While doing my daily required reading of articles, blog posts, tweets and other assorted media across the web about postpartum depression and related illnesses, I came across a question a while back posted on Mamapedia by a mom with postpartum anxiety. She was looking for advice on natural treatments because she didn’t want to take the Prozac prescribed by her doctor.
She received 22 answers by other mothers, many warning vehemently against taking any medication for postpartum depression or anxiety. These are some of the things she was told by the moms:
For many people, postpartum anxiety is caused by a deficiency of omega-3s and a lack of coping mechanisms. Read the book Feeling Good and take omega-3s.
Acupuncture works.
If he is suggesting serotonin imbalance, then speak to your herbologist again. Don’t go on medication! You have to take too much time to wean off. There are many things that will help the levels naturally
If you don’t want to take Prozac, then ask for something less dramatic. (something less dramatic? huh?)
I highly recommend contacting Dr. ____who is truly an amazing Chiropractor and Nutritionist and would definitely be able to help you naturally.
Please don’t settle for drugs that will be only partially successful in masking your issue and give you the side-effects galore. There are so many safe and effective homeopathic remedies.
I don’t know the mom who posed the question. I don’t know if her postpartum anxiety is mild or severe. I don’t know whether she has a history of mental illness. I don’t know if she’s had suicidal thoughts. I don’t know if she’s taken antidepressant medication before and it didn’t work or caused unacceptable side effects for her. I don’t know if she’s tried therapy. All I know is that she has received advice from people with no medical training, some of whom have a bias against medication but claim to know what will work to fix her postpartum anxiety.
To be sure, there were women who responded to the Mamapedia question who I felt had some good suggestions, including reaching out to other moms for support, getting your thyroid checked and getting adequate sleep, nutritionand exercise. Medicine is not the only answer for postpartum depression, and it’s not the answer for every person. But that doesn’t mean it’s evil incarnate, and that going to your “herbologist” is the right answer for people with moderate to severe postpartum depression and related illnesses.
I see this all the time. Natural is better, right? Sometimes, yes. Sometimes, no. It’s not just pharmaceutical companies that have an agenda to sell you their drugs. There are also lots of people who are trying to sell you their unproven, often untested remedies.
Alternative medicine is highly unregulated and not necessarily any more effective, or safer, than mainstream medicine. According to the Associated Press in a story this year on alternative medicine:
“Ten years ago the government set out to test herbal and other alternative healthremedies to find the ones that work. After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.
Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine.”
You probably didn’t hear about that, because it’s not a positive outcome for such a popular concept. If you were aware, you likely heard proponents argue that the research wasn’t conducted correctly. You were probably told that the fact that many alternative health remedies work no better than placebo is no different than the fact that some prescription medicines are found to work no better than placebo.
Antidepressants, in fact, have been found in certain studies to work no better than placebo. After reviewing those studies, Dr. Steve Novella, who writes the blog Science-Based Medicine, wrote a great piece about this called “Do Antidepressants Work? The Effect of Publication Bias”.
“At this time it is premature to conclude that modern antidepressant medications do not work. There is sufficient evidence for efficacy to continue to use medication as part of the overall treatment approach to depression. The current consensus is that therapy is also a critical component of the long term treatment of depression, and therefore looking at the use of medications in isolation may not reflect their actual clinical use. Multiple studies have now shown that combination treatment (medications and therapy) are better than either alone. There is also evidence that medication treatment is more successful when multiple agents are tried in order to find the optimal treatment.”
I like Dr. Novella’s blog because he gives everybody the “business” if they don’t get their science right, whether it’s claims made about homeopathy or antidepressants. He explains his belief that the problem with Complementary and Alternative Medicine (CAM) is ” … that they aggressively market CAM as ‘harmless’ and ‘natural.’ They point to the warning labels and informed consents associated with science-based medicines as evidence that the alternative must be safer. In reality, many alternative practices are less effective, and can carry serious risks (usually undisclosed to the patient).”
We need more research on what causes postpartum depression and what the most effective methods are to treat it. This should include looking more closely at alternative forms of treatment, whether it’s acupuncture or yoga or light therapy or omega-3s, to make sure that we aren’t missing anything. Unfortunately, there’s just not a whole lot ofinformation available on that yet, especially for moms who are breastfeeding.
One interesting piece, the best I’ve found so far, took a look at the more common natural treatments suggested to women with postpartum depression. It was published in the Journal of Midwifery and Women’s Health in 2004 and looks at both pros and cons.Their conclusion?
“Especially for women with moderate to severe symptoms, complementary and alternative medicine is a complement to conventional treatments, not a replacement for it.”
So what should you do if you have postpartum depression? One of the MDs who writesthe blog Denialism suggests the following in his post “There is No Such Thing As Alternative Medicine”:
“When someone offers you an ‘alternative therapy’, ask them what it is an alternative to. Does it work better than something else? Is it safer? How do you know? Why should I believe you?”
Then, talk to your doctor.
Update to this piece: I think some readers are getting the impression I think alternative treatments are bad. That’s not my point at all. I simply think we should always look at both sides of any treatment suggested. Everything has side effects of some sort. Everything has risks and benefits.Just because a treatment method is “natural” doesn’t necessarily mean it is safer or more effective. That’s all. If you want to try an alternative method, you should. That’s why I report on them here and here whenever research comes out. I want you to know everything that’s available. You have to make your own choices.
For related articles on this topic, you might want to check out the alternative treatments category here at Postpartum Progress, or the following blog posts:
Psych Central: Consumer Reports on Antidepressants
Mamapedia: The Postpartum Prozac Roller Coaster
Mayo Clinic: Postpartum Depression and Alternative Treatments
Dr. Shoshana Bennett: Natural and Alternative Treatments for Perinatal Mood Disorders
MGH Center for Women’s Mental Health: Fish Oil and Postpartum Depression and Using Omega-3 Fatty Acids to Treat Depression During Pregnancy and Can Estrogen Be Used to Treat Postpartum Depression?
Psych Central: Alternative Practices May Complement Western Medicine
While I normally say live and let live, I'm constantly amazed at how educated people will cram anything in their mouths so long as it says "natural". My lithium is natural, but would kill me if I took it wrong and it wasn't monitored.
I just don't get the knee jerk reaction against medication-it might help. Lord knows it saved my life after trying many other things.
Education. And I don't mean Dr. Google.
I took every remedy I could find or read about for over two years except anti-depressants. Sometimes I improved, but only for a short time and at great cost financially and time-wise. If I could have found a cure I would have. I finally agreed to medication after being diagnosed by a midwife/psychologist who prior to becoming a psychologist was anti-medication in general. She assured me that I had done everything under the sun and that medication was simply a tool so that I could learn skills to regulate my emotions more skilfully and reset my brain chemistry.It's been six months. I am recovering with help and finding myself again. For me, it was important to consider that suicidal thoughts are a life-threatening state of mind. My mistrust of allopathic treatment almost cost me my life. With all that said, I don't recommend anti-depressants anyone, but I would never advise someone against them especially if I don't know the intricacies of their experiences in depression.
I got a prenatal massage when I was 37 weeks pregnant, and the lady who gave me the massage peddled her "natural" products throughout the entire massage.
As I was leaving, she said that whenever she gives a prenatal massage, she always tells the moms-to-be that doctors are so quick to prescribe anti-depressants after pregnancy. She said something to the effect of – "Women have hormone deficiencies after pregnancy – not Prozac deficiencies."
How aggravating that she is saying that the pregnant women who come to see her!
I agree that medication is not the answer for everyone, but if it works – then more power to you! I know it's made a tremendous difference in my life.
Now THIS – this is such a great statement from this post – "Especially for women with moderate to severe symptoms, complementary and alternative medicine is a complement to conventional treatments, not a replacement for it."
I love the fact that the emphasis is on the idea that it is a complement, and not a replacement.
Again – what a wonderful and informative piece – thanks!
Great post Katherine! Here's something you might find interesting. I was on Effexor for close to a year and half. All my blood work while on it came out normal, including work to check my liver functioning. Then I got weaned off.
To help with pms symptoms I decided to try St. Johns Wort. Blood work soon after found my liver functioning tests to be way off. We couldn't figure out what was wrong with me and I was about to be sent off for more testing, until I remembered to report that I was taking a "natural" remedy – St. Johns Wort. You wouldn't believe my shock when I learned that it was this "natural" alternative to antidepressants that was causing my liver to over function! Go figure! I got off St. John's and my liver functioning returned to normal. So much for being a safe alternative!
Another excellent post, another rational analysis of an important issue. I can't thank Katherine enough for this blog.
So much of the anti-medicine, pro-"alternative treatment" bias is based on the belief that natural equals good and beneficial. This belief falls under scrutiny. Living in houses, especially houses with central heating, plumbing, and electricity is unnatural; living under the stars is natural. Clothing is unnatural; nakedness is natural. Even the most low-tech forms of agriculture are unnatural. Anyone claiming that Nature is Always Best has no credibility unless they are a nudist, homeless, hunter-gatherer.
The perception of nature as a beneficent, intelligent, purposeful entity is not objectively verifiable. Nature is arbitrary–the result of chance mutations and random events. (If Mother Nature were a real person instead of an abstraction, the state would have terminated her parental rights long ago.) The belief that Nature "knows" what's good for us, and therefore must be obeyed, is, in essence, a faith-based belief–dare I say religious belief? Individuals are free to adopt which religious beliefs they please, and doubtlessly many individuals find great comfort and strength in their religious beliefs. But religious beliefs cannot be a basis for public policy, or for obfuscating open-minded inquiry, or for bullying "heretics" into compliance. Having personally experienced religious bullying during my days of PPD (albeit religions of the more conventional sort), I shudder at the knowledge that other kinds of believers bully other sufferers.
I wholeheartedly agree with Michelle…thanks Katherine, once again, for a very rational (and thought-provoking) post! By the way, I esp. love the "Anyone claiming that Nature is Always Best has no credibility unless they are a nudist, homeless, hunter-gatherer" comment from Michelle.
Anyway, I just wanted to say that everyone (esp those who are so anxious to jam their own beliefs down everyone else's throat) that in life in general, what works for one person does not necessarily work for another person. Everyone is unique due to hereditary and environmental factors, and everyone should be able to decide what approach to take for themselves.
With respect to PPD, the severity of each person’s PPD differs from one person to the next. As such, an alternative treatment(s) or medication(s) that works for one woman may not work for another. Different medications have different effects on different people.
Hello all. As one who had PPD and years later was diagnosed with Bipolar 2 and OCD I have tried both avenues…pharmaceutical based treatments and wholistic/complementary therapies. I can only speak about my own personal experience.
I am under the care of a Nurse Practitioner who practices complementary treatments but is not opposed to mainstream medicine. I think there is a place for both in our society. I take numerous supplements daily (Targeted Amino Acid therapy, vitamins etc) and progesterone cream during parts of my cycle. I feel better mentally than I ever have!!!!
That being said, my mental well being comes with a price…..I spend about $125 per month on supplements opposed to the $75 I was spending on prescription medicine. Reality check….many people cannot afford that. Most of us are dictated by what our insurance will pay.
I also wholeheartedly believe that if a woman is going to take the "natural route" she needs to be under the care of a qualified, well trained medical provider who specializes in this area. It is never a good idea to start blindly taking vitamins and supplements without the advice of a medical provider.
Also, women need to stick together. Stop passing judgement on a woman who wants to try an antidepressant!!! She gets to choose what she puts into her body!!! Motherhood is hard enough without criticism from others….especially other mothers.
Okay, so I'll step out on a limb and wear the badge Craziest Girl on the Crazy Girl Blog.
I am not one of those people who came to homeopaths easily or willingly. Quite the opposite. I thought they were a bunch of horse manure (and maybe some of them actually are). BUT, during my pregnancy my midwife used a combination of homeopaths and more traditional medicine to help me through hyperemisis, preterm labor, and weeks (!) of prodromal labor. Did everything she do work all of the time? No, definitely not. But the same can be said for pharmaceuticals — not all drugs work for all people or adequately address their needs. More often then not, however, they did help, and with fewer (if any) side effects compared to traditional medical treatments. We tried what was least invasive and most likely to give the desired results, be it homoepaths, "alternative" medicines, or traditional medicine — and then we used what worked.
When it came to my PP PTSD, anxiety and PPD. I was NOT okay with medication, for my own personal reasons. I don't think that anyone who knows me would disagree that I was easily moderate to severe in terms of anxiety and depression. It took a while, but I did find the right balance of homeopaths and supplements. The puzzle piece that took the longest to fall into place was my thyroid. I had it tested no less than 8 times in the first 6 months postpartum. Although I was exhibiting a lot of signs of hypothyroidism, my levels were always completely normal, so doctors would shrug and send me on my way. I finally put myself on a natural thyroid supplement, and whoa nelly, the difference it made. In addition, I had tried traditional counseling but only found it to be slightly helpful. And then I tried reiki, which I didn't expect to work at all, but was willing to keep my mind open. Anyway, to make a long story short, the reiki was difficult to get through at times but has made a tremendous positive difference overall.
I think a flat condemnation of either traditional medicine or natural medicine is silly. Neither is going to be able to offer the answer all of the time, or may not able to help more than it hurts (sometimes the side effects are worse than the therapeutic value). I would never tell another woman that she should try X over Y, but I would always share my experiences with both traditional medicine and natural medicine and I don't think there is anything wrong with that. You seem to approach this subject from a position of never having tried it. I was a harsh skeptic too, until I tried it and it worked.
Dana,
You're not crazy. And you're not wrong to try alternative methods. All I'm saying is that people should keep their eyes open to ALL suggestions for treatments. No treatment is PERFECT, whether medicine or otherwise.
I'm glad you shared your approach and I'm glad it worked for you. I think women should feel they can try whatever they like as long as they are open to something else if it doesn't work.
Exactly. We shouldn't pass judgment. I don't want to pass judgment on people who take the natural approach either. I hope my post didn't do that. I just want people to look at both sides no matter what treatment modality is offered and not assume that just because someone says something is "natural" that it must automatically mean it is safe or effective. People already have that perspective, more often at least, when it comes to medicine but I don't hear it as much when it comes to herbs or supplements.
I love your blog. It was instrumental in my recovery. I take medication and did CBT for severe PPOCD/PPD. However,I don't like medication and if I had a choice I wouldn't take it. It was not my first or second choice. I take it because it's the only thing that works. It's just reality for me. However, I am by design a hippie attachment parenting mom and I BELIEVE in natural. I believe in it because the body does not have a deficiency in chemicals. Omega 3's yes. Vitamins, god yes. I could not breastfeed because I took medication. That is a huge loss to me. But I lost so much more because of the PPOCD. Before I took meds I tried the following: reiki,homeopathy,osteopathy,acupuncture(yes, it works but it's expensive),herbs,flower essences,chiropractic,TCM,nutrition.
We were out thousands of dollars with no results.Everytime I would bring it up with other people I would hear nonsense about how I wasn't doing enough and how evil medication is!HA! I exercise, I take a ton of supplements and it helps.But it didn't cure my depression.It didn't give me my life back.
FYI, fish oil is great for panic attacks. It worked for me when I was pregnant and didn't want to take medications.
One of the best ancient healing is acupuncture, among all of the ancient process of muscle relaxation and muscle pain relieving too.
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