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Postpartum Depression

From National Institute of Health research

Previously attributed to exhaustion and the demands of motherhood, we now have evidence of specific chemical causes of postpartum blues and depression.

When we are under stress, the hypothalamus secretes CRH (corticotropin- releasing hormone) which ultimately increases the amount of the hormone Cortisol, in the blood. Cortisol raises blood sugar levels and maintains normal blood pressure, which helps us perform well under stress. The amount of Cortisol in the bloodstream is directly related to the amount of CRH released from the hypothalamus.

During the last trimester of pregnancy, the placenta secretes so much CRH into the maternal bloodstream that the levels increase threefold. Endocrinologists speculate that this helps women go through the stress of pregnancy, labor and delivery. When CRH levels are high in the bloodstream, thanks to the placenta, the hypothalamus releases less CRH. Thus, the placenta disrupts the feedback system that regulates normal production of the hormone. After the birth, when this supplementary source of CRH is gone, it takes a while for the hypothalamus to get the signal that it needs to start making more CRH again. For some women, this takes longer than others. For some, it may require a temporary anti-depressant medication to help trigger the normal brain feedback system again.

CRH levels were monitored in women from the last trimester to a year after they gave birth. All the women had low levels of CRH in the 6 weeks following birth. The women with the lowest felt depressed.

These finding reassure that postpartum depression can be a transient phenomenon with a biochemical cause.
 

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