Women's Health
4 min read
December 20, 2022
Combatting postpartum depression

Combatting postpartum depression

Postpartum depression (PPD) is a complex condition with biological, psychological, and social dimensions. While conventional treatments are often necessary, a growing body of research highlights several non-pharmaceutical and adjunctive approaches that may safely and effectively support mood, bonding, and recovery during the postnatal period.

Below are alternative methods which have been studied for their efficacy and effectiveness in combating postpartum depression.

Saffron

A double-blind, randomised, placebo-controlled trial was conducted on 60 new mothers diagnosed with PPD. After 8 weeks, results showed that the saffron group experienced a 96% remission rate for postpartum depression from just 15-mg Saffron per day, more than double the remission rate of placebo group ‘Researchers concluded that saffron can have a safe and significant mood-elevating impact for those suffering from postpartum depression who want to safely breast-feed their newborns’ (8)

When compared with antidepressant medications, saffron has been found to have similar efficacy – without the side effects.

Folate

In placebo-controlled trials, folate has been used as an adjunctive treatment to fluoxetine. Findings indicated significantly greater improvement in the folate group, a difference most pronounced in women (14)

94% of women who received fluoxetine, with the addition of folate 500 mcg per day, were treatment responders, compared with 61% of those who received fluoxetine and placebo

It is recommended that women of reproductive age consume 0.4–1 mg folate daily to reduce the risk of neural tube birth defects.

Exercise

Exercise is integral to optimal health in pregnancy, as well as in the prevention of heart disease, obesity, and diabetes, along with other comorbid diseases. Regular physical activity (after selectively auditing through 216 studies) during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, was found to reduce the risk of developing depression in pregnant women and after the birth of a child (6)

Massage

A meta-analysis of 17 RCTs of massage therapy in depressed people concluded that massage therapy is significantly associated with reduced depressive symptoms (11), decreased urinary levels of cortisol (12); and increased urinary levels of serotonin and dopamine (13)

The purpose of this post is to raise awareness and display the vast array of possible paths one could take in supporting their own mental well-being when combatting PPD.

Infant Massages

Infant massage improves mother-infant interaction for mothers with postnatal depression (7)

Seafood

In a large Danish prospective cohort study of more than 54,000 women, participants who were in the lowest quartile of self-reported fish intake during pregnancy were at increased risk of being treated for depression with an antidepressant up to 1-year postnatally (9). Rather than extrapolating this solely to benefits Omega-3, it is important to take into account that sociodemographic characteristics not only influence food availability in house-hold diets but also emotional statue

Bright Light Therapy

In participants who received at least three weeks of bright light therapy each morning for 1-hr had improvements in their depression scores by a mean of 49%; among participants who completed at least 5 weeks, scores improved by 59% (10)

Caveats in this field of research are that the study pools are low most likely due to the ‘cost vs return’ of investing into studies in this sector

References:

  1. J Midwifery Womens Health. 2013 Nov-Dec; 58(6): 643–653.
  2. Lindah l V, Pearson J L, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health 2005;8:77–87.
  3. Phytomedicine. 2017 Dec 1;36:145-152. doi: 10.1016/j.phymed.2017.10.005. Epub 2017 Oct 7.
  4. Clin Obstet Gynecol. 2009 Sep; 52(3):456-68.
  5. Acta Obstet Gynecol Scand. 2001 Mar; 80(3):251-5.
  6. Medicina (Kaunas). 2019 Sep 2 ;55(9). Epub 2019 Sep 2. PMID: 31480778
  7. J Affect Disord. 2001 Mar;63(1-3):201-7. PMID: 11246096
  8. J Integr Med. 2013 Nov;11(6):377-83. doi: 10.3736/jintegrmed2013056.
  9. Strom M, Mortensen EL, Halldorsson TI, et al. Fish and long-chain n-3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort. Am J Clin Nutr 2009; 90:149–55.
  10. Oren DA, Wisner KL, Spinelli M, et al. An open trial of morning light therapy for treatment of antepartum depression. Am J Psychiatry 2002;159:666–9.
  11. Hou WH, Chiang PT, Hsu TY, et al. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin
    Psychiatry 2010;71:894–901.
  12. Field T, Diego M, Hernandez-Reif M, et al. Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behav Dev 2009;32:454–60.
  13. Field T, Diego MA, Hernandez-Reif M, et al. Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol 2004;25:115–22.
  14. Coppen A, Bailey J. Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. J Affect Disord 2000;60:121-30.
  15. Mischoulon D, Fava M. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. Am J Clin Nutr 2002;76:1158S 61S.
  16. Roder C, Schaefer M, Leucht S. Meta analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John’s Wort [in German]. Fortschr Neurol Psychiatr 2004;72:330–43.

Next news

Nutrition is the language of our cells –it dictates how we look, feel, function and perform. It is drastically undervalued when compared the uncountable list of benefits proper nutrition can yield. For this reason, I have decided to write about my top choices of foods that support physiological or neurological changes to favour improved training performance. My initial thoughts were to create a ‘top 10 foods’ article but anyone who knows me, will understand that I really love getting into the nitty-gritty detail.

This will be a 5-part series ranging through meats, nuts, seeds all the way through to vegetables and fruits.

Focal Points

The primary focal point for strength performance is to increase neurological drive (supporting dopamine and acetylcholine production) whilst avoiding any suppression (which would be induced from any GABAergic or serotonergic actions). This will optimise drive, motivation, muscle contraction, muscular tone, focus and clarity whilst avoiding any inhabitation or relaxation.

Other key factors to look at when improving performance would be to ensure that there are optimal levels muscle carnosine levels to buffer PH and offset fatigue, support thyroid function, improve blood flow, support DNA formation, strengthening structural connective tissue and activating the correct pathways to supply the body with available energy stores.

For optimum strength performance, you preferably want to avoid carbohydrates pre-training to ensure there is no pump-induced fatigue and to minimise serotonin secretion – therefore fats and proteins are best choices.

This being said, everyone is individual and what will be highly beneficial for one person may not reap similar effects in another due to food intolerances, nutrient status, hormonal levels and genetic code.

Bone broth – do you even bone though?

This is classed as ‘natures multi mineral’. For thousands of years humans have consumed bones, with theories going as far back as Palaeolithic eras. Bone broths contain bio-available minerals (easily absorbed by the body) such as; calcium, magnesium, phosphorus, silicon, sulphur to chondroitin sulphate and glucosamine.

Cooking bones in a broth releases a combination of nutrients that support:

  • Healthy joint mobility and function
  • Collagen biosynthesis
  • Modulating appropriate immune and inflammatory responses
  • Improved gut health
  • Joint health is a key limiting factor on strength and performance. The neurological system will inhibit strength as a self-safety mechanism to protect the joints by preventing any further damage.

One of the most valuable components of bone broth is gelatin, this acts like a soft cushion between bones that helps them move without friction. Gelatin also provides us with building blocks that are needed to form and maintain strong bones; helping take pressure off aging joints and supporting heathy bone mineral density. Weight training can increase bone density, joint health and mobility but only when it is complemented with an appropriate nutrient regime to feed the specific prosperities to do so.

Another key nutrient in bone broth is collagen, this is found in everything from our joints, bones, ligaments and tendons all the way down to the cellular level. Collagen supports the function of chondrocytes, these are small cells found within the cartilage of joints. Chondrocytes produce mucopolysaccharides and the formation of new collagen that keep joints cushioned and lubricated. Research done by the Department of Nutrition and Sports Nutrition for Athletics at Penn State University found that when athletes supplemented with collagen over the course of 24 weeks, there was significant improvements in joint comfort and a decrease in factors that negatively impacted athletic performance. (Clark KL1, Sebastianelli W, Flechsenhar KR, Aukermann DF, Meza F, Millard RL, Deitch JR, Sherbondy PS, Albert A)

Another powerful nutrient that supports joint health and functionality in bone broth is hyaluronic acid; this acts as a “shock absorber” for joints. It holds water and forms a gel-like substance, lubricating and cushioning joints by surrounding tissues found around nerves (predominantly found in the synovial fluid between joints).

Bone broth is also loaded with glycine. This is classed as a ‘conditionally essential’ amino acid. It is used in the synthesis of haemoglobin, creatine, porphyrin, bile salts, glutathione and the nucleotides DNA and RNA. Glycine is involved in gluconeogenesis (the manufacture of glucose), it helps drive glucose into cells acting similar to the function of insulin. ‘When glycine was ingested with glucose, the plasma glucose area response was attenuated by > 50% compared with the response after the ingestion of glucose alone’ (Mary C Gannon, Jennifer A Nuttall, and Frank Q Nuttall). This means that the athlete with be able to have a slighter high carbohydrate intake to restore glycogen levels, support mTOR, mitigate cortisol and improve training performance.

Glycine also assists digestion by enhancing gastric acid secretion. Research found that only certain proteins stimulate gastric acid secretion, glycine being one (Wald A, Adibi SA.) – thus helping protein digestion and assimilation for enhanced recovery from workout to workout.

Bone broths help mediate appropriate immune and inflammatory responses due to the nature of healing the gut wall (due to nutrients such as proline, glutamine, arginine, gelatin and collagen). This will improve the gut walls integrity and prevent intestinal damage and permeability. If the gut wall becomes permeable, undigested food, toxins and pathogens can pass through the intestinal barrier and into the bloodstream, resulting in a hyper-vigilant immune and inflammatory response to address the ‘foreign invaders’. A healthy response is required for appropriate modulation of training-induced inflammation and endocrine function to enable efficient recovery and optimise super-compensation for growth and development.

Last but certainly not least; roughly 66% of neurotransmitter (chemical brain messengers dictating functions throughout the body) production is made within the gut. If there is any distress or down-regulation in the gut, neurotransmitter production will decrease – resulting in a decrease neural drive.

If the gut wall is inflamed, there is high chance that the brains barrier (blood-brain-barrier) will also be inflamed due to inflammatory stimulation from the vagus nerve, a nerve connecting the gut directly to the brain. This will decrease the brains performance and neurotransmitter reception in the brain.

Go hard or go bone.

Learning to love liver

Organs meats are incredibly abundant in B vitamins, these are essential in detoxification, the citric acid cycle (energy production), neurotransmitter conversions amongst many other key functions within the body crucial for training performance and recovery.

Catechol-O-Methyltransferase (COMT) is one of several enzymes that degrade dopamine, epinephrine, and norepinephrine. COMT introduces a methyl group to catecholamines, donated by the nutrient S-adenosyl methionine (SAMe). Nutrients such as 5-methylfolate (bioactive B9) or methylcobalamin (bioactive B12) support the production of SAMe (Goodman JE, et al. Carcinogenesis. 2001). This is crucial for training performance as the accumulation of too much epinephrine or norepinephrine can lead to over-excitation ‘burn out’ from central nervous system (CNS) fatigue.

Vitamin B12 deficiency is associated with elevated levels of homocysteine (a proinflammatory molecule), fatigue, weakness and adrenal dysfunction (consequently leading to poor energy regulation and a lower androgenic profile).

The recommended minimum intake for B12 is 2.4mcg per day, this is easily hit from beef liver which supplies over 70mcg per 100g (now this may seem extremely high when compared to the RDA, due to it’s nature of being a water-soluble vitamin, toxicity levels are far higher, with no signs of oral toxicity from up to 2,000mcg).

Liver also has a considerable amount of folate (roughly 290mcg per 100g). In 100g of beef liver, there is just over 70% of the RDA requirements for folate (sitting around 400mcg) however this is roughly 3 times less than the optimal levels. We must note, folate is different to folic acid – folate is the bioavailable form that the body actually requires rather than the synthetic version, folic acid, which can place your body under greater amounts of stress dependent if you have a defect in the MTHFR gene. Folate is quintessential for proper methylation whilst also assisting with the recycling BH4 back from its used form, BH2 (Coppen A, et al. J Affect Disord. 1989). This is a key co-factor for the conversion of dopamine (amongst other neurotransmitters) and nitric oxide – thus increasing neural drive and performance whilst increasing the delivery of nutrient-rich, oxygenated blood to throughout the body.

Now I am going to talk about nucleotides, this is a classification of nutrients that are very powerful but unfortunately only known by a minority within the strength and performance world. You name it, Liver is incredibly abundant in this nutrient. They form the backbone of the DNA double helix – this is the most basic genetic material found in the nucleus of a cell that helps forms a blueprint of life. Nucleotides serve varied roles in energy metabolism (integral role of fat, protein and carbohydrates metabolism), enzymatic regulations, signal transduction and as structural components of coenzymes.

Dietary nucleotides are needed by certain cells and their functions for cellular regeneration, largely within the gastro-intestinal tract. Epithelial cells are situated within the intestines, their own production is too low to cover there needs for mucosa growth and its repair process (Sanderson IR, et al. J Nutr. 1994). Within the intestinal flora, specific strains are unable to produce their own nucleotides such as bifidobacterium longum (Rossi M, et al. Arch Microbiol. 2000). The health of the gut dictates your recovery capacity, and you can only train as hard as you can recover. This is done through mediating appropriate immune and inflammatory responses whilst optimizing nutrients digestion and assimilation required for new cellular turnover.

Another aspect how nucleotides can drastically support optimal recovery is the formation of lymphocyte and macrophage cells (Coffey RG, et al. Fed Proc. 1985). These cells are required for appropriate immune function and therefore your management of your biochemistry from training induced stress and inflammation. They have a fast proliferation rate which places a very high demand on nucleotide availability, therefore having a bigger pool of nucleotides means that they have a more efficient production rate.

Nucleotides support the oxygenation of blood, as erythrocyte cells are unable to produce their own nucleotides (Micheli V, et al. Quad Sclavo Diagn 1983). This will increase the circulation and flow of blood around the body to optimize performance and nourish muscles and organs with nutrients in order to heal.

Dietary nucleotides have indirect benefits to support other organs and metabolic processes such as liver function, repairing damaged DNA from oxidative stress and support RNA formation required for the formation of new proteins.

Nucleotides have also been shown to reduce post-exercise immunosuppression and hypothalamic-pituitary axis (HPA) axis activation, whilst also lowering cortisol and creatine kinase (J Strength Cond Res. 2016 Feb) therefore favouring a physiologically anabolic state.

Nutrition
6 min read
Top foods for improved training performance
Top foods for improved training performance
Part 1 of a five-part series exploring performance nutrition through a functional lens. This article examines how bone broth and liver support neural drive, joint health, recovery, and metabolic resilience to enhance strength and training performance.
September 10, 2025

The paradigm of depression being a disease/disorder has evolved around the concept that neurotransmitters are primarily the root cause.

Yet, dysregulation in this field could very well be a symptom, coping mechanism and signal from a multitude of different issues ranging from inside, as well as outside of the body (as explained in my previous post).

The association of depression solely being linked to low levels of norepinephrine and serotonin is flawed throughout studies. There are many other variables that can result in this outcome.

Several studies indicate that as few as 25% of depressed patients have low levels of neurotransmitters, while paradoxically, some patients have abnormally high levels of neurotransmitters with no history of them ever being low.

Does the placement of depression into the category of disease/disorder attach a greater overwhelming thought process to the word than if we were to label it as a symptom?

One could argue that generally speaking, symptoms are alleviated with greater ease when compared with the disease.

It is easy to allow our identity to be taken hostage by adopting the ownership of depression and succumb to its depths.

Yet when we shift our thinking to understand that depression does not embody us as individuals, nor does it yield an element involved in modeling our identity, we shift our thoughts to a greater sense of self-empowerment.

We can overcome the ‘depression vs self’ mentality by accepting that depression is an adaptive and protective mechanism from the human body, accompanied with respect for the opportunity it brings forth to gain further insight into what needs nurturing.

I understand this is a challenging and delicate shift to take, yet the perception of the experience is paramount to one’s thoughts.

Could we disempower the shackling chains of emotional paralysis, gain buoyancy in the swamp of thoughts and restore vitality into one’s behaviour when depression is approached in the light of a symptom?

Can we utilise it as foresight with direction to what may require attention and care within our body and how we live?

This paradigm shift allows more of a harmonious level of awareness with the experience of depression and what possibilities it may bring.

References:

  1. Asberg M, et al. Arch Gen Psychiatry. 1976
  2. Mol Psychiatry. 2010 March
  3. Della FP, et al. Pharmacol Biochem Behav. 2012
  4. Della FP, et al. Behav Brain Res. 2012
  5. Della FP, et al. Metab Brain Dis. 2013

Mental Health
6 min read
Depression: disease or symptom?
Depression: disease or symptom?
Viewing depression as a symptom rather than an identity can foster self-empowerment, insight, and more personalised paths to healing—shifting focus from labels to understanding what the body and mind may be asking for attention and care.
December 10, 2022

Depression is a complex disease with multiple contributing factors. The diagnostic criteria for depression include:

  • Depressed or irritable mood
  • Decreased interest in pleasurable activities and ability to experience pleasure
  • Significant weight gain or loss (>5% change in a month)
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive guilt
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death or suicide
    (Berton O, et al. Nat Rev Neurosci. 2006)

Chances are that you have felt several of the above criteria but yet you may not have associated it with depression.

This is because depression is a broad term that may affect one person differently to the next, along with having a diverse range of possible causations.

Below is a list of some of the factors that can lead to depression and apathy:

  • Trauma
  • PTSD
  • Abuse
  • Post-natal depression
  • Adverse childhood exposure
  • Lack of safety
  • Economic struggles
  • Autoimmunity
  • Social isolation
  • Heartbreak
  • Social media
  • Lack of purpose
  • S.A.D – Seasonal Affective Disorder (Vitamin D deficiency)
  • Mold exposure
  • Anaemia
  • Sex hormone imbalances (Low/high oestrogen, low testosterone)
  • Hypo/hyper thyroidism
  • Stress
  • Pain
  • Chronic illness
  • Genetic traits
  • Methylation issues
  • Heavy metal toxicity
  • Parasites
  • Nutrient deficiencies (B6, etc)
  • Nutrient excess
  • Artificial light exposure
  • Poor sleep
  • Mitochondrial dysfunctions
  • Poor gut health
  • Gut/brain axis inflammation
  • Cytokine model of depression
  • Medication
  • Loss of a loved one
  • Divorce
  • Substance abuse
  • Neurotransmitter imbalances
  • Lyme
  • Toxic and ambivalent relationships

Each reason, being so unique, may require a completely different approach for therapy from the next.

This reverberates a quote of William Osler, stating ‘It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has’. Unfortunately, society generally neglects the beauty of individuality whilst overlooking the crucial interplay and synergy from the multifactorial systems essential for optimal function within our body.

Mental Health
6 min read
The diversity of depression
The diversity of depression
Depression can arise from trauma, physiology, lifestyle, environment, or biochemical imbalance. Because no two cases are the same, effective care depends on understanding the individual—not just the diagnosis.
December 10, 2022
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