A baby’s birth can be an exciting and joyous event but some women may suffer from postpartum disorders following childbirth. This condition can negatively affect, sometimes severely, the mental health of a woman. PPD or postpartum depression is the most common experience women experience after giving birth and it’s mainly caused by hormonal changes occurring during blood loss and during post pregnancy (perinatal depression). Factors such as loss of free time, feeling overwhelmed, and loss of sleep, contribute to PPD.

TCM and Postpartum Depression

In TCM or traditional Chinese medicine, PPD is often explained in terms of Blood: the loss and exertion of blood that happen at childbirth lead to a TCM condition known as deficient Blood. This leads to fatigue, insomnia, mild anxiety, and depression: mentally, the mother may feel unable to cope. She may feel guilty, lose any libido, and become tearful. A more extreme type of deficiency can result in a more serious type of depression with more agitation, mental restlessness, insomnia, and extreme anxiety.

By definition, post-natal depression is depression that emerges soon after childbirth in a previously mentally-healthy woman. It is NOT post-natal depression if the woman was already suffering depression prior to pregnancy and childbirth.

We require adequate body fluids (Yin) – semen, mucus, blood, etc. – to sustain normal internal functions and healthy internal organs. We will become hungry or thirsty and feel dry and hot without this moisture. Because of this, there are not enough body fluids (Yin) to moisten all tissues. This may then lead to problems such as emotional distress, excess acid conditions, blood deficiency, and endocrine imbalances.

Yang deficiency leads to low endocrine function, fatigue, and even infertility. This deficiency can develop if the body lacks Yang energy (by nature, Yang is moving and is the energy that moves Yin fluids throughout the body). The eggs become weak and unable to settle in the uterus; menses either stops altogether (amenorrhea) or becomes irregular. The energies Yin and Yang are vital in supporting life (the fetus a woman carries). Yin is responsible for healthy eggs, sperm, and hormones; Yang is the force that supplies moving energy that keeps a woman pregnant. Hence, any disproportions existing in these processes before the woman becomes pregnant may be aggravated upon birthing and further develop into more imbalances that can manifest physically as well as emotionally.

In TCM, PPD is often clarified in terms of Blood: the loss and exertion of blood that happen at childbirth, the lack of sleep and appetite that often follows delivery, and the demands of breast-feeding, bring about a state of Blood and Qi deficiency, and perhaps Liver Qi Stagnation.

Blood is fundamental for the functions of the Heart; in other words, in order to carry out the heart’s physiological functions, it needs to be nourished by Blood. Also, the Heart is where the Shen (consciousness, mind) resides and when Blood- Heart is deficient, the Shen has no residence (Heart isn’t nourishing Blood so the physiological responsibility of housing the Mind is damaged) and the Mind becomes anxious and depressed. This leads to fatigue, insomnia, mild anxiety, and a state of depression: mentally, the mother may feel guilty or angry, loses her libido, becomes tearful, or feels unable to cope. From deficient Blood, other problems may crop up: in women who are susceptible to deficient Yin and who are also predisposed to deficient Yin, after some time, their condition may give rise to Empty Heat and Yin deficiency. This can lead to an even more severe type of depression with more intense agitation, mental restlessness, insomnia, and anxiety.

After childbirth, issues of psychotic, phobic, obsessive or neurotic behavior can come about usually due to Blood stagnancy vexing the Mind (rather than Heat-Phlegm, which is more common). In such instances, the woman is not only confused but also depressed. She may exhibit phobias, obsessive behaviors and, in severe cases, may exhibit schizophrenic and even psychotic behavior. She may be offensive and aggressive, may have delusions and hallucinations, display suicidal ideations, and even harbor harmful intents against her baby.

PPD Pathology and Etiology

While several patterns of disharmony exist, we will turn our attention on Blood pathologies: 1) Constitutional Predisposition to Emotional-Mental Problems, 2) Blood Stasis post Childbirth, and 3) Excessive Blood Loss during Childbirth:

1. Constitutional Predisposition to Mental-Emotional Problems – Often the reason for the occurrence of mental problems post childbirth, a constitutional predisposition to emotional-mental problems leads to signs that may include a tongue with a deep Heart crack, a “hammer-shaped” tongue, eyes without shen or eyes lacking any glitter, and an extremely swollen tongue with a extremely sticky fur.

1. Blood stasis post childbirth – This condition frequently occurs in women who have a past history of Blood stasis. In the Penetrating Vessel, Blood stagnancy rebels upwards and vexes the Heart (the organ by which the Penetrating Vessel flows): blood stagnancy blocks and vexes the Mind as the Heart houses the Mind and governs Blood. This is an example of Mind Blocked and Unsettled.

1. Excessive blood loss during childbirth – This imbalance often leads to deficient Blood; since the Heart governs Blood and houses the consciousness (Mind), Heart Blood deficiency is unable to house the Mind. In women with a history Blood deficiency, this condition may develop even if the blood loss during childbirth is not that quite heavy. Blood Deficiency will lead to depression that, in turn, leads a case of Mind Weakened; if the Blood deficiency leads to insomnia and anxiety, it may result in Mind Unsettled and Weakened.

Clinical Signs and Treatment

Blood is central to PPD pathology: this may be either due to Blood stasis, deficient Blood turning into deficient Yin, or deficient Blood. For proper diagnosis and treatment, we very much recommend that the woman consult with a doctor of Chinese medicine.

Conclusion

PPD works extremely well Chinese nutritional therapy, herbal medicine, moxibustion, and acupuncture in Spokane. Almost all cases can be treated within a relatively short period of time.