Maggie and her husband were elated when they welcomed their first child into the world three years ago. Maggie knew she could expect a period of joy, family, and good feeling after the birth of her beautiful son. What an unexpected and unwelcome surprise, then, when she found herself sad instead of happy, crying instead of laughing, and experiencing postpartum depression instead of the joys of new motherhood.

Maggie is not alone. The American Psychological Association estimates that up to one in seven women experience postpartum depression (PPD), or depression that occurs after giving birth (that is, postpartum). PPD is characterized by the symptoms typically associated with clinical depression, including a loss of interest in activities, change in weight and eating habits, change in sleep habits, sadness and crying, difficulty concentrating and focusing, and more.

In addition, women suffering from PPD may experience symptoms unique to the experience of motherhood, including fear of being a good mother, fear of being left alone with the baby, and feeling disconnected from the baby. On top of that, many women experience large amounts of guilt for feeling the way they do, for not being able to “keep their chin up” and enjoy their new baby, as they’ve been told they should.

PPD can be devastating to the woman experiencing it and can also have adverse effects on the baby and the rest of the family, too. Unfortunately, getting the right treatment can be challenging.

Why is treating postpartum depression so difficult?

Sociological, logistical, and biological factors combine to make PPD a difficult condition to diagnose and treat.

For one, there’s a stigma attached to PPD that’s absent from other conditions. Many women experiencing PPD won’t speak about it to their doctors or even their family members because they’re too ashamed or embarrassed of how they’re feeling. While the stigma has been lifting in recent years as more women come forward to talk about their experiences with the “baby blues,” we still have a long way to go as a society in giving women the support and space they need to safely talk about it.

For other women, practical considerations prevent them from getting the help they need. Many women in the U.S. may want to seek treatment but can’t for various reasons, including scheduling, transportation, and money issues that mean they’re unable to see a physician in the first place.

In Maggie’s case, she did have the courage to go to the doctor with her symptoms, and her doctor sent her to a psychiatrist who put her on antidepressants. This wasn’t an effective treatment for Maggie and she didn’t feel any better. At this point, Maggie was seriously doubting she’d ever be able to find an effective treatment for her PPD. What if hormonal imbalance is the underlying cause of her postpartum depression?

The link between hormones and postpartum depression

Estrogen and progesterone are two hormones essential in regulating menstruation, conception, and pregnancy. Before pregnancy, progesterone is produced mainly in the ovaries. During pregnancy, it’s produced by the baby’s placenta at higher and higher levels until the baby is born, at which point it drops off precipitously.

This drop in progesterone is important because it signals to the body that lactation can begin. However, if the ovaries don’t go back to their pre-pregnancy production levels soon, hormones remain unbalanced. Estrogen dominates over progesterone, leading to estrogen dominance and “functional hypothyroidism.” It’s “functional” because while thyroid hormone levels may be adequate, in the presence of too much estrogen it’s not assimilated into the cells correctly, mimicking the effect of hypothyroidism– which is associated with depression.

Sometimes the problem is not functional hypothyroidism but actual hypothyroidism, where the levels of T3 or T4 (or both) are too low. Women who have never had a problem with their thyroid before may develop autoimmune thyroiditis during or after pregnancy. This often goes undiagnosed by physicians, as blood panels may still come back showing “normal” levels of thyroid hormones. (This can be corrected by asking to be tested for anti-thyroid antibodies.)

Why antidepressants aren’t the answer

It’s easy to see how depression caused by imbalanced hormones or a hormone deficiency would not be alleviated by antidepressants, no matter what kind and how many were prescribed. Postpartum depression is not caused by a low level of antidepressants in your system. Instead, the solution is to take supplemental hormones to help re-balance the body. Bioidentical progesterone in combination with desiccated thyroid hormone can relieve postpartum depression in women whose symptoms are caused by this imbalance. Progesterone alone can also help with keeping mood elevated and energy levels up, and can be taken as early as the morning following delivery.

Seeking a solution for postpartum depression

What happened to Maggie? After not finding relief from antidepressants, she didn’t give up but kept looking for a solution and considered whether hormones might be a factor in her PPD. She started a treatment plan that included both bioidentical progesterone and small amounts of desiccated thyroid. When she had her second child a couple years after her first, she experienced none of the depression, anxiety, shame, or guilt she had the first time around. Instead, she got to experience the joys of motherhood, as she had always imagined it.

Dr. Hotze reveals the underlying cause of postpartum depression:

If you believe you are suffering from postpartum depression, I encourage you to contact us at the Hotze Health & Wellness Center. We want to help you not only lift yourself out of depression but go on to thrive and experience a joyful, healthful life! Contact us today at 281-698-8698 to talk with one of our wellness consultants.

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