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Can cannabis help with postpartum depression?

Can cannabis help with postpartum depression?

Postpartum depression new mother with baby

Many people use cannabis to help with depression. But is it safe or effective when you’re a new mother?

This article examines the evidence, how to maximize the benefits of cannabis, and explores the risk factors.

Smoking cannabis — or worse yet tobacco — is bad for moms and their fetuses or babies. Many medical professionals may also automatically caution against even using cannabis in non-smokable forms during pregnancy and breastfeeding.

While emerging research is showing that cannabis may be effective in managing the symptoms of depression and other mental health disorders, research into its use for PPD remains largely unexplored and unpublished about.  Here’s what we know.

What we know about cannabis and postpartum depression 

mother sleeping baby
Much of what we know about whether or not cannabis can help treat PPD is anecdotal. (Shutterstock)

Postpartum depression (PPD) is not included as a qualifying condition for medical cannabis in any US state and much of what we know about whether or not cannabis can help treat PPD is anecdotal. Some women who chose to use cannabis for postpartum depression say they did so because standard prescription treatments did not help and the side effects from pharmaceutical treatments were intolerable.

Turning to cannabis as an alternative has helped many new mothers overcome insomnia, anxiety, loss of appetite, stress, isolation, use of more addictive substances as self-medication, and other issues associated with PPD1.

One common reason that cannabis is not recommended for postpartum depression, however, is that the THC and other cannabinoids in cannabis do pass into breastmilk2.

Given the lack of safety information on the impact of cannabis on neonates and infants, breastfeeding when consuming cannabis is not recommended. Of course, if a new mother is not breastfeeding, this is a moot point.

Bottle feeding a baby
Breastfeeding when consuming cannabis is not recommended. Of course, if a new mother is not breastfeeding, this is a moot point. (Shutterstock)

Another reason is that toxic contaminants (possibly from solvents in concentrates or extracts) or from pesticides can have adverse health impacts. Thus, only “clean” products should be used.

The evidence supporting using cannabis for depression in general is more encouraging. At least seven scientific studies have concluded that cannabis leads to improvements in depressive symptoms, although it was not clear if those improvements came from the successful treatment of other disorders3.

While some researchers have concluded that cannabis use is related to an increased incidence of developing depressive disorders, others have found that this correlation balanced out when considering covariates such as one’s socioeconomic status, tobacco use, and an array of other factors45

The effect of cannabis is often individual and varies widely among different people. There are also thousands of cannabis strains, each with a unique profile of active compounds such as cannabinoids, terpenoids, and flavonoids. This makes it difficult to give an unequivocal answer about whether, which type of cannabis, and how much is a suitable treatment for depression.

The need for more research is especially true for women suffering from PPD. 

Postpartum depression: Beyond the baby blues

Postpartum depression
Chemical changes in the brain and other factors can lead to a major depression. (Shutterstock)

Having a baby is supposed to be one of the happiest moments in a woman’s life, but it is also a stressful life change that can have a negative effect on the new mother’s mental health.  Of course this can affect the wellbeing of everyone around the mother, including the new addition to the family. 

Up to 80% of women experience mild depressive symptoms in the first week after delivery, which often last for a couple of weeks to a few months6. But in some cases, chemical changes in the brain and other factors can lead to a major depression that can be temporarily severe or evolve into a long-lasting postpartum depression. One in five of those mothers with PPD will suffer for more than a year.

Postpartum depression affects up to 17% of healthy mothers, making it a leading cause of maternal disability7. Unfortunately, it is incredibly common. It has been estimated that only 20% of women who experience symptoms seek treatment for PPD, making it likely that even these worrying estimates underrepresent the enormity of the problem8.  Furthermore, not seeking treatment means not being able to solve the problem, exacerbating the situation all the more.  

What causes PPD?

  • Physical changes: A rapid drop in estrogen,  progesterone, and oxygen-carrying red blood cells after birth can cause mood changes.  Hormone changes are a known trigger to changes in mood for some individuals.  In addition, before, during and after childbirth there is invariably sleep-deprivation, appetite and energy level changes, and a degree of pain and discomfort which can also affect mood. Furthermore, some women experience medical complications during and after childbirth, including anemia, infection, and nutritional deficiencies. Other physical and social changes, including potential changes in body image and dealing with feelings of resentment of the baby at times, are also likely contributors.
  • Pre-existing conditions: Women who have previously experienced major depressive disorders (including PPD) or anxiety are much more likely to develop postpartum depression9. History of drug use, including cannabis, has also been related to a higher incidence of PPD but studies pointing to previous drug use have been critiqued for failing to consider other contributing variables10.

Symptoms of postpartum depression

  • Mood swings and irritability
  • Frequent crying
  • Insomnia, fatigue, and other sleep disorders
  • Disrupted eating patterns (overeating, loss of appetite)
  • Difficulty bonding with baby
  • Feelings of hopelessness and worthlessness 
  • Inadequately caring for the baby
  • Anxiety, panic attacks
  • Self-harm or suicidal ideation

Current treatment options for post partum depression

  • Therapy or counselling: This treatment option involves meeting with a mental health professional to talk through PPD.  This can be a therapist, psychologist or psychiatrist or other type of counselor. New mother support groups are recommended. 
  • Pharmacological: Antidepressants help regulate chemical imbalances in the brain that contribute to depression. Many of these medications are considered safe to use during breastfeeding11.  Nonetheless, they are often associated with an array of side effects. Starting a medication should be done in consultation with a doctor.  
  • Complementary medicine: Organic food, sunshine, exercise, measuring vitamin D levels, Treatments like omega-3 fatty acids, St. John’s wort, yoga, and acupuncture are sometimes recommended, but there is little or conflicting evidence that they are actually effective. After delivery supplemental iron, folic acid, and vitamin C may be recommended. It’s best to get nutrients from diet. Simple foods including green leafy vegetables, cooked non-spicy foods, fish, eggs, a variety of fresh fruit and vegetables, lentils, and yogurt, hemp seeds, and extra virgin olive oil may provide nutrition. Many women still need iron supplements — especially if breastfeeding and or vegan — for three months after delivery or beyond breastfeeding to restore iron lost in the bleeding associated with delivery. Ask your doctor or nurse.  
  • If you do use cannabis, common sense harm reduction guidelines are: Firstly no smoking! Use clean products and in the lowest doses to get relief. Ask your friends and others who were in similar situations and learn from their experiences. 

 If you think you might be experiencing postpartum depression, contact your doctor.

Sources

  1. Bonn-Miller, M. O., Boden, M. T., Bucossi, M. M., & Babson, K. A. (2014). Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users. The American journal of drug and alcohol abuse40(1), 23–30. https://doi.org/10.3109/00952990.2013.821477
  2. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Cannabis. [Updated 2021 Feb 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501587/
  3. Walsh, Z., Gonzalez, R., Crosby, K., S Thiessen, M., Carroll, C., & Bonn-Miller, M. O. (2017). Medical cannabis and mental health: A guided systematic review. Clinical psychology review51, 15–29. https://doi.org/10.1016/j.cpr.2016.10.002
  4. Lev-Ran, S., Roerecke, M., Le Foll, B., George, T. P., McKenzie, K., & Rehm, J. (2014). The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies. Psychological medicine44(4), 797–810. https://doi.org/10.1017/S0033291713001438
  5. Blanco, C., Hasin, D. S., Wall, M. M., Flórez-Salamanca, L., Hoertel, N., Wang, S., Kerridge, B. T., & Olfson, M. (2016). Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study. JAMA psychiatry73(4), 388–395. https://doi.org/10.1001/jamapsychiatry.2015.3229
  6. Stewart, D. E., & Vigod, S. N. (2019). Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics. Annual review of medicine70, 183–196. https://doi.org/10.1146/annurev-med-041217-011106
  7. Shorey, S., Chee, C., Ng, E. D., Chan, Y. H., Tam, W., & Chong, Y. S. (2018). Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of psychiatric research104, 235–248. https://doi.org/10.1016/j.jpsychires.2018.08.001
  8. Anokye, R., Acheampong, E., Budu-Ainooson, A., Obeng, E. I., & Akwasi, A. G. (2018). Prevalence of postpartum depression and interventions utilized for its management. Annals of general psychiatry, 17, 18. https://doi.org/10.1186/s12991-018-0188-0
  9. Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., & Bahrami, M. (2017). Postpartum depression risk factors: A narrative review. Journal of education and health promotion, 6, 60. https://doi.org/10.4103/jehp.jehp_9_16
  10. Chapman, S. L., & Wu, L. T. (2013). Postpartum substance use and depressive symptoms: a review. Women & health, 53(5), 479–503. https://doi.org/10.1080/03630242.2013.804025
  11. Berle, J. O., & Spigset, O. (2011). Antidepressant Use During Breastfeeding. Current women’s health reviews, 7(1), 28–34. https://doi.org/10.2174/157340411794474784
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