The role of diet in perinatal anxiety and depression

Keep reading to find out:

• Can diet reduce risk?

• How can what we eat improve perinatal anxiety and depression?

• What doesn't help

• Practical tips and take aways

• Additional resources and support

  
  

This week is Perinatal Mental Health Awareness Week!

So, to raise awareness I wanted to share from my experience as a mum and also share my perspectives as a women's health and eating disorder dietitian on how diet and nutrition can support our mental health during pregnancy and postpartum.

Unfortunately, perinatal anxiety and depression is common.

In Australia 1 in 5 expectant or new mothers and 1 in 10 fathers experience perinatal anxiety or depression.

I am one of those 1 in 5.

Throughout my pregnancy I experienced debilitating anxiety and depression.

It left me feeling isolated, overwhelmed with fear (what impact might this be having on my baby?) and riddled with guilt (how can I feel so low when I am lucky enough to experience something so wonderful?).

It made everyday tasks including eating challenging. Which, alongside morning sickness and then later the increased demands of caring for a new born and breastfeeding, made things even harder and left me feeling low and depleted.

In my experience, seeking and finding the right support from family and counselling helped me through my dark periods more than anything else. So while I wholeheartedly believe what we eat (alongside good sleep, some physical movement and time outside) can help reduce our risk and improve symptoms for some people - it is not a cure. You can do everything "right" nutritionally and still experience perinatal anxiety or depression.

How does anxiety and depression affect our eating?

Perinatal anxiety and depression commonly change appetite, food choices and eating patterns. While it affect everyone in different ways, common experiences include:

• Loss of appetite and eating less

• Eating more

• Weight loss or weight gain

• Higher cravings for "comfort" foods

• Nausea, gut upset or tummy pain 

• Skipping meals due to fatigue, low energy or food anxiety

• Finding it difficult to shop, plan or prepare meals

• Eating more convenient, processed foods

• Have difficulties eating socially

Perinatal anxiety and depression also has a bi-directional relationships with eating disorders. Meaning if you are experiencing an eating disorder it may increase your risk of perinatal anxiety and depression or worsen symptoms. Conversely perinatal anxiety and depression may increase the risk or lead to an eating disorder.

These effects to our eating can also result in micronutrient deficiencies and health implications.

So, if you are struggling - please reach out for support. Personally, I found that sharing the load and letting others look after me both physically and mentally improved my health, the health of my baby and took away some of the mental burden I felt trying to navigate it alone. 

Can diet reduce the risk of perinatal depression?

In short - Yes! But to a moderate extent.

Your gut and brain actually talk to each other (also called the gut-brain axis) which means what we eat can influence how we feel.

Research shows that it is our overall diet (more than individual foods or nutrients) that can have the strongest influence on risk. Diets that contain high amounts of plant foods, fish and less processed foods are associated with lower levels of perinatal anxiety and depression.

Can diet improve symptoms of anxiety and depression?

In short - Yes! But in addition to standard psychological care, medication and other lifestyle changes.

Evidence suggests that making changes to our diets can reduce the severity of symptoms in some people, especially for those who have nutrient deficiencies or high levels of inflammation.

What can help?

1. Be compassionate with yourself and lower the bar - it's ok if you use convenient foods, make simple meals or have comfort foods to help you eat when energy and motivation is low. Look for options that provide more nutrients that also support your health and mood like baked beans, toast with peanut butter, canned tuna, microwavable rice and frozen vegetable packets)

2. Aim to have three meals a day and 2-3 snacks - Regular eating can help keep our energy and hormones steady which can have a huge impact on our mood.

3. Increasing your intake of nutrient-rich foods. You could try:

4. 1-2 different types of fruit or vegetables at each meal

5. A handful of raw nuts as a snack

6. Easy protein sources with every meal (e.g boiled or scrambled eggs, pre-cut chicken strips and tinned legumes or hummus)

7. Swap regular oil for olive oil

8. Opt for more fish - Omega 3 Fatty acids have shown to reduce inflammation and increase our feel good neurotransmitters 

9. Tinned tuna or sardines, frozen fillets baked are all easy ways to eat fish

10. Or choose an omega 3 supplement

11. Consider nutrient deficiencies - Adequate levels of iron, vitamin D and folate reduce the risk of perinatal depression. Correcting levels of these micronutrients has shown to help reduce the risk and symptoms of anxiety and depression.

Other things you can try:

• Eat somewhere you feel comfortable and safe (the couch, outside in the sun, picnic on the floor)

• Eat with someone

• Use meal templates (e.g. Taco Tuesday, Fish Friday)

• Bulk cook and freeze

• Grocery delivery

• Keep up your hydration

• Ask others to prepare a meal

What doesn't help?

1. Trying to get your diet "perfect" - there is no perfect diet and you're not getting it wrong. Food anxiety, rules and restrictions increase stress, so give yourself grace.

2. Processed foods high in sugar and refined grains - these foods are 100% allowed but when they make up the majority of the diet they can increased risk of anxiety and depression and worsen symptoms.

3. Avoiding joy foods - Anxiety and depression often reduce feelings of pleasure, including foods you enjoy and look forward to can help improve energy and mood.

4. Comparison - it can be easy to compare yourself with other parents or people on social media. Let's be honest they are unlikely to show you the struggles they are facing and every one and everyone's pregnancy and parenthood journey are completely different! Try to focus on yourself and how you can care best for you and your baby during what is an incredibly challenging time.

5. Ignoring persistent changes to your appetite or eating - If you are struggling with your eating or weight the best thing you can do is seek support early. Planning meals, shopping, cooking and cleaning all take tremendous motivation and energy. So reach out for support from friends, family or a professional who can give you practical support and advice.

Easy, nourishing, mood-boosting meals to try:

If thinking of what to eat or getting the energy to prepare meals feels hard, here are some quick, low effort, nourishing options that might help reduce the mental burden.

Breakfast:

1. Toast with a boiled egg + avocado

2. Bagel with nut butter + banana

3. Crumpet with cottage cheese and defrosted berries

4. Granola with yoghurt and blueberries

5. Weet bix with milk and tinned peaches

6. Rolled oats topped with peanut butter and berries

7. Smoothies with milk, frozen fruit, chia seeds and rolled oats

8. Chia seed pudding or overnight oats (bulk prepped from the fridge)

Lunch:

1. Wrap with BBQ chicken, cucumber, tomato, avocado and dressing

2. Tinned tuna, microwavable rice cup, steamed frozen vegetables

3. Cheese and tomato toastie

4. Canned soup with wholegrain bread

5. Baked beans on wholemeal toast

6. Ready-made falafel, pita bread, bagged salad and hummus

7. Snack plate - crackers, cheese, dip, veggie sticks, nuts, fruit

8. Leftovers from dinner

Dinner:

1. Baked defrosted salmon topped with pesto served with steamed frozen vegetables

2. Omelette or scrambled eggs with cheese, tomato, spinach

3. BBQ chicken on bread rolls and bagged salad

4. Pasta with jarred pasta sauce, lentils/meat and steamed vegetables

5. Stirfry using tofu, frozen veg, oyster sauce with microwavable rice

6. Tacos using tinned refried beans, lettuce, carrot, cheese and salsa

7. Curry using chickpeas, frozen/fresh vegetables, jarred sauce with microwavable rice

8. Frozen meals - look for options that include meat and vegetables

Snacks:

1. Apple + nut butter

2. Popcorn + glass of milk

3. Hummus + carrot sticks

4. Handful of raw nuts

5. Yoghurt cup or custard pouch

6. Muesli bar + piece of fruit

7. Beef jerky stick

8. Hot chocolate

Looking for additional information and support?

National:

• Gidget Foundation - provides emotional well-being support to new and expectant parents, including counselling and peer support groups.

• PANDA – provides mental health information, services and programs from pregnancy and the first 12 months after birth. PANDA’s national helpline is available 1300 726 306 (Mon-Sat, 9am to 7.30pm AEST)

• ForWhen – a free phone line that connects new and expecting parents or carers to perinatal and infant mental health services and supports in their local area. Call ForWhen on 1300 24 23 22 (Mon- Fri, 9am – 4.30pm) 

• COPE – The Centre of Perinatal Excellence provides information on fertility, pregnancy, early parenthoods, grief and loss as well as information for family and friends and care providers.  

  
  

Canberra Based:

• Perinatal Wellbeing Centre – provide telephone counselling support, support groups, social groups, and education and information to expectant and new parents up to two years post birth.

• Perinatal and Infant Mental Health Consultation Service - supports people who are planning pregnancy, are pregnant or a mother of a baby under 12 months, who have a severe mental health issue.