Originally posted April 10, 2014.
In Part One, we looked at the hormonal-neurotransmitter feedback loops in a woman’s body and how they relate to mood during the menstrual cycle.
(the Hypothalamus-Pituitary-Adrenal Cortex Loop and the Ovarian-Hypothalamus-Pituitary Loop)
In Part Two, we looked at a woman’s hidden hormonal shifts during pregnancy and birth. Today, we look at the hidden postpartum hormonal shifts.
Postpartum and hormonal shifts: A vulnerable time of life
After giving birth, a woman’s hormone levels drastically plummet. The literature says within one to five days after birth, estrogen levels drop to the level of a normal menstrual cycle. A woman’s body needs time to adapt to all of the physical changes. Remember that estrogen precedes serotonin, the mood stabilizer, in the brain. And a steep drop in progesterone has a depressive effect as well. There’s a big chance for dysregulation in the brain-gland feedback loop (Sichel and Driscoll, 1999).
Prolactin and oxytocin
Other hormones that come into play postpartum and have an effect on the HPA and mood are prolactin and oxytocin. Prolactin is produced in the pituitary gland and is the milk-producing hormone. Prolactin levels rise during pregnancy and while breastfeeding. Some studies indicate prolactin is protective of postpartum depression, but others indicate prolactin causes vigilance, appropriate to a protective mother, but this feeling can morph into anxiety and irritability. The presence of prolactin varies whether or not a woman chooses to breastfeed (Donaldson-Myers, 2012).
Oxytocin is another neuro-hormone with a big effect on mood and happiness. Oxytocin is synthesized in the hypothalamus and released by the pituitary gland. Oxytocin is secreted during breastfeeding. Research has shown that oxytocin induces feelings of calm and bonding (Donaldson-Myers, 2012). And the presence of oxytocin varies whether or not a woman chooses to breastfeed (Donaldson-Myers, 2012).
Next, we’ll take a look at how an individual’s life events affect her brain-bio state and her moods.
Life events: Abuse and trauma
Life events, such as physical and emotional abuse, neglect, hunger, natural disasters, loss, and positive events all shape a person’s propensity towards mental health or mental distress and neuroticism. It’s well documented that people who have experienced trauma and or sexual and emotional abuse in their lifetime have a higher risk of suffering from depression and other mental illnesses.
The aftereffects of trauma and abuse are profound. The HPA axis feedback loop is actually dysregulated by the presence of continued and strong fear, helplessness, anger and emotional distress. From this abuse and fear, deep psychobiological effects resonate throughout the brain and hormonal systems and the person’s experienced life.
As discussed above, the stress system consists of the neuro-endocrine interaction of the hypothalamus, pituitary, and adrenal cortex (HPA), which is integrated with other systems in the body. The stress system’s response varies with our perceived reality and the resulting emotions of fear, anxiety, security, happiness and other states of mind (Jolley & Spach, 2008).
In a healthy, non-depressed woman, the system is in a feedback loop, regulating hormonal levels and keeping physiology and mood in balance (Jolley & Spach, 2008).
But, abuse can alter a person’s hormone levels forever. Survivors of childhood abuse show patterns of having less circulating cortisol. Cortisol is important in that it has an effect on blood glucose levels, releasing it for use during stressful periods. From being overstimulated and asked to produce more and more neuro-hormones, the brain structure, the hypothalamus and the pituitary gland, suffer a distinctive effect, called HPA axis blunting. From lowered reactivity of the brain structure, the hypothalamus and the pituitary gland, there follows lowered cortisol levels in the bloodstream and thus, associated depressed mood (Jolley & Spach, 2008).
Hormones and mood: What does this mean to an individual woman?
On an individualized, clinical level, it’s difficult to directly assess how these hormonal changes will impact or are impacting an individual woman. Will she become anxious or depressed? During pregnancy and in the transition to postpartum, dramatic changes in the HPA axis occur. These dramatic hormonal changes of pregnancy are challenging to the CRH-cortisol-ACTH stress response. In some women, the feedback loop is perturbed and becomes either hypo- or-hyper stimulated, resulting in depression and anxiety
We do know that 85% of women suffer from premenstrual syndrome (PMS) and about 85% suffer from the more severe premenstrual dysphoric disorder (PMDD). 85% of women suffer from the baby blues and 20% suffer from a form of postpartum mood disorders. So the hormonal changes do impact alot of women in some way.
Plus, a history of mood disorders or childhood abuse affects the HPA axis and can set a mom up for her system to have trouble re-adjusting during her menstrual cycle, her pregnancy, childbirth and also postpartum.
Plus, women vary widely in their individualized emotional and psychological responses to breastfeeding. Some love the experience, others find breastfeeding to be a chore and feel stressed out from it. Some women want to stay home with their babies full-time and yet others want to get back to a well-developed career or the social buzz of the office or need the financial security.
The point of this overview about hormones and mood was to bring to light the many physical factors that are behind the biology of reproduction and mood, so there’s a wider awareness that women have very real physical vulnerabilities that directly affect mental health.
SELF-CARE IS NOT A LUXURY!
So, taking care of yourself on many levels, emotionally, mentally and physically in your childbearing year is not a luxury. It’s a necessity to build your physical stores to protect your brain-bio health.
You can help out your HPA axis by practicing good nutrition, taking adequate vitamin supplements, augmenting your natural hormonal balances with aromatherapy and herbal supplements, getting enough sleep, exercising properly and practicing relaxation and emotional awareness exercises.
There are lots of good nutrition books out there. Did you know the precursor to estrogen is protein? Enough vitamins to feed your brain and body is essential as well. Essential oils, herbs and supplements all influence hormonal levels. In the Resources Section is a list of some nutrition and wellness books and websites.
I can’t state strongly enough, if you neglect yourself, you neglect your limbic system, your brain system that is open to the outside world. Your emotional system, the limbic system, affects your HPA axis feedback loop, and this in turn, affects your hormones and neuro-transmitters., which impacts mood.
Self-care is good for you! Good for your body mind and soul!
During pregnancy, addressing your anxiety and fear is a good way to bolster your emotional health during and after birth. Stress drains your body and brain’s hormonal supply. Address the emotional and psychological aspects of pregnancy and lessen the stress on the underlying physical systems. This care directly extends into managing pain and fear during birth (Jones et al, 2012). When you eat well and take special care of yourself with adequate vitamin supplements, you build up your brain’s hormonal stores.
If a woman spends a lot of time in an anxious state prenatally, it will be harder for her to come to a state of trust and relaxation during birth. Antenatal anxiety also is precursor to depression and can set her body up for postpartum depression.
Remember studies show that in a healthy, non-depressed woman, the HPA axis system is in a feedback loop, regulating hormonal levels and keeping physiology and mood in balance but in people with emotional challenges, the HPA axis has trouble physically getting back to normal. So, give your body and brain a break.
Rest and eat well and practice stress management!
Relaxation practices are one way to help regulate your psychobiology.
So, in sum, the psychosocial challenges coupled with physical hormonal challenges of pregnancy and childbirth may set the stage for perinatal or postpartum mood disorders. For example, a pregnant woman with significant life stressors such as miscarriage, grief and loss of a loved one, moving, career challenge, and conflict about her maternal identity, is prenatally challenging her stress response system.
Taking care of yourself prenatally is a great way to help your stress system catch a rest and inoculate yourself against depression and anxiety. If mom becomes depressed, the entire family should rally around her and help her get adequate sleep, nutrition, practice self-care, reduce stress and help her get her hormonal systems back in balance (Jolley & Spach, 2008).