Postpartum anxiety is an ever growing illness, particularly in western cultures and stemming from western lifestyles that create adrenal fatigue, exhaustion, overload and shutdown.  Due to the nature of our culture, more women experience postpartum anxiety than men, but this is certainly an illness that can be seen in dads and other supportive persons of a new baby, depending on the circumstances.

Most women are seeing western medical providers throughout their pregnancy and postpartum so treatment of postpartum anxiety and depression typically takes a western approach with prescriptions like Zoloft and other anti-depression medications.  For many women, they don't want to take this route (especially as the first approach) and are seeking natural and herbal treatment for postpartum anxiety but may not know who to turn to or have been told this isn't the best approach.

I believe you, Mom, and you, Dad, are intelligent human beings that can make informed decisions.  If you're reading this, you're seeking treatment or being active in seeking help for your condition.  Not all families are lucky enough to know that what they're experiencing as postpartum anxiety and depression is anything other than expected and normal.  We've made western mothers and parents believe they should be able to handle life with a baby, that it is supposed to be exhausting, and that baby blues are expected.  I'm calling B.S.

Baby blues are sometimes the first sign that something is wrong.  A mother and father should be nothing other than happy and fairly rested after they have the baby.  If they're not, and this doesn't quickly change, postpartum anxiety and depression are the next step.  We don't wait until the last straw.  We take a holistic preventative approach and then treat with the first signs of any issue.  The fact that western medicine is typically the treatment, however, makes it all that more difficult to accept help since the prescriptions come with side effects like severe depression and suicidal thoughts, nausea, headache, constipation, insomnia, seizure, hallucinations...  Not really the type of first treatment anyone expects.  So while these medications may have their place and time, there are a world of options moms have for natural treatments with postpartum anxiety and depression as well as baby blues and prevention.

General Prevention & Natural Treatment of Postpartum Anxiety and Depression

General wellness is imperative for all prevention and healing of all dis-ease.  You will see these same things repeated over and over and over again throughout Esali Birth.  With these general lifestyle choices, that is often all you need.  "Let thy food be thy medicine" as Hippocrates said - not as a form of treatment, but as a form of prevention.  Your daily (especially long-term) choices allow your body to work well or not.  I know it may not be that easy - but these choices will go along with every single treatment program.  These, of course are pregnancy and breastfeeding compatible.

• Plan for Support - Prior to birth, plan to have someone, or multiple people, help you so that you (and Dad) can rest for at least 3 weeks.  You will have a wound the size of a small dinner plate that needs to heal after birth where the placenta has detached.  Whether this is someone living in with you or multiple people bringing you meals and planning for cleaning for you, the support and rest will help you heal faster and everyone the ability to sleep more, even if that means multiple naps during the day.
• Get help with Breastfeeding - If breastfeeding is not easy, it is easy for this to influence happiness, sleep, and postpartum healing.  Breastfeeding should not hurt.  Engorgement is not normal (common, not normal).  Nipple shields are a clear sign something is wrong with the latch.  Tethered Oral Tissues are real (and bodywork and/or tie revisions can help tremendously).  Many medical providers, even with a "lactation consultant" title or training, do not have adequate experience or skill to support long term breastfeeding.  Get help.  If the tips don't start improving things in 24 hours, seek additional help.
• Tell Your Birth Story - Share your thoughts and feelings and series of events of your labor and birth with someone who will HEAR you, and someone that doesn't try to convince you that "all that matters is a healthy baby."  YOU matter, too.  Your happiness IS your health.  Women desire to share their birth story and being told to supress thoughts (positive or negative) about this life-changing event can lead to significant trauma later in life, confidence, and overall depressive natures.
• Eat Well - Eat adequate greens in all forms multiple times a day.  Eat a rainbow of colors of vegetables and fruits; steam them for maximum nutrient bioavailability.  Eat sprouted legumes, seeds, grains.  Eat minimally processed foods.  Balance your meals with adequate healthy fats, proteins, and carbs.
• Move Well - Strive for walking a minimum of 1 mile a day and make a goal of an average of 3-10 miles a day prior to birth, and after you've healed postpartum.  This doesn't have to be done all at once and remember it is an overall average.  Take a day of rest, take a day for extra activity, sprinkle in movement and walking here and there.  Add in some calf stretches, bellydancing, hiking, squatting, climbing, hanging, lifting and whatever feels good to get your whole body moving more.  It is the movement throughout the day that allows nutrients to be taken to where it needs to go and hormones to flow well through your body.  Lack of movement means poor sleep as well and that causes more adrenal exhaustion and anxiety.
• Hydrate Well - Hydration is more than drink more water.  You can drink plenty of water, but without proper nutrients and movement you won't retain the hydration.  Be sure you're getting all your necessary vitaminerals through balanced eating.  Cucumbers added to your water make great electrolyte balance and hydration balance.  Coconut water is another option.  Lemon water (with the organic peel) improves the detoxification system and reduces toxin overload that often contributes to mood disorders
• Get Sunshine - A minimum of two hours of natural sunshine daily will be more than enough to allow your body to create Vitamin D (for immune support and hormonal balance).  Prison inmates are blessed with two hours of outdoor time daily... I think you can make the choice to achieve that as well and get used to a variety of different weather conditions.  Sure, take it easy sometime - but you'll feel better the more you get outside.
• Rest - You must get adequate sleep and down time.  Sometimes the postpartum period won't allow full rest (particularly without a lot of real support), so lay down and take it easy for a good 4-6 weeks.  Depression symptoms peak around 4 weeks postpartum (also common after a great birth where mom is so energized she doesn't rest or get support).  Nurse the baby, eat, pee, clean yourself up and don't do anything else.  Seriously.  This time period is when a new mom (and dad, ideally) should be pampered.  We were NOT made to do this alone.  We were NOT made to go back to work at 3 weeks or 6 weeks or 12 weeks after having a baby!!!  I know your circumstances may not support the ideal, so do what you can and get support for the most minimal tasks until you feel rested - as long as it takes.
• Self Care - You need time for yourself.  As mothers, our postpartum anxiety might begin with believing we are the only one that can care for our baby, particularly if we're breastfeeding.  You need time away from baby, and your significant other, and other kids, and you need time to be with your own thoughts - especially if dealing with postpartum anxiety.  30 minutes a day minimum by yourself to take a bath, write in your journal, interpret your dreams, go for a walk, do a craft, read.  1 hour minimum weekly with other adults that you enjoy being around (strive for this daily).  1 hour minimum weekly with your significant other while no one else is around (strive for this daily).  Your baby will be OK.  Your baby can be brought to you at any time baby needs you - and be sure whomever is caring for your baby at this time understands the importance of that.  The older your baby gets, the easier it will become for others to find soothing methods that will allow you to have your full 30 minutes and more.  Just can't bring yourself to get away?  Then hang out with a group of people with your baby that will also help you care for your baby.  Learn to babywear (and nurse using a carrier) or a stroller.  A big part of this step is doing something for YOU.  Paint, sing, dance, read, take a bath, go shopping, hang out with friends, hike, boat, ski.  Do something YOU love JUST for you - even if it is little bits at a time.  We'll talk more about this throughout this post.
• Eliminate (or significantly reduce) caffeine, acidic foods, and sugary foods.  All these wreak havoc on the blood glucose, hormonal balance, and hydration levels in the body.  1 cup of coffee or tea may be "fine" daily in western terms, but we're looking at these issues from a more body-supportive approach.  If you're relying on these things to function daily, there are underlying problems.  Some of which are caused by the tannic and acidic nature of the diuretic constituents, fluctuations of blood sugar levels, and suppression of natural energy promoters in the body.  Coffee and black tea (even when decaf and especially when sweeteners and sugars like creamer, sugar, honey, agave, maple syrup...etc. are used) cause significant drops in energy and fatigue for 1-3 days following consumption.  Reduce and then eliminate the consumption of these until they become an occasional treat.  Don't be at their mercy.

For more guidance on general wellness, join the free Esali Birth Prep course valuable for all stages of the childbearing years for happier healthier living.

Chores & Habits for Prevention and Treatment of Postpartum Anxiety and Depression

We were not meant to do life alone.  We are social creatures.  Our civilized culture has made us live apart from people and particularly in America we suffer from independence-syndrome where we're so stuck on being independent we lose connection and help.  You can't really have it all, and it's showing strongly in mothers suffering from postpartum anxiety and depression.  Create a true village for yourself as much as possible.  If that village is just your immediate family, you may find herbal support more necessary.  You may find other treatments more necessary.  Unfortunately, that's the downfall of teaching our children to do things on their own as soon as possible... self-soothe, eating solids, sleeping in their own bed (or crib from birth), off to school, off to college, get your own place to live, live isolated/meet brand new people (often move away)... have a baby and other than "letting the doctor take care of you" you're meant to do life without much help.  Sometimes help from people in our culture is more difficult than not getting help, I know that, so use these tips.

• Hire a Postpartum Doula - Someone that gets life with a new baby, doesn't want to just snuggle the baby (though will if that's what you need), and provides unbiased love and support and house cleaning and errand running and food prep, and pampering and hugs and will leave or come when you need them.  This used to be mom, sister, friend, and mother-in-law - but with our independent nature and strong separation from biological birth and living, we often have to hire these people in our culture.
• Schedule - Keep a calendar with auto-reminders so you don't have to think so much.  Make habits of putting tasks and calendars on a device you use, be it a journal, your tablet, or your phone.  Connect it with the rest of the family as needed.
• Be sure your schedule isn't jam packed.  You may know that you don't want to go to the annual Christmas party this year, but you don't have to go to the family dinner or to church or to all these traditions that are taking your energy.  Heal, rest, do what makes sense for you and your family.  Everyone else will get over it.  Even if "they did this when they had a new baby" - a history of doing too much is a precursor to postpartum anxiety and depression in you and your children.
• Reduce the Laundry - If you work, especially, reduce your clothing options to 2-3 tops, 2-3 complimentary shirts, 2-3 pants, 1-2 shoes plus a few accessories.  Choose all these items with similar colors and patterns to easily mix and match, your accessories can be your wow pieces.  This reduces how much you have to think and how much laundry you have to do.  Same with the rest of the family.  Cycle out your clothes for the season if it helps so you are less likely to have too many dirty clothes at once.  Rewear clothes that actually don't need cleaned.  When your kids can walk, they can help with laundry by at minimum picking up clothes and making sure they go in a basket - make it a game.  The older they get, the more they can do.  My kids (now 9 and 6) have been doing their own laundry for years.  My husband has always done his own laundry.  Yes, we help each other out, but cleaning how is not mom's job even if she's a full-time stay at home mom (particularly during the first 3-6 months and while breastfeeding).  Be realistic and help where it is needed.
• 15 Minutes of Cleaning - Set a timer (or put on some music) once, twice is better, a day for 15 minutes.  We're looking for that 15 minute indication.  Do whatever you can do in the necessary parts of the house (kitchen, main living space, getting laundry started, bathroom, bedroom).  Pick-up, tidy-up, start a load of dishes, sweep the floor... whatever... for 15 minutes.  You might be amazed how much you can get done when you know you don't need to do it all.  You might be amazed how great your kitchen looks with all the stuff just organized.  These 15 minutes give you motivation to get something done and permission to stop when the timer ends.  If you can't schedule this at a specific time every day and you feel like the only time you have is when the baby is sleeping, do it as soon as the baby goes to sleep - but make a rule that as soon as these 15 minutes are up, you will lay down and rest and try to nap yourself.  You're not trying to host a dinner party, you're just looking for basic function with a space to move around in a little better - its all for sanity.
• Clean the Kitchen - At minimum, keep your kitchen clean.  If nothing more than making sure you have a clean surface to prep on and clean dishes, make this a priority.  Kids are great at putting dishes away when they're little, scrubbing when they're older, and loading a dishwasher if it is available.  Sometimes, the dishes might not be totally clean, but they're away in the dishwasher and can be easily wiped off for use.  You're more likely to eat healthy when you have a place to prep.
• Prep Your Meals - Prenatally, use a meal-planning calendar to prepare for your postpartum and stock your freezer with healthy meals that can be heated up when you don't have leftovers or someone bringing a meal.  Prep veggie trays, fruit bowls, healthy snacks, get a salad spinner, make soup and learn to love leftovers (even if they're remade).  Take one day when you have a lot of help, and do as much as you can to prep for the week (or the month).  If you can segment food and freeze it to throw in a pot or crockpot, go for it.  Write down your meal options on a calendar to help with grocery trips and cooking meals (great for dads).  Get your kids to help.  Kids LOVE mixing, chopping, stirring and getting things from the refrigerator and pantry.  My kids help me so much (particularly my youngest) that when I have to prepare a whole meal on my own I'm a little bit lost.  We started them with hook and loop wooden veggie and knife sets, then plastic knives for chopping salads, and watched them carefully with sharper knives at a young age.  Cooking is a life skill that will teach about health, numbers, patience, art, love and social connection.  You can't go wrong.  Have your kids plan the meal if they're old enough.  Even if it's PB&Banana with raw veggies or Spaghetti (with a salad).

Generally, solicit more help for prevention and treatment of postpartum anxiety and depression!  Make a plan to eat an extended family-meal 1-4 times a month. You bring the salad, because it's the easiest (and you know you'll have fresh greens that way) and enjoy someone else's cooking, plus the leftovers to bring home.

Herbal Supplements for Prevention and Natural Treatment of Postpartum Anxiety and Depression

A good whole foods and minimally processed supplement can help fill in the gaps.  Esali Herbal Powders, available in the Esali Shop, include the following herbs for daily use as a supplement.  While I am not recommending specific brands, Mega Foods supplements are whole-foods derived and have high quality business practices if you're looking for a more conventional option as well.  These herbs may be used as a supplement during pregnancy or breastfeeding with guidance from an herbal counselor.  Some women are not comfortable taking kelp during pregnancy because of kelp's high iodine levels, however, in the Esali Herbal Powders Thrive blend the overall amount is quite low.  Of course, you also need to be aware of your iodine intake (i.e. if you eat iodonie-fortified table salt then skip the kelp, or switch to a healthier salt source).

• Nettles (excellent on their own as a tea and soup green as well if you do nothing else - Power Green for hormonal and organ balance, detoxification support, and vitaminerals)
• Spirulina (Power Green for hormonal and organ balance, detoxification support, and vitaminerals)
• Chlorella (Power Green for hormonal and organ balance, detoxification support, and vitaminerals)
• Kelp
• Shiitake Mushroom
• Beet Root (Cardiovascular System Health)
• Cranberry (Urinary & Immune Health)
• Alfalfa
• Wheat Grass
• Barley Grass
• Oat Straw

Adrenal Supportive Herbs for Postpartum Anxiety and Depression

Most cases of anxiety are related in some form to overstimulation for extended periods.  Sometimes the birth, breastfeeding or postpartum period can be the event that is just too much for a taxed body to handle (even if you had a great pregnancy).  Sometimes hormonal imbalances from various causes (unbalanced diet, processed foods, artificial foods, soda, lack of sleep...etc.) causes anxiety.  In either case, daily adrenal support (tea or tincture - whatever you're more likely to take) can help along with being intentional with your daily tasks.  Adaptogenic herbs, those that help the body to adapt to and rebalance during environmental stress through non-specific activity.  In other words, help your body to work more efficiently without targeting a specific organ.  Adaptogens normalize functions of the body (decrease/increase as needed) to help bring your body back to a state of homeostasis.  They mostly achieve this through improved digestion and detoxification by stimulating the liver's functions of converting glycogen to glucose and increasing blood glucose levels, enhancing the entry of glucose into cells, and improving the usage of glucose within those cells while also normalizing the response to stress by preventing exaggerated stress responses.  While some women are comfortable using adaptogens during pregnancy, it is not widely recommended.  These herbs are fine to use while breastfeeding.

• Pare down the schedule.  Learn to say, "No" to others and sometimes to yourself.  Listen to your cycle seasons and support your system by scheduling tasks that fit with your hormonal needs.  During postpartum, this means to treat your season like you would during menses.  Relax.
• If any of your anxiety, unhappiness, or stress is related to communication and parenting, seek alternative parenting methods - Aha Parenting is an excellent website for positive parenting approaches that can really shift the family dynamic and mood for all ages - www.ahaparenting.com
• Adaptogenic herbs in tea or tincture form (1-3 tincture dropperfuls or cups of tea total per day - I like to start with 1 a day and go from there).  Herbs may include (on their own or as a blend): Ashwaghanda, Rhodiola, Holy Basil, Elethero, or Shatavari (this one particularly for women's hormonal balancing).  There are many adaptogenic herbs, these are some of the most common.

Nervine Supportive Herbs for Postpartum Anxiety and Depression

Nervines are herbs that have a direct action on the nervous system through toning and nutrition or easing tension and creating muscle relaxing effects.  In general, the nervous system always needs supported in any dis-ease, but especially through anxiety and depression illnesses.  Some nervines are better for chronic (daily and regular) use and others for acute (immediate short term use).  You will likely add nervines as a daily therapeutic and keep 1-2 options for those really tough as-needed moments.

Nervines for Daily Routine Use for Postpartum Anxiety and Depression

The following are fine to use during pregnancy (with the exception of Motherwort) and breastfeeding.  1-3 doses daily.

• Oat Straw/Milky Oat Tops - This demulcent herb gently, but powerfully, nourishes the nervous system.  Excellent for morning or evening use.  Incredibly mild flavor (similar to oats themselves) able to be blended with just about everything.  If you're looking specifically for the calming aspect, you need milky oats - Avena sativa tinctured while in their milky oat stage.
• Chamomile - Great for tension and stress, particularly when it affects the digestive system.  Great as a before-bed tea (note that steeping it over about 5 minutes will be strong, but it will have a stronger diuretic effect).  Great blended with other herbs.  Can also be infused into an oil for a relaxing muscle rub.
• Catnip - Makes a great mild-tasting tea with a very gentle relaxing effect particularly for abdominal and digestive tension (very useful for kids).  Great blended with other herbs to enhance the relaxing effects.
• Lavender - Either the whole herb or the essential oil.  As a daily routine, lavender in a warm bath (not the essential oil unless it is in a diffuser) or on a diffuser necklace, or sniffed directly out of the bottle or bag.  Great as a bedtime routine to support better sleep - particularly when sleep issues are caused from anxiety.
• Frankincense - The essential oil, especially when used alongside lavender essential oil, can be a wonderful quick-fix for moments where you feel overwhelmed.  I love to just hold both bottles up to my nose and take 3 very long slow deep breaths.  It is effective, quick, and doesn't overuse my oils.  I can do this as often as I'd like to throughout the day, because sometimes it doesn't matter what you do - you have a bad night and need a little pick me up that is nourishing to your body.
• Motherwort - NOT FOR USE IN PREGNANCY - The mother herb and wonderful for mother-related anxiety and hormonal balancing, for PMS symptoms and other hormonal and mood fluctuations are present and particularly when the heart is concerned or where palpitations are anxiety-related.  This is one of the main ingredients in the Esali Birth Mother Me Tea blend available in the shop (with motivational scrolls for a little extra love and pick-me-up).  Heavy and long-term use may interfere with other cardiac treatments.  It is a mild menstrual-promoter and as such should not be used in pregnancy.  1-4 ml tincture of 1:5 solution in 40% alcohol up to 3x daily or 1-2 teaspoons in 1 cup boiling water steeped 10-15 minutes drank 1-3x daily (this one is bitter - be prepared).
• Vitamin D3 - Cholecalciferol- OK, Not an herb or a nervine, but necessary if you're not getting enough sunshine.  You'll feel it in your nerves in terms of anxiety and likely cold, flu and other illnesses. (Fortified milk and juice won't cut it and isn't a part of a balanced diet).  Dr. Weil recommends 2,000 IU of Vitamin D3 daily and for a breastfeeding mom 6100 IU/day of Vitamin D3 is enough for mom and her baby.  There is teetering evidence on if any supplementation of Vitamin D works at all, but no matter what, take it with healthy fats because Vitamin D is fat soluable.  You need sunshine daily in all weather conditions (or extra amounts on days if you know you won't be out the next), but supplementation or full spectrum bulbs might be on your next purchase list.  If you're low in Vitamin D, you're likely low in magnesium as well.
• Magnesium - Oral Chelated Magnesium Glycinate and Topical Magnesium Chloride combination.  This is not an herb or nervine, but likewise necessary for nerve health and if you're not eating a balanced diet (particularly high in wild-harvested green foods) you're likely lacking in this very necessary nutrient responsible for numerous whole body functions.  Magnesium is in many of the tonic and nervine herbs such as Nettles, as well.  For many, topical magnesium is the most readily absorbed.  Flakes in a bath or topical solutions.  If you're low in magnesium, you're likely low in Vitamin D as well.

Nervines for As-Needed Limited Use for Postpartum Anxiety and Depression

* ASTRISK NOTE:  Do not use the herbs noted with an '*' astrisk if you are taking a prescription depression or sedative medication unless under the direction of your care provider.  They can interact and enhance each other - not always the outcome you're seeking.  If pregnant, use these herbs with guidance from an experienced herbalist.

All of the herbs in this section are OK for use while breastfeeding.

• Lavender - This is included in both sections as lavender can be used daily for general support, and the essential oil is great for in-the-moment anxiety relief by taking three very long deep breaths through your nose directly out of a bottle.
• *Skullcap - Makes a great mild-tasting tea with a relaxing effect particularly for anxiety and anxiety-related tension.  Great blended with other herbs.
• *St. John's Wort - Hypericum perforatum - Great for neuralgic pain and other inflammatory issues (often common with anxiety and depression).  Also useful for injuries to the spine, coccyx, and traumatic shock quite common after modern births, particularly in a hospital or birth center where women usually don't labor instinctively (choosing their own positions for labor and birth) or where birth has been induced or augmented.  A long history of perinatal use for anxiety and depression.  Note, reduction of oral contraception efficacy has been noted.  2-4 ml 3x daily of a 1:5 in 40% alcohol solution or 1-2 teaspoon of dried whole herb infused into 1 cup boiling water (pour over the herb) and steeped 10-15 minutes 1-3 times daily.
• *Kava-Kava - Not for long term use.  Heavy long term use may cause skin irritation.  Heavy long term use may cause liver issues.  This is best used on a limited as-needed basis.  When you didn't get much sleep the night before.  When you're having a rough day (or week).  It can be used for mild insomnia and depression and in such cases can be used for a longer period.  This is a great tincture to keep on your person (particularly to alternate with Lavender or if lavender only makes you sleepy rather than anxiety reducing).  Kava can be great for hormonal-related anxiety and depression.  No more than 60-120 mg kavalactones 3x daily.  You know a strong tincture when it tastes nasty.
• *Passion Flower - Passiflora is great as a soother and sedative (often used for insomnia).  Excellent for neurological-related conditions like seizures and Parkinson's disease and other anxiety conditions.  1-4 ml of a 1:5 solution in 40% alcohol about an hour before bed for support while sleeping or up to twice daily for anxiety-related concerns.  Or 1 teaspoon of dried herb infused in 1 cup boiling water (pour over the herb) and steeped for 15 minutes about an hour before bed or up to twice daily.
• *If you're lacking quality sleep, especially if you think yourself awake, a blend of 2 parts California Poppy, 1 Part Valerian, and 1 Part Passion Flower tincture, 5 mL about 30-60 minutes before you want to go to sleep.  Chill for a while and you'll have a more restful sleep which can really change how you feel during the day.

Now, don't let anyone tell you there are no holistic or natural or herbal options when it comes to postpartum anxiety and depression.  Most of these are lifestyle changes.  Sometimes it can be support with other aspects like sleep support rather than specific herbs for anxiety and depression - it depends on root causes and lifestyle.  Sometimes, it is changing our own perspective and our eating/lifestyle choices that can be the hardest.  Once you do (and do it slowly as needed), you'll feel so much better.  I can't say life will ever be easy, but you'll figure out what works for you and everyone will be healthier for it.

If you're looking for support, get in touch!  I'd love to listen to your story and help you find a specific wellness plan that works for your personal constitution and situation.