Some mothers experience postnatal blues a few days after giving birth. Signs and symptoms include mood swings, anxiety, sadness, crying, irritability and having trouble sleeping. However, such condition mostly last for a few days or a week. If it continues for more than 2 weeks, one may be suffering from postnatal depression and should seek professional advice as soon as possible.
Postnatal depression affects about 10-15% of women after childbirth. The symptoms, apart from those above, can also include:
- extreme lethargy
- lack of appetite
- not able to enjoy anything
- severe mood swings
- intense irritability and anger
- withdrawal from family and friends
- loss of interest in sex
- sense of inadequacy or guilt
- sense of hopelessness
- feeling of isolation
- withdrawal from family and friends
- lack of feeling of bonding with the baby
- thoughts of harming oneself or the baby
Causes and Treatment of Postnatal Depression According to TCM
According to TCM, the mental, emotional and cognitive elements of a person are governed by Shen, which resides in the Heart. Shen is often translated as spirit or mind in English. In TCM the Heart does not comprise of the heart organ alone, it is a complex system in the body which includes other physical parts such as blood vessels and certain functions such as memory.
The Liver is another system that is closely related to emotions. Hence in depression, the Heart and Liver are the two systems that are most affected. In general, there are three main reasons that can lead to postnatal depression:
- Deficiency in Heart and Spleen
- Blood stasis
- Liver-Qi stagnancy
1. Deficiency in Heart and Spleen
The process of pregnancy and delivery involves the loss of Qi and Blood during delivery. Coupled with pregnancy and breast feeding, which also draws on the mother’s Qi, Blood and vital essence, it can result in the Heart being weakened, manifesting in symptoms such as anxiety, depression, tearfulness, insomnia, poor concentration and memory, palpitation, etc. The Spleen is another system that is easily affected by lack of Blood, in which case, its deficiency shows up as lack of appetite, lethargy, having loose stool, etc.
Commonly used herbs for deficiency in Heart and Spleen include Chinese angelica root (dang gui), astragalus root (huang qi), ginseng root (ren shen), codonopsis root (dang shen), dried longan pulp (long yan rou), white atractylodes rhizome, poria spirit (fu shen), sour jujube seed (suan zao ren), polygala root (yuan zhi), etc.
2. Blood Stasis
Blood stasis can arise from three circumstances. It can result from deficiency in Qi and Blood to move the blood, or emotional stress or distress causing blockage of energy flow, or it can also be due to blood or tissues that are not cleared from the uterus during delivery. All these three reasons can result in blood stagnancy in the Heart meridian (energy channel), thereby showing up as symptoms of melancholy or depressiveness, aversion to talking, dreamy sleep and insomnia, poor concentration and memory, dark facial colour, prolonged discharge of lochia, etc.
Herbs used in syndromes related to Blood stasis include Chinese angelica root (dang gui), red peony bark (chi shao), Szechuan lovage root (chuan xiong), myrrh resin (mo yao), cinnamon bark (gui pi), Chinese wild ginger (xi xin), deer musk (she xiang), etc.
3. Liver-Qi Stagnancy
In the syndrome related to Liver-Qi stagnancy, it is likely that the mother has a more passive, melancholic or anxious character. After delivery of the baby, symptoms can aggravate to include depressiveness, uneasiness and anxiety, tendency to sigh, insomnia, nightmares, ease of getting scared, feeling of chest tightness, lack of appetite, uneven flow of lochia, etc.
Herbs to treat postnatal depression caused by Liver-Qi stagnancy include bupleurum root (chai hu), Chinese angelica root (dang gui), white peony root (bai shao), poria (fu ling), albizzia bark (he huan pi), polygonum vine (ye jiao teng), magnetite (ci shi), etc.
Prevention of Postnatal Depression
- Prevention of postnatal depression should start early from the 3rd trimester of pregnancy. This is especially important for mothers who are anemic, generally weak or have history of feeling melancholic or depression. Seek the advice of a TCM physician if unsure.
- Mothers should make it a priority to look after themselves well. After childbirth, attention tends to be diverted to the new born baby and mothers may feel neglected. The husband and family members should acknowledge that the mother’s needs are as important as the baby’s and that her physical and emotional needs should also be well taken care of.
- Diet should be nutritious, well-balanced and easily digestible. After delivery, a nutritious diet is important to replenish back what has been lost during delivery and pregnancy. It should be noted that nutrition’s role is not limited to nourishing the physical body; it has an important part to play with regards to the mental and emotional well-being of the mother as well.
- With a new born in the family, the mother and family members would need to learn to adjust their lifestyles and schedules to take care of the baby’s needs. A mindset to allow for flexibility is important as it will minimize stress in the course of making the adjustments.
- Seek for support if one notices signs of depression. Be willing to speak out one’s observations and feelings, and do not be afraid to ask for opinions, help and support from family members, friends, other mothers or health professionals.
(by Tan Shiau Tse, TCM Physician, Copyright® HST Medical Pte Ltd)