For those of us who are hormonally sensitive, postpartum depression can be a real concern once you’re pregnant. If you’ve experienced depression before, as part of hormonal imbalance issues like PCOS or PMS, then it can be worrying to know that you might be more susceptible to depression as part of the hormonal shifts post-birth.

In this episode I want to define what postpartum depression is, what causes it, how to prevent it and where to look for support. So whether you are currently pregnant or not, this episode is one we all can learn from so that we can be prepared to help ourselves and also the women around us. Postpartum depression isn’t talked about enough, and because of this, I feel like so many women experiencing it feel shame and feel alone. That’s where we as a community can really come through to make a difference.

Clinical postpartum depression is defined as a new mother having feelings of harm for herself or her child, and this is the case for many sufferers and requires medical intervention. For many other women, however, who do not fit that definition, they experience the mood altering effects of rapid, ongoing, and long-term hormonal fluctuations which results in not feeling like yourself, having mood swings, and low energy – in effect it’s mild depression, postpartum.

This is a less obvious mild and functional form of depression, which is not classic or clinical postpartum depression, and can linger long after the official postpartum phase has ended, affecting a woman for years. The combination of hormone changes, changes in sleep, and not eating properly for your new mom life, can leave you vulnerable and cause this to become something more permanent if self care is compromised.

I get how challenging it is to fit self-care into your intense schedule as a new mom. It can feel impossible, but it’s important. Fight against your instinct to put your own care at the bottom of the list and know that it’s a number one priority.

After the postpartum phase is considered over however, you would then just be categorized as having depression or anxiety, and perhaps even be recommended medication. As you know, I think it’s so valuable to see the root cause of this situation you may be finding yourself in, so you can address it properly. Food and lifestyle changes are very important parts of the puzzle, but are often ignored and not addressed.

While there is a drop in hormone levels postpartum, combined with hormonally disruptive sleep schedules that come with a new baby, there are steps you can take to support your health and safeguard against depression during this time.

With new understandings about mental health, from pioneers like my colleague Dr. Kelly Brogan, with her book, A Mind of Your Own, we know that feeding your brain can keep it performing optimally and protects your mood balance.

Being aware that you might be susceptible is important, as is having a handle on your hormonal imbalance issues before you even decide to conceive. I recommend to my clients to prepare for pregnancy at least a few months (ideally a year) prior to trying to get pregnant if they are already dealing with irregular cycles, problem periods and other hormonal health issues.

That said, if you are pregnant while reading this and concerned about postpartum depression, there are still actions you can take once a baby is born. Going into a pregnancy hormonally healthy without unresolved health issues is ideal, but not absolutely essential for avoiding postpartum depression.

Anyone can be at risk from depression postpartum.

By leveraging good functional nutrition basics, you can give yourself all the support possible to keep yourself balanced during this huge transition.

Clinical postpartum depression can be triggered by the rapid hormonal fluctuations post pregnancy and you should seek medical support if you need help.

Mild depression postpartum also needs support and I think it’s important to look at all of the functional causes that might make this worse for you and to think about ways you can be proactive about avoiding as many of these as possible.

• There is a rapid drop in estrogen in the first few months after birth which affects mood, verbal skills, and even socializing habits.

• New moms are always coping with sleep deficiency, which leads to imbalance in the adrenal gland and thyroid hormone levels.

• New moms are often micronutrient deficient. Making a tiny person extracts as much nutrients from your body as physically possible. If you have a history of dieting, restriction of calories or food groups, then you may already start your pregnancy state with a deficiency – leading to higher levels of deficiency postpartum. This is not good for the baby or you. Low levels of micronutrients contribute to low hormone levels too.

• Prolonged breastfeeding keeps estrogen levels low and can dramatically impact your mood. Stopping breastfeeding can create an additional hormone and therefore mood shift and is best done slowly over 2 to 3 months.

• Many new moms stop their prenatal supplement routine too soon, even though you need to continue this into (and well past) the 4th trimester.

• Many women feel they want all their pregnancies close together – especially if they’re starting in their mid-30s, in order to “get it all out of the way,” to have siblings close in age, or capitalize on their fertile years. If your next pregnancy and birth is very close to the prior, you must be even more vigilant about nourishing your body, restoring micronutrient levels, and not focusing on postpartum dieting to lose baby weight, but prepping your body for another request to 3D print a new tiny human!

• Many environmental factors can be at play with postpartum depression: an unsupportive spouse, lack of childcare, and financial strain. Birth and a new baby can trigger anxiety that feels very primitive and primal – it’s more intense because you badly want to do right by your child. It can make for a very emotionally charged time. And it’s not always easy to tackle what can be an isolating experience if you’re not surrounded by a supportive community of friends and family who are truly there for you.

It’s harder to maintain hormonal balance when grappling with a new schedule, but it’s not impossible. It takes awareness of what your body needs to maintain peak physical and mental health. And of course, we all desire to be as healthy as we can in order to take care of a new baby, so this can be a great motivator in making the necessary commitments to self care.

It’s also important to be aware that clinical and mild postpartum depression doesn’t always happen the day you get home from the hospital, it can be after three months or even later. That’s why during the 4th trimester it’s so important to take care of yourself as much as your baby. If you’re breastfeeding, it’s even more crucial that you eat well and take care of your health, for as long as you’re breastfeeding and for several months beyond.

You know I love talking about how food is medicine!

After birth, I want you to concentrate on eating a diet with high nutrient density, a lot, and frequently. This is not the time to crash diet or worry about baby weight. Eat well and the pounds will fall away naturally. Depriving yourself will only trigger hormonal imbalance.

Let’s give you a sample of how to eat during your 4th trimester and beyond, as you continue to breastfeed. You’re going to notice that lots of snacking and small meals throughout the day are excellent between nursing, napping, and recovering from labor and delivery.

Breakfast – Steel cut oats with black sesame seeds, coconut oil, flax, cinnamon, goji berries

Snack – 2 eggs scrambled in coconut oil with turmeric

Lunch – Salmon and quinoa with lentils and fermented sauerkraut

Snack – Avocado on black rice bread

Dinner – Bison/lamb/beef burger with green beans and sweet potato baked fries

Snack – 2 dates or dried figs with 3 squares dark chocolate

Snack – Macaroon or gluten-free lactation cookie

Snack – Bone broth with black rice bread and chicken liver pate

Lots of snacks, right?

Eating this way supports each of the areas of health that can be off-balance post-birth:

• your micronutrient levels

• your microbiome

• your hormone production

The protocol for the postpartum phase emphasizes these nourishment goals, because it's all about nourishing yourself!

Also consider increasing the use of warming, drying spices like cinnamon, cayenne, and nutmeg.

You may want to hold off on too many raw vegetables, cold smoothies, raw juices, and raw fruits for the first 40 days postpartum. Then only slowly reincorporating them back in.

These tenets are sourced in Traditional Chinese Medicine which emphasizes the importance of restoring Yin energy post-birth. It’s also great for the baby’s own digestion as most newborns can’t actually tolerate even cooked veggies in a mother’s milk at first.

The book The First Forty Days is an excellent resource on postpartum nourishment to enhance your health and the health of your baby.

This nourishing food supports each element to provide a strong foundation. If you have this foundation laid down it is much easier to deal with sleep deprivation and stress. Your body will not respond as dramatically to your changing way of life.

The food provides the strength you need to take on this new challenge. It also supports you as you potentially prepare for another pregnancy.

I like to call this “active recovery” – instead of assuming your body will spring back or assuming that once you’re physically healed that the work is done, know that you have to be active in your post-birth recovery every single day. Don’t see it as an additional responsibility, see it as something you’re doing to excel at taking care of your child.

You’ve heard of a labor and delivery doula, but there’s also such a thing as a postnatal doula as well. She can check up on you right after the birth, but can carry on doing so several times throughout the rest of that first year. If you’re able to have doula support, I highly recommend it.

It goes above and beyond the six-week postpartum check up you’ll get from your doctor (where you may not yet be presenting symptoms). Doulas take the time to see you in your home environment, spend time with you, listen to you, cook for you and care for you, as well as the baby, as they know how vital it is that a new mom is healthy and happy.

Although this may seem like a luxury, it’s actually not that expensive and many doulas now work on a sliding scale too. In most European countries, it’s totally the norm for one year of postpartum.

Whether you can hire a postpartum doula or not, it's important to find someone to reach out to. The better your support circle is, the better you’ll get through it.

I hope that talking about this can help us be more aware for ourselves and for our sisters, friends and daughters so that women are no longer suffering in silence.

I put a poll out on my IG last week asking if any of you had experienced PPD and also if you had any advice. I was amazed at the number of you that said yes, that you have experienced PPD, and with each and every pregnancy!

I wonder how many of you had people around you who were aware of what you were going through and if they were able to give you the support you needed.

My own sister opened up to me and said that she dealt with PPD after her pregnancies, and I had no idea! I felt terrible! But, she said that she didn’t let anyone know she was struggling, because she felt that it meant that she was a bad mother. You couldn’t find a better mother than my sister! I don’t want that situation to be happening for any of you girls! Broke my heart!

Your advice was awesome too. Mostly it focused on the things we’ve talked about today. Like, the importance of self-care, getting enough sleep, nourishing yourself, and finding support around you. Also, give yourself grace through this transitional time.

Love, Cody