Today, a friend told me about a recent experience with her family doctor that reduced me tears. If ever I needed more convincing that the pre and post natal classes I'm doing next month are absolutely essential for mothers, I got it today.
My friend had her children years ago but she, like so many of mothers, is depleted. She works full-time, hasn't slept through the night in years and has bouts of anxiety that paralyse her. She went to her doctor the other day - a fellow woman and mother herself - and asked her what she could do to help her deal with the anxiety. The doctor prescribed cipralex, an anti-depressant.
Here's what the doctor didn't do:
- she didn't ask her patient about her quality of sleep
- she didn't ask her patient about her diet
- she didn't ask her patient about what else was going on in her life, i.e. her relationship with her husband, her children, her parents, her siblings, her work, her colleagues
- she didn't probe to see if the anxiety could be linked to anything deeper
But THIS is what made me cry.
When my friend told her she would prefer not to take anti-depressants, the doctor replied:
Don't you want to be a good mother? Sometimes, all we need is a little help and there's nothing wrong with that.
I could write volumes about everything that stinks about that response: the lack of empathy, the judgement, the guilt trip - the utter abuse of power. But instead, to all mothers who suffer from anxiety, here are some facts, supported by scientific research that might help you tackle your anxiety in a more productive way.
FIRST THINGS FIRST: YOU ARE NOT ALONE. YOU ARE A GOOD MOTHER - PERIOD.
According to a 2009 online poll from the Anxiety & Depression Association of America 52% percent of women who have been pregnant reported increased anxiety or depression while pregnant. 32% reported a decrease in symptoms after childbirth; but 16% experienced no change. And please note that "decrease in symptoms" - doesn't mean elimination of symptoms.
Anxiety afflicts the majority of mothers and there has been NO SCIENTIFIC STUDY LINKING ANXIETY TO A WOMaN'S PERFORMANCE AS A MOTHER.
There has been no study because it would be utterly ridiculous. Let's be honest, all mothers think they could be better mothers, regardless of whether they experience anxiety or not. That's called UNCONDITIONAL LOVE and wanting the best for our children. No one should put that into question, least of all a trusted medical professional.
ANTIDEPRESSANTS SHOULD BE PRESCRIBED FOLLOWING MEDICAL EVALUATION & USED IN CONJUNCTION WITH THERAPY -- BUT THAT'S NOT HAPPENING
Since the launch of Prozac in 1987, antidepressant use has quadrupled in the United States, and more than one in 10 Americans now takes antidepressants, according to the Centre for Disease Control & Prevention. (The statistics are similarly alarming for most of the developed world). Antidepressants are the second most commonly prescribed drug in the United States, just after cholesterol-lowering drugs.
AND HERE'S THE CLINCHER: most antidepressant prescriptions -in fact, four out of five - are given by primary-care physicians who may have limited training in treating mental health disorders (Psychiatric Services, 2009).
That means that patients are being told to pop antidepressants like panadol without an assessment of root cause and without being prescribed a course of therapy which could help them deal with the root cause of their issues. By 2005, only one-fifth of patients prescribed anti-depressants were receiving therapy, according to a study of more than 50,000 medical surveys that was co-authored by Mark Olfson, MD, professor of clinical psychiatry at Columbia University (Archives of General Psychiatry, 2009).
So moms - if you are on anti-anxiety medication or thinking of going on it - you are entitled to a physical and an emotional examination and should be under the care of a therapist or someone who can help you deal with the root cause. Anti-depressants were never meant to be prescribed loosely so that they become the equivalent of a temporary band-aid to your problem: a band-aid that comes with a long list of side-effects.
Side effects to anti-depressants include: feeling fuzzy, lack of sex drive (and honestly, do we need to aggravate this?), nausea, loss of appetite, insomnia (one of the root causes of anxiety), changes in heart rate, dizziness, fatigue, constipation and congestion or runny nose.
I'll stop there. The list is longer. But I just wanted to point out that sometimes the remedy is worse than cure, and it sure isn't sustainable.
BIOCHEMICAL IMBALANCES WHICH COULD BE AT THE ROOT OF ANXIETY AND SHOULD BE ADDRESSED PRIOR TO PRESCRIBING ANTI-DEPRESSANTS INCLUDE:
- POTENTIAL THYROID DISORDER and for this a FULL THYROID PANEL (not just TSH) is required. A full thyroid panel includes TSH, Free T3, Free T4, Reverse T3, Thyroid Peroxidase Antibodies and Thyroglobulin Antibodies.
- POTENTIAL FOOD & CHEMICAL ALLERGIES. The gut and the brain are inextricably linked via gut hormones and neurotraNsmitters and in ways that scientific research is just beginning to understand. Allergic reactions or intolerances create blockages in our detoxification pathways, making it difficult for us to detox hormones & toxins, creating hormonal imbalances which affect mood. The most common food that's been linked to mental health problems is wheat. However, if you're already on a wheat-free/gluten-free diet, perhaps some other trigger is holding you back from feeling better.
- ADRENAL IMBALANCES. Many women suffer from adrenal fatigue after having children due mainly to lack of sleep, increased stress, career demands & increased family responsibility. Many women who suffer from anxiety also have adrenal depletion. Please get your hormones levels tested and know that the adrenals, much like the thyroid responds positively to nourishment and TLC.
- INFLAMMATION ROOTED IN GUT MICROBIOTA IMBALANCES. The research is still nascent in the field but there is a growing body of research that is tying mental health problems, like anxiety to excessive inflammation as part of the root cause. Inflammation upsets brain health and the most common cause of inflammation is rooted in faulty digestion which leads to an overload of toxins for the liver. If you are a mother suffering from anxiety who also struggles with asthma, allergies, hives, decreased immunity- then please pay attention to your gut and seek to improve gut health.
SLEEP IS FUNDAMENTAL
People with insomnia or disrupted sleep patterns have greater levels of depression and anxiety than those who sleep normally. They are actually 10 times as likely to have clinical depression and 17 times as likely to have clinical anxiety. Research indicates that when sleep is disrupted over and over, it can alter brain activity and neurochemicals that affect a person's mood and thinking.
Having children together with other worries, e.g. family, finances, career -- have a tremendously negative impact on our sleep. In fact, 37% of 20-39 year-olds and 40% of 40-59 year-olds report that they're short on sleep according to the American Sleep Association. So, if you're a mother suffering from anxiety, have a look at your sleep. If you're not getting at least 7 consecutive hours of sleep on a continuous basis, then please consider doing something about it prior to beginning a course of anti-depressants.
What can you do about it? Well, it depends on what the root cause is.
- If your children are continuously waking, a sleep consultant could help you out with that. If your children are sleeping through the night and you suffer from insomnia or interrupted sleep, then have a look at your lifestyle to understand possible triggers and seek the appropriate help.
- Diet also plays a massive a role. Many mothers have their children's scraps for breakfast and dinner and lack the required protein intake that provides the body with the building blocks to make SEROTONIN - our happy hormone. Serotonin is also the precursor to MELATONIN, the hormone that regulates your sleep cycle.
BLOOD SUGAR REGULATION ALSO IMPACTS MOOD & ANXIETY
Please have a look at your diet and work with a nutritionist or naturopathic physician to ensure that you are not inadvertently aggravating your blood sugar. Blood sugar, in the form of glucose, is the basic fuel for all brain operation and physical activity. If you've gone too long without eating OR if you haven't eaten enough OR if what you have eaten is far too high in sugar and causes you have a major slump then you will start to experience glandular imbalances as you struggle to regulate the high sugar levels. These imbalances result in high adrenaline, which is usually perceived as anxiety or panic.
Examples of meals that could set off your blood sugar are:
- toast and coffee (or scraps of toast and coffee or no breakfast at all)
- a bowl of pasta & tomato sauce
- fried rice or risotto
- a cheese sandwich
- a yoghurt or milk-based fruit smoothie
White carbs and dairy have a high glycemic index, which will force a spike in your blood sugar that will need to be regulated by insulin and will result in hormonal imbalances.
NOURISH YOUR BODY & TARGET NUTRIENT DEFICIENCIES WHICH HAVE BEEN EXACERBATED OVER TIME BY HORMONAL BIRTH CONTROL, PREGNANCY & BREASTFEEDING
Patrick Holford's, "Optimum Nutrition for the Mind" is not the only book chalk full of research to support the link between nutrient deficiency and depression, anxiety and other mental issues. Long-time users of hormonal birth control suffer deficiencies in zinc, folate, B-vitamins, Vitamin C and magnesium - all vital nutrients needed for energy creation, immunity, stress management and sleep. Mothers who haven't been able to adequately look after their diet during pregnancy and afterwards will almost certainly be deficient in the very nutrients which are most beneficial to brain and hormonal health, namely B-vitamins including folate, B6 & B12, Omega-3 fatty acids, zinc, VitD3, selenium AND magnesium.
Low serotonin has been linked with high levels of anxiety (source). In order to make enough serotonin, the brain needs a continual supply of nutrients, such as tryptophan and vitamin B6 -which we get from sources including fish, red meat, egg, starchy vegetables & poultry.
In order to convert tryptophan & vitamin B6 into the precursors for serotonin, we need iron, other B-vitamins and magnesium. If we don't have enough of these nutrients in our body because we've been depleted by pregnancy and breastfeeding and have not adequately replenished our reserves, then the brain will not produce sufficient serotonin, resulting in depression & anxiety.
Addressing these nutrient deficiencies through a whole-food nutrient-rich diet could go a long way in helping you tackle the root cause of your anxiety in a sustainable way.
So mothers out there reading this -- please share with your friends. Many mothers don't talk about their anxiety because they're ashamed of it. And yet, as we can all plainly see - anxiety is so very common, and I would argue even inevitable, for many mothers.
If your anxiety has reached a debilitating point - then please reach out to me or someone else that is willing to listen to you and explore the root cause.
And in the meantime, why not try my nutritional strategy to start paving the way for a stronger mind-body connection:
(are you eating high quality protein with every meal to help you make serotonin and melatonin?)
(are you showing your body love, kindness and self compassion by eating 6-8 daily cups of leafy green, cruciferous & rainbow vegetables; and a good dose of healthy fats like avocados, salmon, coconut oil, nuts & seeds?)
(are you drinking enough water and getting the fibre you need to detoxify your body on a daily basis?)
One step at a time, you will get stronger, you will get better. Trust the science of how your body works. It will never let you down.
Cristina Tahoces will be discussing post-natal depletion and how nutrition can help support mothers who are at risk for post-natal depression and anxiety at the BLOOM HATCH & THRIVE prenatal classes next month on March 8th and March 20th. Please register to attend.
If you suffer from anxiety or would like to work with Cristina to address issues of post-natal depletion, please contact her. Post-natal depletion is not limited to the immediate months after birth, just as motherhood is not limited to that moment when we give birth.
Thrive Nutrition Practice focuses on digestive healing, blood sugar regulation & post-natal recovery. You are also welcome to join the Facebook Group "Thrive Nutrition Practice: Post-natal depletion" or "Thrive Nutrition Practice" for weekly articles, recipes & promotions.
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