum Depression with a story. My one and only daughter was born when I was 38. I was delighted to have her, but started getting increasingly depressed and angry as the weeks passed.
Finally, at 6 weeks in, I called my GP in desperation since I had a good relationship with her. I told her that my nipples were so tender and chapped I couldn’t nurse anymore, I had painful tendonitis in my wrists from holding baby, and I was enveloped in a deep, dark cloud of depression. The very first question she asked was, “Did you stop taking your essential fatty acids???” I was blown away! How did she know and why did it matter? The answer was “Yes.” I had gotten too overwhelmed and exhausted to even notice that I had run out of the fish oil and borage oil I took daily. They supplied me with large amounts of the Omega 3 fatty acids, which were anti-depressant, anti-inflammatory and reduced fatigue, along with Gamma Linolenic Acid, which turned into an anti-inflammatory and antidepressant brain chemical called PGE1.
I immediately replenished my stock and within a few days, the depression was completely gone, my nipples had healed so that I could continue nursing, and the wrist pain was tolerable. I will be forever grateful to my doctor that even 32 years ago, she was on top of the science, and was able to connect the dots for me, when I couldn’t do it for myself.
Post-partum depression is thought by the CDC to affect 1 in 8 new mothers in the US, about 12.5% or 500,000 women a year. It can take many forms. Post-partum psychosis is the most severe and seems to affect about 1% of women. Reasons given typically from a Conventional Medicine perspective include stress from a variety of sources, sleeplessness, and hormonal changes. People in high-risk categories include those with a previous history of mental illness, depression or anxiety, and those in very stressful situations such as being single, young, without social or family support, financially stressed and those facing trauma or illness.
Treatment tends to include recommendations for more exercise, stress management training and counseling, getting more support, and antidepressants or other medications. (UPMC.com on 6/30/2025).
While all of this may be true, Functional Medicine/Nutrition for Mental Health has the ability to look deeper for root causes and thus can give us many more treatment options. Here is my approach.
- Assess for nutrient and neurotransmitter adequacy and address using amino acid and nutrient therapy along with dietary recommendations. These can start improving symptoms within 20 minutes.
- Support the mother in getting necessary emotional, financial and social support. Support adrenal function. Refer as needed.
- Assess for thyroid disorders as pregnancy and post-partum are high risk times in a woman’s life to develop thyroid and autoimmune disorders. Refer as needed.
- Assess for reproductive hormone imbalances and address. Refer as needed.
- Assess for Copper Toxicity as a cause of post-partum psychosis and address
- If none of the above works to relieve symptoms, refer for psychotropic medication. In the case of psychosis, symptoms may need to be medically managed immediately, while underlying root causes are being assessed and addressed.
Now let’s look at each of these a little closer.
- Depleted Nutrient and Neurotransmitter Status: Mood and behavior are primarily mediated through adequate neurotransmitter functioning in the brain. This requires optimal levels of precursor amino acids, necessary co-factor vitamins and minerals and the right fatty acids for cell membrane integrity. These nutrients all come from the food we eat on a regular basis. If any of these key nutrients are missing or get depleted, mood and behavioral symptoms occur. Pregnancy can be a high-risk situation for nutrient deficiency, as can the immediate post-partum time period. During pregnancy, the nutrients from the mother’s diet are needed to create every single cell in the baby’s body, along with enzymes, neuropeptides, genetic material, etc. If the mother is not eating or supplementing optimally, her tissues can become depleted, setting her up for mood and energy issues both during pregnancy and post-partum. A case in point is the Omega 3 fatty acid, DHA. DHA coats every single one of baby’s neurons and is also important in the growth and development of the retina. The body will preferentially use Mom’s DHA stores for baby, often leaving Mom depleted, especially if she has had several babies in a row, without supplementing it. Symptoms of Omega 3 deficiency include slow, sluggish depression, anxiety, brain fog, inflammatory pain and fatigue. The WHO in the 1980’s recommended that all pregnant women and premature babies supplement with it. N-3 (Omega-3) Fatty Acids in Postpartum Depression: Implications for Prevention and Treatment – PMC
Adequate nutrient intake can be especially problematic if morning sickness is severe and pervasive. Some women actually lose weight during pregnancy. Also, many women stop eating regular meals after baby is born due to chaos and fatigue. It can be challenging to remember to keep taking supplements, or to replace them in a timely manner when they run out. It is imperative that the post-partum mental health consultant carefully inquire about food and nutrient intake during pregnancy and the post-partum period. It is also recommended to use a Neurotransmitter Depletion assessment tool, such as the Amino Acid Therapy Chart devised by Juia Ross, MA and taught through the Academy for Addiction and Mental Health Nutrition. This tool quite accurately identifies which neurotransmitter systems are depleted and which amino acids can quickly start rebuilding them. Adding fish oil and a strong multivitamin can start filling in the gaps.
Finally, helping women feed themselves adequately is crucial. This can be problematic for single mothers, those without good marital or community support, or those with food insecurity, but brainstorming ideas together goes a long way to finding effective solutions. It only takes a day or two of proper nutrition for people to experience clear and welcome relief.
- High Stress Causing Nutrient and Neurotransmitter Depletion: Highly stressful life situations such as being a teen or single mother, financial and housing insecurity, pregnancy trauma, illness, relationship distress or isolation are all risk factors for PPD. What do they all have in common? Chronic stressors such as these, significantly drain our nutrient and neurotransmitter stores, as the body and brain step up to allow us to cope more effectively. Stress also tends to interfere with our ability to eat and sleep well, and exercise in a beneficial manner. Thus, the body and brain become increasingly depleted, leading to an increase of mental health symptoms. This is true for everyone, not just child-bearing mothers. However, pregnancy, birth and the post-partum period are themselves inherently stressful, thus compounding the effect. Furthermore, the adrenal glands and HPA axis become more activated. This can also lead to fatigue, anxiety, insomnia and depression down the road.
- Thyroid Dysfunction: Doctors routinely test pregnant mothers for thyroid dysfunction as severe hypothyroidism can cause birth defects. However, once baby is born, the thyroid as a source of post-partum distress is often overlooked. However, apparently, 8-10% of post-partum women are at high risk for auto-immune thyroid disorders such as Grave’s Disease, or Hashimoto’s Thyroiditis. https://my.clevelandclinic.org/health/diseases/15294-postpartum-thyroiditis#symptoms-and-causes. Postpartum thyroiditis: an autoimmune thyroid disorder which predicts future thyroid health – PMC. According to the second article here, smoking can increase risk of thyroiditis from occurring, and selenium can be protective. Negro R, Greco G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. J Clin Endocrinol Metab 2007;92:1263–8 [DOI] [PubMed] [Google Scholar]. Post-partum thyroiditis usually progresses through 3 stages. It starts with symptoms of hyperthyroidism, often moves to hypothyroid symptomatology and then usually resolves within 18 months. However, in some women, these disorders can become permanent.
- Hormone Dysregulation: Some women, but not all, seem to be extremely sensitive to post-partum hormone fluctuation. Lower oxytocin levels can correlate with PPD. In a few studies, treatment with Premarin relieved symptoms of PPD. The Role of Reproductive Hormones in Postpartum Depression – PMC
- Copper Toxicity: According to two top researchers, Dr. Albert Mensah and Dr. William Walsh, symptoms of depression, anxiety and even psychosis can be caused by higher levels of copper in the blood. Copper can increase during pregnancy due to higher levels of estrogen, and might already be elevated for genetic and environmental reasons. Dr. Walsh found that Copper levels can be easily tested for, and Dr. Walsh suggests that serum copper levels over 110 can be problematic. “Diet can play a significant role in copper toxicity and the development of PPD. Foods that are high in copper, such as liver, shellfish, nuts, and chocolate, should be consumed in moderation. In contrast, foods that are high in zinc, such as meat, eggs, and whole grains, can help to balance copper levels in the body by competing with copper for absorption in the digestive tract. A diet rich in antioxidants, such as fruits and vegetables, can also help to reduce oxidative stress and inflammation in the body.” Post Partum Depression PPD and Copper Toxicity. Zinc supplementation may also be helpful.
As you can see, PPD, like other mental health disorders, has many different causes and therefore many different solutions. And of course, some women can have several of these factors operating at the same time. It is useful to work with a trained mental health nutrition coach to get to the bottom of these issues and tailor the most effective treatment to the actual causes.
