
Postpartum Depression & Executive Women
I’ve talked many women dealing with depression off the ledge. Going into a high-level intervention I never know what to expect. I must meet each woman where she is at that time. It’s like a white-water raft ride through her neurological architecture, and to me it’s as physically draining as any triathlon.
Navigating depression with a headstrong, independent alpha-type woman who has taken a beating to gain status and recognition is a like climbing Mount Everest in the dark. I’ve learned I must go slowly and watch every step to gain her respect and confidence so that she doesn’t walk away from the help she needs.
Story of a Former Female Executive
The mother of a newborn arrived at our office smartly dressed in a black pant suit, black Jimmy Choo heels and a lime green Hermes purse draped over her left arm. We’ll call her Lynn. Lynn had quit her job as the head of Human Resources for a medical device company so she could focus her energy on her pregnancy. I’ve worked with many women in her position; they are outliers shunned by both men and women as they moved up the ranks of corporate America. These women are damned if they’re executives and looked down upon if they want to become mothers. It’s a confusing time of mixed messages.
Lynn was distraught and scared. She was battling depression while caring for her newborn. She described her symptoms of fatigue, lack of sleep and mood swings. Then she leaned in and whispered, “I wanted to throw my baby down the flight of steps today. That’s why I’m here. I can’t take this anymore and I know I need help.”
Lynn looked into my eyes for understanding and answers. I had to flip a switch to compartmentalize and detach; if I got too empathetic, I’d get lost in non-productive emotions and we’d get nowhere. When you must be actively engaged, knowing one word could send this woman off the rails, it’s draining. I had my game face on full blast.
She continued, “I can’t make my husband happy; I left a job I loved for this shit. I’m fucking done! I have no life. I want to kill myself.”
From the Boardroom to the Nursery
Many of the women I’ve spoken to have admitted that the transition from high-level executive to mother of a newborn was not what they expected. Going from working sixty hours per week and making hundreds of decisions daily to spending time with a newborn with no vocabulary was like living in an altered state of reality. Adapting to this new role can’t be accomplished with a few prenatal classes.
Another stress is that their need for affiliation is not being met. Having a large peer group of friends can be healthy if those friends don’t drain you of energy with their problems. Women avoid talking about the feelings of loneliness that can accompany motherhood because they confuse this completely normal emotional response with selfishness. So many new mothers beat themselves up when they are doing their best.
Partners make things worse when they say insensitive things like, “I’m working my ass off to put a roof over our heads while you’re at home with the baby.” The fathers I’ve worked with are not bad people, they just need to be educated. They misunderstand their partner’s emotions and aren’t great at expressing their own. When probed, the typical response of a frustrated male is something like, “I did everything she wanted. This is on her—from day one, she’s controlled the show. Now I have no fucking idea what she wants me to do. I’m lost!” Ah, after three defensive statements we get to the truth on the fourth. He doesn’t know how to help, and he’s scared.
Educating couples is like a dance. I say this because I’ve been accused of taking sides and this slows their progress when they should be working as a team. They must understand the basic physiology of stress and how physical, mental and emotional stress amplify the fight-or-flight response. This is a first step in symptom resolution.
The Ups and Downs of Female Hormones
During pregnancy, a woman’s progesterone levels elevate, which makes her feel amazing. As soon as she delivers, her progesterone levels crash; it can be that immediate. Some women don’t even want to hold their child. They are worn out, metabolically devastated and want to be left alone.
Many women remain depressed for years after their first child and want to get pregnant again because of that amazing feeling they had throughout the pregnancy from elevated progesterone levels. They want that feeling back because it was the best they’ve ever felt.
Conventional Treatments for Postpartum Depression
The conventional approach to treating depression includes antidepressants and talk therapy with some sleeping pills thrown in. This protocol turns mom into a wounded warrior, numb to the life around her. Psych meds, SSRIs and sleeping pills make you wake up in a haze every day, barely able to put one foot in front of the other. The world becomes a black and white movie, void of all sound and emotion. Forget caring for a new baby when walking to the mailbox seems like a trek across no man’s land.
Depressed women crave foods that I call poor man’s Prozac: white rice, bread, pasta and alcohol. The simple carbohydrates in these foods spike blood glucose and insulin while elevating the neurotransmitter serotonin which relaxes the brain chemistry, lifting depression for a few hours. Alcohol raises estrogen levels which also helps elevate serotonin. Addictions can start with this kind of self-medication; however, the food and alcohol may be the only thing that keeps a depressed patient from pulling the trigger. This will become the new normal for mom if we don’t develop an intervention fast.
We need to stop treating depression with a mono-therapeutic, one-size-fits-all protocol. It doesn’t work. Psychiatric treatments and antidepressants do very little to alleviate symptoms. To correct a multifactorial, gender-specific metabolic process, nutritional and hormonal deficiencies need to be addressed, along with microbiome testing. It should be a combination of interventional endocrinology, cellular biology and nutritional biochemistry.
Women have three different estrogens, progesterone, testosterone, thyroid hormones and adrenal hormones—all of which affect sleep, mood and energy levels. We must start with correcting these hormonal deficiencies before going to anti-depressants. Along with that, we must balance both nutrition and the microbiome to increase the feel-good neurotransmitters (dopamine and serotonin). It’s dangerous to treat just the head and not the metabolism.
Preventing Postpartum Depression
Incidentally, the dominos start to fall before the fetus starts to develop. How is that? Well, the nutritional and hormonal deficiencies of the mother and father PRE-CONCEPTION slow the development of multiple organ systems. Vitamins, minerals, amino acids and essential fatty acids are all needed in the correct ratios to have a healthy baby.
Most executive women are deficient from years of working 60-hour weeks with a poor diet and sleep habits. When the baby is developing, these nutritional and hormonal deficiencies are amplified, accelerating the mining of nutrients from the mother’s brain, heart muscle and bones. The human metabolism is a force still not completely understood by the best PhDs in molecular biology; however, studies have shown that nutritional deficiencies cause birth defects and delayed growth.
Conclusion
So, what happened to Lynn, our Jimmy Choo-wearing former executive? Seventy-two hours after she started her program, she called.
“Russ, this can’t be a placebo effect, can it? I’m already feeling better! My head is clear for the first time in months! How can this be?”
I replied, “You were extremely deficient in progesterone and testosterone. Both are natural anti-depressants. The vitamins and amino acids you’re taking also help make the feel-good neurotransmitters serotonin and dopamine.”
“This is crazy Russ, why didn’t my fucking OB-GYN know about this? You know how long I’ve been feeling bad?! This was just three fucking days! My God, every woman needs to hear about this!”
Every new client I meet has a story and preconceived beliefs I must overcome slowly. While developing Lynn’s treatment plan, I shot two videos on estrogen dominance and uploaded them to my YouTube channel. I knew she was going to tell all her friends so I wanted to have short, powerful videos she could share. Ladies, always ask about getting your hormonal levels evaluated. It’s critical.
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