Marijuana And Pregnancy #6: Treating Postpartum Depression
Is marijuana a safe and effective option for treating postpartum depression? In the latest marijuana and pregnancy installation, we look at how the herb may affect you and your baby.
Using marijuana while pregnant is extremely controversial. Many mothers swear by the herb for managing uncomfortable side effects of pregnancy. Yet, when a mother faces the uphill battle of postpartum blues, do the risks of using cannabis outweigh the risks of depression? Ultimately, that’s a very personal choice to make. To help you make an informed decision, here’s the scoop on using marijuana to treat postpartum depression.
What causes postpartum depression?
The hormones released during pregnancy are powerful compounds. Your body undergoes a continuous transformation from the moment of conception to several months after delivery. There are sudden spikes and drops in mood-impacting hormones throughout the process. While these chemical changes affect all women differently, you can bet that you’ll feel a little moody at some point no matter who you are.
After delivery, both estrogen and progesterone levels drop significantly. This can have a profound impact on mood for some women. Coupled with the stress associated with having a child like changes in sleep, the stress of bringing home a baby, lack of alone time, it’s only natural to feel a little unlike your usual self post-birth. In fact, there’s a special term for feeling melancholy postpartum: the baby blues.
But, while most women go through a period of moodiness post-birth, there is a difference between normal ups and downs and full-on postpartum depression. No one knows precisely what causes depression. Like in other mood disorders, however, a combination of genetics, environmental, and biochemical factors are thought to contribute to the condition.
On average 15 to 20% of women in the general population are likely to develop postpartum depression. That number more than doubles if you already have a mood disorder, hovering around 40 to 67%.
Postpartum depression vs baby blues
The baby blues is a period of intense moodiness that typically lasts 3 to 5 days post-birth. The blues can signify postpartum depression if they last more than two weeks. Some of the warning signs include:
- Social withdrawal
- Slowed speech or movement
- Reduced interest in work or things you once loved
While many people joke that all of these symptoms are normal for parents of a newborn, Karen Kleiman explains the situation best in the Psychology Today blog:
We’ve all heard the joke: Is it possible to have postpartum depression after 21 years? She won’t leave the house!! What’s not so funny is that postpartum depression can and does linger. Our clinical experience shows us that it can emerge any time during the first postpartum year and due to the excessive demands – physically, emotionally, biochemically, environmentally – many specialists extend the diagnostic period to the first two postpartum years.
Make no mistake: postpartum depression is clinical depression. It just happens to be triggered post-birth. This really isn’t surprisising, as your body has just undergone extreme and rapid chemcial changes, your sleep routine and normal schedule have just been profoundly interrupted, and there is a lot of anxiety associated with bringing home a newborn. This is all regardless of what an incredibly happy and beautiful experience childbirth truly is.
Clinical depression is biochemical. It’s also an affective disorder. In severe depression, you lose all affect. “Affect” is the observable expression of emotion. To take from Elizabeth Wurtzel’s Prozac Nation:
One day you realize that your entire life is just awful, not worth living, a horror and a black blog on the white terrain of human existence. One morning you wake up afraid that you’re going to live… That’s the thing I want to make clear about depression: it’s got nothing to do with life. In the course of life, there is sadness and pain and sorrow, all of which in their own time and season are normal- unpleasant, but normal. Depression is in an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest.
Depression is not your fault, far from it. An intricate balance between your environment, genetics, and biochemical stressors are what tip the trigger into a depression.
During a depression, you won’t feel or act like your normal self. You may feel inappropriately fatigued, irritable, and find yourself plagued by dark thoughts. It’s of vital importance to seek medical attention if these feelings linger, your thoughts become a little too dark, or your depression interferes with your ability to go about your everyday life.
Can marijuana help postpartum depression?
Marijuana is well-known for its antidepressant effects. In fact, it’s the reason why many patients seek out a medical marijuana authorization. But, when it comes to postpartum depression, some cannabinoids might be better than others. They may also work best when they’re combined with one another. Below is a discussion of THC and CBD and how these two primary cannabis compounds might impact postpartum depression.
When it comes to psychoactive THC, the cannabinoid appears to have both depressant and anti-depressant effects. How can this be? You might be wondering. Well, one 2007 study found that it depends on the dose. In low doses, THC was found to have potent antidepressant effects. In high doses, it was found to actually increase depressive symptoms in animal models.
One more recent, large-scale study found that marijuana use in general (including THC) was not associated with increased depression or mood disorders. The study followed 35,000 people for 3 years. So, while some studies suggest that too much of the psychoactive might make you feel worse, others have found that it has no link to feeling blue. This research also goes hand-in-hand with all of the anecdotal evidence out there that suggests certain marijuana strains are helpful with depression.
The bit of bad news about THC for postpartum depression are the highly debated risks about the psychoactive’s impact on a growing baby. These risks are outlined in more detail below. It’s important to keep in mind, however, that the actual experience many mothers have with THC during pregnancy tends to be quite different from what medical professionals suggest. Many mothers have used marijuana throughout pregnancy and given birth to healthy, thriving children.
For more information, check out this study about the effects of marijuana on Jamaican children who were exposed to marijuana prenatally. The results might surprise you!
Nonpsychoactive cannabidiol (CBD) may provide an alternative to those wishing to use marijuana to combat postpartum depression and avoid the negative potential of THC. CBD has shown tremendous therapeutic potential as an antidepressant, antianxiety, and antipsychotic.
There’s one big problem, however: there are no known studies which examine the safety of CBD in nursing mothers. Because there is virtually no information out there about the risks or longterm impacts of CBD on a developing baby, we cannot really say for sure that it is 100% safe.
What we do know, however, is that CBD works in the body much differently than THC. THC replaces the body’s natural endocannabinoids, anandamide, and 2-AG. CBD, on the other hand, produces positive effects by blocking the breakdown of anandamide and stimulating 2-AG.
The result? More of our own naturally produced endocannabinoids in our system.
Though medical professionals are concerned about THC’s effect on a developing brain, recent studies have found that anandamide is readily passed along to the baby via breast milk, and it’s supposed to be.
In fact, research from Israel has determined that endocannabinoids like anandamide and 2-AG are key to triggering a successful sucking response in animal models. When endocannabinoids were absent, rodent models experienced a condition known as non-organic failure to thrive. They became malnourished due to lack of appetite and difficulty feeding. This can be fatal for humans and animals alike.
So, endocannabinoids in breast milk are a good thing. But, we still do not know if too much anandamide or 2-AG in milk has any significant negative effect, what it actually does in developing infant, or whether or not CBD has adverse side effects if passed along from mother to infant. The isolation of CBD is too new a phenomenon for us to fully be able to understand the effects of this powerful antioxidant.
Marijuana and your baby: the risks
The number one point of contention about marijuana use post-pregnancy is the fact that THC can be passed along to the baby via breast milk. HERB has written extensively about this topic in the article Marijuana and Breastfeeding: A Touchy Subject.
While THC can be passed along to the baby, the research about the extent of the harms this causes is highly debated. Many medical professionals are concerned that THC, when passed along via breast milk, impacts an infant’s brain during a critical stage of development. This has the potential of inhibiting motor skills, and perhaps causing long-term behavioral changes over time.
But, for every study that suggests a negative impact, there is another one that has found no significant changes in behavioral, cognitive, or motor development. For a more elaborate overview of the research, be sure to check out the article.
One potential long-term consequence not discussed in the above-listed article regards excess anandamide in breastmilk. This may be relevant to CBD use during pregnancy, but it is difficult to tell at this point.
Too much anandamide in mother’s milk is associated with an increased risk of weight problems later in life. One 2012 study found that excess anandamide during lactation eventually lead to weight problems in adult rodent models.
In the study, researchers from Chile gave mice pups doses of anadamide during each milk feeding period. They then recorded weight and food intake every 10 days after weaning, into adulthood. They found that the mice who were treated with anandamide “showed a significant increase in accumulated food intake, body weight, and epididymal fat during adulthood when compared to control mice.”
They also found that the CB1 receptor, the cell receptor they anandamide binds to in the body, was expressed an average of 150% more in the anandamide treated mice vs. non-treated controls.
While this study is enlightening, it doesn’t directly answer the question about the longterm impacts of CBD. For one, is there a dose-dependant relationship between the amount of CBD consumed and increase in anandamide? If so, does CBD increase anandamide levels enough to cause any issue? And what about THC? Since it replaces anandamide in the body, does it have the same effect on weight gain?
Further, other studies in animal models have shown that rodents exhibiting depressive symptoms have lower levels of endocannabinoids in their systems. If a mother uses CBD to cope with postpartum depression, is the drug potentially helping to return low endocannabinoid levels to normal? These are questions which only medical professionals can answer, and the political climate surrounding the herb further delays coming to any firm conclusions.
It is true, however, that human beings have been using cannabis medicinally for centuries–including use specifically for postpartum depression. Back in the day, you can bet that the herb our ancestors were using had nowhere near the THC content that we’ve cultured in modern-day cannabis. Though there’s no way to say for sure, it may have contained a more balanced amount of the cannabinoids that we have selectively bred out of the plant in exchange for a more recreational high.
One other major point of concern is the act of smoking around a newborn baby. Though cannabis and tobacco are very, very different plant, burning plant matter produces carcinogen-containing smoke. As HERB has discussed in our article Does Marijuana Increase the Risk of SIDS?, secondhand smoke, in general, is thought to affect pathways in the brain that control an infant’s breathing. This potentially increases the risk of sudden infant death syndrome.
So, if you choose to use marijuana as a treatment for postpartum depression, you might want to step outside while you light up or switch to a different consumption method like marijuana tea, Canna Caps, or other edibles.
Risks of antidepressants
Though there are risks associated with marijuana use during pregnancy, there are also risks associated with prescription psychiatric medications. Many common antidepressants are considered safe to use during pregnancy (especially Zoloft, Paxil, and Luvox).
But, some SSRIs and other mood-stabilizing drugs are also passed along via breast milk. One 2011 review of clinical literature on antidepressant transfer into breast milk found that SSRIs, in general, are found in relatively low concentrations in breastfeeding infants.
Though, many of the studies on the long term effects of antidepressant exposure are small in size. According to a 2009 review:
Data remain limited, correlations with clinical outcome require increased methodological sophistication, and rates of adverse events have not been established. We cannot conclude that undetectable levels of drug have no short-or long- term effects, nor that measurable drug levels in infant serum are associated with adverse events.
The 2011 review reported that suspected effects of antidepressants on a baby include:
- Watery stools
- Decreased feeding
- Sleep difficulties
It’s important to note that these effects were reported for Prozac and Celexa. Otherwise, adverse effects of other antidepressants remain undetermined. Most studies have been conducted in infants under one year of age while long-term studies are lacking.
Impacts of depression on a baby
Yet, while many psychiatric medications (including cannabis) have some type of impact on your baby, so does depression. When a mother is depressed, her newborn is likely to experience:
- Visible behavor changes
- Cognitive changes
- Emotional issues
- Low birth weight
- Delayed psychomotor development
- Poor mother/baby bonding
These symptoms in the baby are often relieved with the mother’s depression lifts.
Because postpartum depression is a serious issue and has potentially long term negative impacts on both mother and child, many doctors will perscribe medication and/or therapy to alleviate the problem. Because of this fact, it’s important for a mother to feel safe and comfortable with her treatment options.
Destigmatizing postpartum depression
Mothers experiencing depression really don’t have it easy. There is an incredibly hash stigma attached to the condition. At the same time, taking antidepressants and other pharmaceutical drugs while pregnant or nursing also holds a certain sigma due to their suspected impacts on the baby. As one mother in a Marijuana.com forum articulates the dilemma:
I have a 5-week old baby boy. I feel like I am getting postpartum depression, not the psycho kind where women kill their kids, just feeling down and depressed. I am breastfeeding and this is a priority to me that I won’t change. I have 3 options… Use medical marijuana to help with the depression and residual pain from the C-section, use prescription antidepressants and pain killers, or just deal with it. I will not give my baby formula.
Whether or not marijuana, particularly high CBD marijuana, can provide a safe, natural alternative for treatment of postpartum depression desperately needs to be evaluated by the scientific community.
Cannabis is already the most common illicit substance used by women during pregnancy. If the harms associated with postpartum depression outweigh the harms associated with cannabis use, then it’s worthwhile to consider medical cannabis for postpartum depression. However, as things stand now, the harms are highly controversial.
Women need to feel safe when coming forward about postpartum depression. They also need to feel safe about the medicines they use to treat it. Many mothers feel like marijuana is the safest choice, which is why they’ve elected to use it during and/or post-pregnancy. Though, this is generally against common medical advice. Because of this is the choice many women feel safest using regardless, fully examining the risks in comprehensive studies is a must. Here’s hoping reliable research will be available sometime soon.
Do you or someone you know have experience with marijuana and postpartum depression? Share your story with us on social media or in the comments below.