The relationship between perinatal circadian rhythm and postnatal depression: an overview, hypothesis, and recommendations for practice

Abstract

Postnatal depression (PND) is an important public health problem with far-reaching consequences for mothers, families, and society. Current treatment approaches tend to focus on the depressive symptoms of the mother. We propose the need for a shift in the conceptualisation of PND and its management, by focusing on circadian rhythm as an early manifestation of mother-infant synchrony. We have reviewed the relevant interdisciplinary literature to formulate a hypothesis and suggest recommendations for practice. We hypothesise that, after a mother’s circadian rhythm becomes ‘desynchronised’ immediately following birth, persistence of this disruption is implicated in the development of PND. This has important implications for novel treatment strategies in the critical and vulnerable postnatal period, for example the use of outdoor-based interventions and light.

Trajectories of sleep quality and depressive symptoms in women from pregnancy to 3 months postpartum: a prospective cohort study

“…Several explanations could account for the co‐occurrence of poor sleep quality and depression in the perinatal period, including disruptions in biological pathways, such as reproductive hormonal changes, physical discomfort, and circadian rhythm changes (Bei et al, 2015). In particular, increasing evidence suggests the potential connection of circadian dysregulation in the pathogenesis of postpartum mood disorders, thus highlighting the influence of sleep regulation following birth on the development of depression in the postpartum period, which is a vulnerable time with changes in maternal sleep, mood, and circadian rhythm (Gallaher et al, 2018; Hall et al, 2022). Further, mothers’ beliefs and thoughts about sleep and their cognitive arousal have been associated with their sleep disruption, which can predict the risk of depressive mood (Kalmbach et al, 2021).…”

Co-designing a nature-based intervention to promote postnatal mental health for mothers and their infants: a complex intervention development study in England

“… 9 10 The therapeutic benefits of such interventions may be particularly useful for mothers and their infants. 1 Benefits include enhancing nature connectedness (which correlates positively both to overall wellbeing 11 12 and pro-environmental behaviours 13 ), an enriched sensory diet, increasing exposure to natural light, 14 increasing physical activity, 10 15 providing opportunities for shared attention and enjoyment, and enhancing parental self-efficacy. 16 Therefore, nature-based interventions may represent an engaging, sustainable, inclusive and scalable approach to supporting the mother–infant dyad in the postnatal period.…”