A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health

Abstract

BackgroundResearch in the field of psychoneuroimmunology (PNI) has revealed that depression is associated with inflammation manifested by increased levels of proinflammatory cytokines.DiscussionThe old paradigm described inflammation as simply one of many risk factors for depression. The new paradigm is based on more recent research that has indicated that physical and psychological stressors increase inflammation. These recent studies constitute an important shift in the depression paradigm: inflammation is not simply a risk factor; it is the risk factor that underlies all the others. Moreover, inflammation explains why psychosocial, behavioral and physical risk factors increase the risk of depression. This is true for depression in general and for postpartum depression in particular. Puerperal women are especially vulnerable to these effects because their levels of proinflammatory cytokines significantly increase during the last trimester of pregnancy – a time when they are also at high risk for depression. Moreover, common experiences of new motherhood, such as sleep disturbance, postpartum pain, and past or current psychological trauma, act as stressors that cause proinflammatory cytokine levels to rise. Breastfeeding has a protective effect on maternal mental health because it attenuates stress and modulates the inflammatory response. However, breastfeeding difficulties, such as nipple pain, can increase the risk of depression and must be addressed promptly.ConclusionPNI research suggests two goals for the prevention and treatment of postpartum depression: reducing maternal stress and reducing inflammation. Breastfeeding and exercise reduce maternal stress and are protective of maternal mood. In addition, most current treatments for depression are anti-inflammatory. These include long-chain omega-3 fatty acids, cognitive therapy, St. John's wort, and conventional antidepressants.

Maternal alterations in the proteome of the medial prefrontal cortex in rat

“…The value of the correlations demonstrated in this study is increased by the lack of previously available specific molecular markers of postpartum depression [45][46][47].…”

“…Thus, Cryab could become a specific molecular marker of postpartum depression, which is missing at present [45][46][47]. Cryab is a member of the small…”

Four Research Findings That Will Change What We Think About Perinatal Depression

“…Recent studies constitute an important shift in how we think about depression, and explain why all types of physical and psychological stress can lead to depression (Robles, Glaser, & Kiecolt-Glaser, 2005). As such, inflammation is not simply a risk factor for depression; it is the risk factor because it underlies all the others (Kendall-Tackett, 2007, 2010. Inflammation is assessed by measuring plasma levels of proinflammatory cytokines.…”

Efficacy of Mixed Attachment Intervention on Postpartum Depression of Women in Isfahan

“…Post-delivery depression is a basic depression and necessitates the simultaneous existence of 5 items disturbing physiological order of the body at least one of which is a depressed temper or losing interest in activities [2]. The exact cause of the disorder is still unknown but bases on different studies in addition to biological factors, the most common factors contributing to this disorder include the age of the mother, unwanted (unplanned) pregnancy, unstable job and income situation, family problems and recent life crises [3,4]. Benig supported by family, having other children and breast feeding are the factors which play an important role in preventing post-delivery depression [5].…”