Nutritional deficiencies can be a main cause of depression during and after pregnancy

Nutritional deficiencies can be a main cause of depression during and after pregnancy

or expecting moms, a pregnancy is or at least is supposed to be the happiest period in their life.
Yet, for quite a few of them, that isn't the case. By now we've acknowledged that especially postpartum depression is a real phenomenon.
But pregnancies themselves can also be very tough on women: morning sickness, bloated legs, heartburn, aches and pains are very common phenomoenons. Anywhere from 14-25% of pregnant women experience some form of pregnancy depression: a sustained feeling of moodiness or blah, from loss of joy to high anxiety and frank sadness.
 
While the reason for pregnancy depression can be hormonal or psychological, it is wortwhile to look at possible nutritional deficiencies from having to feed a living being inside your body, which would make anyone feel depressed, pregnant or not. 
 

Most common micronutrients of which a deficiency may cause depression

 
Below we list micronutrients that are useful to ingest higher levels of during and after pregnancy. One such micronutrient is the B-vitamin 5-MTHF which most know as folic acid. 
Folic acid is widely prescribed to women who are or want to get pregnant, since it is vital for a growing fetus, but few of us know it is also quite useful in avoiding depression, which is why it deserves to be discussed at length. 
 
 
Omega-3 fatty acids
These essential fatty acids reduce inflammation and play a critical role in brain function, especially memory and mood. 
 
Vitamin D
Vitamin D deficiency is a major epidemic that doctors and public health officials are just beginning to recognize. This deficiency has been linked to depression. Most of our levels drop off during the fall and winter months, since the sunrays are not powerful enough to create pre-vitamin D in the skin. 
 
 
Magnesium
Among the minerals, magnesium is the most commonly found deficiency. Over half the populaition is deficient. 
Our lifestyles decrease our levels: excess alcohol, salt, coffee, sugar, phosphoric acid (in soda), chronic stress, antibiotics, and diuretics. Magnesium is sometimes referred to as the stress antidote. Magnesium is found in seaweed, greens, and beans. 
 
 
Vitamin B6 and B12
B vitamins like vitamin B-6 and vitamin B-12 can provide some incredible health benefits, including reduced stroke risk and healthy skin and nails. On the other hand, a vitamin B deficiency may impact your mental health. More than a quarter of severely depressed older women were deficient in B-12, according to one 2009 study.
The best sources of vitamin B-6 are poultry, seafood, bananas, and leafy green vegetables. 
Vitamin B-12 is found in animal foods (meat, fish, poultry, eggs, and milk) and shellfish, such as clams, mussels, and crab. 
 
Amino acids
Amino acids (the building blocks of protein) help your brain properly function. A deficiency in amino acids may cause you to feel sluggish, foggy, unfocused, and depressed. Good sources of amino acids include beef, dairy, eggs, fish, legumes, seeds, and nuts.
 
Iron
Iron deficiency is pretty common in women. About 20 percent of women, and 50 percent of pregnant women, are deficient in iron. 
Only three percent of men are iron deficient. The most common form of anemia (an insufficient number of red blood cells) is caused by iron deficiency. Its symptoms are similar to depression: fatigue, irritability, brain fog. 
Good sources of iron include (organ) meat, fish, and poultry. 
 
 
Zinc
Zinc is used by more enzymes (and we have over 300) than any other mineral. It is crucial to many of our systems. It activates our digestive enzymes so that we can break down our food, and works to prevent food allergies (which, in turn, averts depression in some people, since some of our mood disruptions are triggered by food allergies). It also helps our DNA to repair and produce proteins. 
Finally, zinc helps control inflammation and boosts our immune system. 
 
 
Iodine
Iodine deficiency can be a big problem because iodine is critical for the thyroid to work as it should, and the thyroid affects more than you think: your energy, metabolism, body temperature, growth, immune function, and brain performance (concentration, memory, and more). When it’s not functioning properly, you can feel very depressed, among other things. 
You can get iodine by using an iodine-enriched salt, or by eating dried seaweed, shrimp, or take an iodine supplement. 
 
 
Selenium
Like iodine, selenium is important for good thyroid function. It assists the conversion of inactive thyroid hormone T4 to the active thyroid hormone, T3. It also helps one of our important antioxidants (glutathione peroxidase) keep polyunsaturated acids in our cell membranes from getting oxidized. 
Brazil nuts are the most abundant food source of selenium.
 
 

Folate is not just vital for babies, but for adults as well. 

Folate (also known as B-9) is a vitamin that is necessary for, among other things, the formation of red blood cells, protein metabolism, cell growth and division, and prevention of neural tube defects. 
In addition to anemia and other health problems, folate deficiency may lead to the development of major depressive disorder (MDD). Similarly, having either a folate deficiency or problem with malabsorption is associated with poor response to antidepressant medications.
 
Folate is found naturally in grains, fruits, vegetables, beans, and other foods. For most people, the synthetic version, folic acid, is absorbed more rapidly than folate; however, it must be converted back to folate to be used by the body.
 
Although folic acid is routinely added to many processed foods, including cereals, energy bars, and breads, the inability to properly metabolize or absorb folate can result in a deficiency — even if one consumes the recommended amount (400 mcg) of folic acid.
 
Specifically, certain diseases, including gastrointestinal disorders like celiac disease, liver disease, and a genetic mutation (MTHFR); alcoholism or excessive alcohol consumption; taking certain medications; being on kidney dialysis; and being pregnant can lead to a deficiency. 
Frequent vomiting due to pregnancy or an eating disorder can also lead to deficiency.
 
Blood levels of folate may not accurately reflect the levels that are present in the central nervous system. In cases where a folate deficiency is pronounced or when a medical issue inhibits absorption of folic acid, the more bioavailable form, methylfolate, is recommended, and often at higher doses than the % Recommended Daily Intake (or Daily Value) of 400 mcg.
 

Methylfolate for treatment-resistant depression

Researchers first began to link folate deficiency with depression in the 1960s. Although everyone feels down or sad at some point, major depressive disorder affects roughly 6 to 7 percent of adults in a given year, and nearly twice as many women as men.
 
Approximately 50 to 70 percent of patients on antidepressants fail to have a remission of their depressive episode. For these patients, clinical trials and case studies suggest that methylfolate can improve response to antidepressants.
 
Furthermore, although atypical antipsychotic medications are sometimes used to augment the effects of antidepressants, these drugs are associated with side effects such as weight gain and dyslipidemia (which can cause elevated triglycerides and LDL cholesterol).
 
Some researchers have advocated the use of methylfolate supplementation for those who don’t respond well to antidepressants alone because methylfolate has not been shown to cause the side effects associated with antipsychotics. In general, methylfolate is well-tolerated.

How does it work?

Methylfolate is the only form of folic acid that crosses the blood-brain barrier and plays a role in neurotransmitter synthesis. It indirectly facilitates the synthesis of serotonin, dopamine, and norepinephrine, three neurotransmitters involved in mood regulation and other important functions. Methylfolate has been shown in several studies to enhance the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), two commonly prescribed classes of antidepressants.
 
In two randomized, double-blind, placebo-controlled trials, investigators examined the effects of methylfolate supplementation on symptoms of depression in participants whose depression was resistant to treatment with SSRIs. 
SSRI dosages were kept constant throughout the study. 
In both trials, patients were assigned to receive either methylfolate, a placebo alone or both for half the time but dosage was twice as large in the second trial at 15mg. 
 
The team found there was no significant difference with regard to benefit across the treatment groups during the first trial in which patients received 7.5mg of methylfolate. 
In the second trial, however, adjunctive methylfolate showed significantly greater efficacy compared with continued SSRI therapy plus placebo in terms of both the response rate and degree of change in depression symptom score, as well as on two secondary measures of symptom severity. 
Methylfolate was well tolerated, with rates of adverse events no different from those reported with placebo.
 
The researchers concluded that adjunctive methylfolate at the higher dose of 15 mg/day may constitute an effective, safe, and well-tolerated treatment strategy for patients with major depressive disorder who have previously had either a partial response or no response to SSRIs.
 

Recommendations 

Folate deficiency or malabsorption due to illness, taking certain medications, or other issues can increase the risk of developing major depressive disorder, as well as make it more difficult to treat. Methylfolate supplementation may be beneficial for those who have major depressive disorder that has not responded adequately to treatment with antidepressant medications.
 
Those who have medical conditions or are on medications associated with poor absorption should consult with their physicians about whether folate supplementation is warranted, and at what dose. A thorough inventory of symptoms should be part of the medical evaluation, as blood levels of folate may not accurately reflect levels in the central nervous system.

Conclusion 

There are many reasons why women can get depressed during and after pregnancy. Hormones raging through the body, sleepless nights, etcetera. Sometimes this requires psychological counseling, but othertimes it can be as simple as making sure to obtain all of the required macro- and micronutrients.
Blog post related items

Get every new article on your mail