The Problem of Postpartum Depression
Low serotonin levels
Why are so many people apparently suffering the effects of low serotonin levels? There are a number of reasons. Serotonin and a group of neurotransmitters called the catecholamines adrenaline (epinephrine), noradrenaline (norepinephrine), and dopamine which are predominantly made by the adrenal glands, work together and need to be in balance within the nervous system. As the general level of stress with which we live has gone up, our adrenal glands have been induced to make more catecholamines. The brain then is faced with the need to make more serotonin to maintain a proper balance. It is estimated that the level of stress most of us face on a daily basis is 100 times higher than that faced by our grandparents. The world keeps getting more complicated, and our nervous systems keep trying to adapt. We have reached a point at which many people's brains are having trouble making enough serotonin to match the levels of adrenal catecholamines required to cope with life.
There are a number of other factors that make it more difficult for our brains to produce enough serotonin. The brain needs a steady supply of the amino acid tryptophan and vitamin B6 to make serotonin. Proteins in foods contain a very small percentage of tryptophan as compared with other amino acids. Only about 3 percent of the tryptophan in food is actually converted into serotonin in the brain. This is partly due to the fact that about 95 percent of the serotonin in the body is needed and used in the intestinal tract. Further, to reach the brain, tryptophan must be ferried across the blood-brain barrier (a protective mechanism in the brain that keeps certain substances from easily entering the inner sanctum of the brain) by means of a carrier protein. Tryptophan has to compete with other amino acids for these carrier proteins, and this limits the amount of tryptophan that can enter the brain at any given time. Further, the adrenal hormone cortisol, which is produced in response to stress, converts tryptophan into a chemical called kynurenine, which cannot be converted into serotonin. If you drink coffee, smoke cigarettes, drink alcohol, eat chocolate, take diet pills, or just have a lot of stress in your life and what mother doesn't? your body will produce too much cortisol, increasing the amount of tryptophan that is converted to kynurenine and limiting the amount available to produce serotonin.
To make matters even a bit more difficult, the production of serotonin does not take place in a single step, but is a complicated biochemical process, and each of the steps along the way requires specific nutrients. Your body must have enough iron and vitamin B3 (niacin) to convert tryptophan into a compound known as 5-hydroxy-L-tryptophan (5-HTP) and enough other B vitamins plus the mineral magnesium to convert vitamin B6 to pyridoxal-5-phosphate (P5P), the form necessary for serotonin production. Without enough 5-HTP and P5P available in the brain, serotonin cannot be made at adequate levels. Doctors cannot simply give their patients serotonin orally or intravenously because serotonin is fat soluble and does not pass through the blood-brain barrier. The only way that the brain can get serotonin is to make it from the specific nutritional precursors available to it at the time. (Fortunately, 5-HTP and P5P are available in supplement form.)
All of these factors can lead to an individual having an inadequate supply of serotonin for optimal health, and in turn may explain the startling statistic that an estimated one in ten Americans and one in four women! is now on SSRI drugs.
The safety of SSRIs for the babies of nursing mothers also has not been proven. Some studies have linked the maternal use of Prozac to colic in nursing infants. A baby with colic can push the most even-tempered mother over the edge. For this reason alone, giving such a drug to a mom with PPD doesn't seem like the best way to support her recovery. Further, Prozac and similar drugs pass into a nursing mother's milk and, thus, into her baby's body. While studies have shown that little or no drug circulates in a baby's bloodstream, others that have looked at the concentrations of the drug in babies' brain tissue have found much higher levels. Nothing is known about the possible harm this can do to a newborn.
Some mothers choose to take the drugs and not to nurse. This deprives their babies of the most perfect food they can be given, and deprives both mother and child of the important bonding that comes with breastfeeding. Mothers with PPD who miss out on the bonding experience of breastfeeding may end up feeling even more distant from their babies. Most of the mothers we have consulted with who chose to take SSRIs over breastfeeding would have chosen to nurse if they had felt there was any other way to heal PPD. Unfortunately, mainstream medicine routinely tells new mothers with PPD that these drugs are the only way out.
More on: Postpartum
From A Natural Guide to Pregnancy and Postpartum Health by Dean Raffelock, Robert Rountree, and Virginia Hopkins with Melissa Block. Copyright © 2002 by Dr. Dean Raffelock. Used by arrangement with Avery, a member of Penguin Group (USA) Inc.
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