The Postnatal Depletion Symptoms Every Mother Should Look Out For
Dr. Oscar Serrallach is bringing attention and a cure to Postnatal Depletion. After witnessing a pattern of chronically depleted patients, his partner Caroline included, Dr. Serrallach began to focus on finding the antidote for this once-taboo topic.
In the interview below we dove into Dr. Serrallach’s tried-and-true methods for tackling Postnatal Depletion and overall maternal wellbeing; a must read for all mothers:
1) What is postnatal depletion (PD)?
Postnatal Depletion describes the set of symptoms of fatigue, poor memory and concentration often associated with hypervigilance, worry, anxiety and depressive symptoms which can occur in the weeks, months and years after the birth of child.
Whilst many of these symptoms can be a normal part of motherhood, they should be short-lived and mild to moderate in intensity as opposed to ongoing and more severe. Postnatal depletion also encompasses the worsening of or starting of a medical condition (especially autoimmunity and allergic conditions) in the months and years after childbirth.
2) What is the difference between postpartum depression and postnatal depletion?
While there is overlap between the 2 conditions there are some important differences:
-2 symptoms that only occur in depression are middle insomnia (being awake in the middle of the night for 1 hour or more and it is not related to child care) and having depressive symptoms 24 hours per day.
-The symptoms with depletion tend to vary both over the course of day and also over weeks .
3) The postnatal period seems to be garnering more press attention recently. Why do you think that is?
I think as a society we see more and more examples of mothers who are struggling and overwhelmed and we live in a world where there is often no down time for the 24/7 of overwhelm. This is uncharted territory in terms of the wellness of our communities and post natal health struggles are just part of this.
Many high-profile people have also spoken out on their personal struggles with motherhood and this is helping many reframe their experiences.
4) Does the upward trend in a mother's age when first becoming a mother make PD (Postnatal Depletion) more prevalent today?
Yes, we are entering motherhood already in a pre-depleted state especially after the very busy lives we typically lead in our 20's. The average age for a mother to have her first baby in Australia is 30.9 and in the USA it is closer to 26 years of age.
This, combined with reduced social support (and high expectations about being able to do things without support), is the perfect environment from which PD can occur.
5) Can you describe how post natal depletion encompasses both psychological and biological issues?
Most people can easy see how biology and psychology are very related and at times intertwined. In post natal depletion, I really focus on how our biology can positively and negatively effect our psychology and focus on the interplay of micronutrients such as zinc and iron, macronutrients such as DHA omega 3 oil, inflammation, diet and hormones. All these can combine to have profound effects on our wellbeing and our psychological state.
I see many cases where the biology drives the psychology.
6) Can a woman take steps to prevent PD while pregnant?
Prevention is better than a cure and my approach to this involves both lifestyle "practices " and supplements.
I think mothers expanding their toolbox to help manage and reduce their stress while they are pregnant is really useful to prevent them from slipping into a sense of unrelenting overwhelm.
Examples would include breath awareness, HEARTmath, guided mediation, yoga, acupuncture and also learning how to prioritize and "book" down time and relaxation.
Life can by busy but there is an art and practice to making sure it does not become overwhelmingly hectic.
In terms of supplements in addition to a typical antenatal supplement, the number one thing I would include would be DHA 1 gm daily for the duration of the pregnancy.
7) Describe your 4 pillars of health, meant to treat postnatal depletion.
The 4 pillars of health are inspired by the idea that we should not only live long (life span) but also live healthy (healthSPAN). So I have used the acronym SPAN, which relates to 4 aspects of lifestyle components that have a major impact on our wellbeing. These lifestyle components are facts of life and we have to have them:
S is for Sleep, P is for Purpose, A is for Activity and N is for Nutrition
Sleep is the non-negotiable part of post natal recovery. You can't ignore or supplement your way around poor sleep. There are many adjustments, practices, herbs and interventions that can make a huge difference for those mothers who are really effected by poor sleep.
Purpose - we all need to have a reason to live and becoming a mother can really challenge or contribute to a mothers sense of purpose. Either way, it needs support and discussion to help a woman integrate being a mother into her life.
Activity - it is important for mothers to be active and have good skeletal and muscular health but it doesn’t necessarily involve what many would consider "exercise". Also her activity should help reduce stress and ideally not increase it.
Nutrition - There is no perfect diet but an ideal diet for each mother. This may change post nataly as I see many mothers becoming reactive to foods that they were previously OK with. There can be changes that are beneficial in terms of changing nutrient ratios of nutrients and eating patterns.
8) What role does breastfeeding and/or pumping play in postnatal depletion?
Breastfeeding can be an enjoyable part of motherhood and really helps baby and mother connect and is ideal for the baby's well-being. It can also offer some help in terms of supporting healthy hormone regulation to allow post natal recovery. I suspect that this is outweighed by the huge demands on a mother in terms of key nutrients, calories and all too often sleep.
Not all mothers are able to breastfeed but all should be supported to do so as the health benefits to baby are considerable.
Breast feeding is a topical and political issue at the moment especially after the US government's opposition to passing a motion to promote breasting feeding at the WHO in July 2018.
The Mother Load is a once per day combination of fat soluble and water soluble nutrients that can really help with recovery from post natal depletion. It contains 6 capsules in prepackaged plastic satchels for ease of taking and transport. One of the key things that make it different from other supplements is the high amount (and correct ratios) of Omega 3 fatty acids especially the super important DHA.
It also has generous amounts of choline, which plays an important supporting role in brain recovery (concentration and memory).
DHA is about replenishing the loss of brain. DHA that is thought to occur during pregnancy and breastfeeding and really helps with reducing anxiety and to a lesser degree depression.
The Mother Load supplement pack also has higher amounts of zinc, iron and Vitamin D which can be synergistic with the nutrients that you would typically find in an antenatal supplement.
10) In your research, have you seen a difference in PD rates in women from other countries/continents? Do you believe policies on maternity leave etc. impact rates of PD?
I can't comment accurately on rates of PD in differing countries and there is so much more research that needs to happen in the field of maternal wellbeing.
When I look at the depth and similarity of many postpartum practices from old cultures from all around the world I believe that the potential to have significant problems post nataly has always been there but I suspect the rates of PD symptoms are very much on the rise in the developed world.
Yes, definitely the more stress and sense of overwhelm a mother feels the more likely she will be of having PD.
11) Is there anything you think society can do/change to help mothers during this postnatal time?
An increased emphasis on the importance of deep support for mothers in the first 6 months after the birth of a child.
This will change as there is more awareness around the research showing the unique changes that occurs in a woman’s body, brain and mind during pregnancy and post nataly.
This includes discussing these changes during antenatal classes and working out a good post natal recovery plan before the birth of the child.
As a society we need to change the conversation we are all having around maternal care and the importance of supporting mothers in those early times. This obviously won’t happen overnight but I am determined to make sure that my kids are living in a society where support post nataly will be much easier to access.
12) In your book you describe how one of your patients was literally running on empty, checking herself out of the hospital with pneumonia to take care of her family. Can you describe a success story, where a patient was able to heal herself and recover from PD?
I see many success stories in my clinic but I have a great one that I think is worth sharing of a mother of a 6 month old who stood up at one of my recent public talks and shared her story.
She had been suffering from severe insomnia since the birth of her child and could not sleep despite her baby sleeping reasonably well. She had never really had sleep issues before and was feeling extremely fatigued but despite this could not get to sleep and was having short periods of light disturbed sleep at best.
She had been to see her doctor who thought she might have depression and gave her a prescription for anti-depressants. She was adamant that she was not depressed and did not take the medication. When her baby was 4 months old she bought my book and read it literally overnight (she joked about having a lot of time on her hands) and implemented everything from the sleep chapter in the book including high dose DHA Omega 3 fish oil, magnesium and Ashwaganda .
She felt she was starting to improve and within 1 month was sleeping fine and felt like her old self. She described both the gratitude of having found her solution and also dread of what might have happened if this option had not been made available to her.
13) Are there a few simple changes that women can make immediately and cheaply that could kickstart recovery? A lot of the time it helps to see a quick early result in order to commit to a program!
The things that can a huge difference quickly are:
a) DHA 2 gm daily for 6 weeks
b) Sleep - prioritizing this for 6 weeks (going to bed early)
c) If iron levels are low on testing having iron orally 30 mg for 2 months and retest (or get an iron infusion if that is available)
d) Curbing social media to 30 minutes twice per day and not checking outside these times.
We thank Dr. Serrallach for dedicated his career to helping mothers! You can find out more about postnatal depletion in his recent book, The Postnatal Depletion Cure published in collaboration with goop.
Get a free copy of The Postnatal Depletion Cure with every order over $100 on Teat & Cosset. While supplies last. Thanks to Grand Central Publishing for their generation book donation.