Depression, Post-Partum and otherwise: Another option

Recent questions about postpartum depression posted on The Skinny Scoop imply that once a woman is diagnosed with post partum depression she has only two options- take medication and stop breastfeeding, or forego medication and continue to breastfeed.

There is a third option, which involves replenishing amino acids (the basic building blocks of protein), and balancing thyroid, adrenal and sex hormones. This approach works for about 80% of the women in my medical practice.  This approach is based on the work of Julia Ross, a pioneer in the field of nutritional psychotherapy, and author of  The Mood Cure. (The Mood Cure program is also effective for women with general depression and anxiety.)

The most commonly used anti-depressants SSRIs (selective serotonin reuptake inhibitors) work by preventing the reuptake of serotonin in the synapses (spaces) between neurons.  This means that the serotonin  stays in the synapse for longer. Although serotonin is technically a neurotransmitter, it is often know as the “happiness hormone” because it contributes to feelings of well-being.

While SSRI anti-depressants increase the level of serotonin at the synapses by preventing serotonin reuptake, the level of serotonin in the synapse can also be increased by producing more serotonin. This can be done by taking tryptophan, the amino acid building block which is the raw material for producing serotonin.  Although tryptophan is commonly associated with turkey it is found in many foods from baked potatoes to yogurt (almost A-Z).  A 4 oz. serving of turkey contains about 350 mg of tryptophan. Treatment doses for tryptophan range from 500 mg-1500 mg. Several studies from the NIH show that breast milk naturally contains high amounts of tryptophan.

The need for for tryptophan can be assessed by testing plasma and amino acid and serotonin levels. The use of single amino acids is contraindicated in pregnant and nursing mothers. However mothers with postpartum depression can safely take Total Amino Solutions containing all 22 amino acids with additional tryptophan.  The effectiveness of taking tryptophan is enhanced by checking and balancing thyroid, adrenal, and sex hormone function, as well as B6  and zinc levels, since these substances affect serotonin action and metabolism.

In 1989 tryptophan was pulled from the shelves, because it was associated with eosinophilic myalgia syndrome. After extensive investigation it was determined that the EMS was due to a contaminant.  Tryptophan is now again commercially available. I recommend buying a product that displays the USP verification label. US Pharmacopia inspection verifies that a given product contains the ingredients specified and no additional ingredients.

To find out if you would benefit from taking amino acids, take the Mood Cure Questionnaire. If you score high on the first section Under a Dark Cloud you will likely benefit from taking a total amino acid solution with additional tryptophan. If you score high on other sections you may benefit from taking a total amino acid solution with higher doses of other amino acids.

For mothers who want to treat postpartum depression with amino acids and metabolic balancing it is strongly recommended that you work with a physician familiar with this approach. For women currently on antidepressants who want to safely  discontinue them, an experienced physician should supervise the transition to avoid serotonin syndrome, a rare complication of combining antidepressants and 5-HTP, tryptophan, or SAMe. To find a physician willing to do the necessary testing of thyroid, adrenal and sex hormones, and supervise your care use the American Holistic Medical Association physician finder.

As mentioned previously, this approach works for about 80% of my patients. For whatever reason about 10% of women respond better to a single antidepressant medication which I will prescribe, and another 10 % have more complicated chemistries which require a combination on medications, for which I refer them to a psychiatrist or psychopharmacologist. As one woman stated in  The Skinny Scoop comments “Healthy mommy is the best mommy”. So explore all your options and do what is best for you and your child without any additional guilt from your own, mother, your mothers group, or overwhelming numbers of blogging experts out there.

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