Women’s Health Today

Omega-3s and a woman’s mental health during pregnancy, postpartum and beyond

Becoming a mother can be wonderful—and highly stressful. Sleepless nights, breastfeeding difficulties, a history of abuse or trauma, low partner support, or a baby with health problems are all stressors that can put you at risk for depression. Fortunately, there are some steps that you can take to help you cope.

You are what you eat

Your inflammation levels are also more likely to be too high if you do not have enough Omega-3s in your diet. Most people do that by eating fish. In countries where people eat between a pound and pound and a half of seafood per week, men and women have significantly lower rates of major depression (Tanskanen et al., 2001), bipolar disorder (Noaghiul & Hibbeln, 2003), and even suicide (Sublette et al., 2006) than in countries where people eat less than that amount. Fish consumption also impacted rates of postpartum depression in a study comparing rates of PPD in 22 countries (Hibbeln, 2002).

Omega-3s also lower inflammation by lowering the number of cells in our blood stream that cause it (known as pro-inflammatory cytokines). Researchers found that people with high levels of Omega-3s in their blood had low levels of inflammation. In contrast, people with low levels of Omega-3s had higher levels of inflammation (Ferrucci et al., 2006). Interestingly, when pregnant women who were at risk for preterm birth were given eggs enriched with an Omega-3 (DHA), the length of their pregnancies increased by an average of six days (Smuts et al., 2003).

Pregnant and postpartum women are especially likely to be deficient in Omega-3s because babies need these fatty acids for their developing nervous systems. Writing about mothers in Australia, Rees and colleagues (2005) observed that babies need about 67 mg a day of DHA for their development. In contrast, Australian mothers were consuming about 15 mg a day—well under what was required. Mothers’ bodies will divert mothers’ stores of DHA to their babies while they are pregnant. But as a result, mothers’ stores become more depleted with each pregnancy, further increasing their risk of depression (Freeman et al., 2006).

Omega-3s are not created equal

So how can you get more Omega-3s in your diet? Go into any well-stocked supermarket and you will see a dizzying array of foods that are fortified with Omega-3s: eggs, cereal, soy milk, snack bars, orange juice. It seems to be today’s new “super supplement.” With regard to depression, Omega-3s are not all created equal. If you are interested in Omega-3s for depression, it’s important to know what you are buying. Many products that list Omega-3s contain alpha-linolenic acid (ALA). ALA is the Omega-3 found in flaxseed, walnuts, and other plant sources. It is an essential fatty acid and is beneficial to cardiovascular health. But it is not effective in either the prevention or treatment of depression (Bratman & Girman, 2003). If you want the anti-depressant effects of Omega-3s, you must look for foods or supplements containing the long-chain Omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Fortunately, there are many sources of EPA/DHA that are safe to take while pregnant and breastfeeding. In fact, I prefer to recommend the supplements over eating more fish because it is impossible for consumers to tell whether fish contains contaminants. Supplements, in contrast, are specifically tested for them.

Some supplements contain DHA alone, which can help prevent depression. Fish-oil supplements contain both EPA and DHA and have been used to treat depression, sometimes in conjunction with medications. If used with medications, they boost the effectiveness of the medications. Sources of both pharmaceutical grade and over-the-counter fish-oil products verified by the U.S. Pharmacopeia are widely available (see list below). Be sure to discuss any supplements you take, including Omega-3s, with your health care provider as they can potentially interact with a small number of prescription medications.