A New Explanation of Postpartum Depression and Postpartum Psychosis

James Howard jmhoward at sprynet.com
Fri Aug 15 09:59:05 EST 1997

A New Explanation of Postpartum Depression and Postpartum Psychosis

At the MSNBC Health Bulletin Board, I was asked if my work could explain 
postpartum depression and postpartum psychosis.  I was able to generate 
an explanation of  these phenomena, and my explanation was posted there 
in "Frontal Lobe and Violence."  Since I think my answer may explain 
these phenomena, I thought it should be posted here, in case anyone is 
interested.  The following contains the question posed to me and my 
James Howard

"Dawn Baynes wrote:
'I do research on woman who go through postpartum depression\psychosis 
and some of the infanticide cases I have studied. Most of these women 
were either very atletic or had male babies. The majority had to be 
induced with pitocin in order to deliver. I would think that the culprit 
could be that these women carry more androgen or testosteron and in 
return lower their progesterone and estrogen --and that would be the 
cause of a lack of oxytocin.  These women also had lactation problems- 
again pointing to oxytocin. Could this be why some mothers go through a 
severe postpartum and have trouble bonding with their child? And could 
this be why they have aggressive thoughts and feelings towards their 
newborns. And quite a few women who get infections of some kind seem to 
experience this illness to. Most of the mothers I talk to--suffer from 
Postpartum Obsessive Thought Disorder- and I would think that the 
intrusive thoughts would be due to a lack of serotonin- and the presence 
of infection and possibly a decrease in estrogen/progesterone and 
increase of androgen\testosterone or a combination of something. 
Unexplained hirsuitism is another symptom.  I'm sure that the hundreds 
of women who commit neonaticide and infanticide are not cold blooded 
murderers!  When I say this I get clobbered by the general public and 
I'm not trying to defend or excuse their behavior but considering a lot 
of  these mothers are religious and pro-life--this is the only thing 
that would make sense to me! I belong to an organization-Postpartum  
Support International-  are you familiar with this group?'

James Howard responds:
I will try to answer your questions.  However, as I do this, it  should 
occur to you, or someone else reading this, that my "work" covers so 
many things.  I think you should have a  brief explanation of this to 
avoid confusion, and this will help you understand my answers.  My 
principle hypothesis is that DHEA acts to optimize transcription and 
replication of DNA.  Therefore, my theory suggests that DHEA is involved 
in the functions of every cell, tissue, organ, body, and can be seen in 
populations.  With that in mind, I will now try to answer your 
questions.  This will be difficult to do, briefly; so, read carefully 
and then put it together.

DHEA is provided for the mother and the fetus from the adrenal glands of 
the mother.  The adrenal glands of the infant do not start producing 
DHEA until birth.  This means that the DHEA provided by the mother must 
provide for all of her tissues and the fetus.  (Since your questions 
refer to the mother, I will not mention the infant again.) At the first 
pregnancy, DHEA decreases significantly in the mother (J. Clin. 
Endocrin. Metab. 1987; 64: 111).  In 1985, because of my principle 
hypothesis, I proposed that low DHEA will result in depression and 
Alzheimer's disease (copyrighted, 1985).  In 1997, DHEA was used in "six 
middle-aged and elderly patients with major depression and low basal 
plasma DHEA."  These investigators found that: "In both studies, 
improvements in depression ratings and memory performance were directly 
related to increases in plasma levels of DHEA and DHEA-S and to 
increases in their ratios with plasma cortisol levels.  These 
preliminary data suggest that DHEA may have antidepressant and promemory 
effects and should encourage double-blind trials in depressed patients." 
(Biol. Psychiatry 1997; 41: 311).

So, just in mothers of low DHEA who give birth, according to my theory, 
one would expect to find depression.  I suggest this is the explanation 
of postpartum depression.  Since you mentioned a number of women who 
required oxytocin (pitocin)for birth, exhibited postpartum depression, 
and infanticide, my explanation is further supported.  Consider this: 
"RESULTS: Oxytocin augmentation followed standard indications in 29 of 
the 55 patients.  The mean maternal DHEA sulfate level was significantly 
lower in these patients than in the remaining 26 who progressed 
spontaneously through labor.  CONCLUSION: Among term nulliparous women, 
maternal serum levels of DHEA sulfate are significantly lower in those 
clinically requiring pharmacologic augmentation than in those 
progressing spontaneously through labor.  Dehydroepiandrosterone sulfate 
may be an important factor in efficient labor."  (Obstet. Gynecol. 1996; 
88: 56)

Furthermore, my theory suggests that reduced DHEA may result in 
psychosis.  At my website, you may read my theory of schizophrenia, a 
developmental problem, I think, is caused by low DHEA.  Schizophrenia is 
known to exhibit significantly reduced DHEA 
(http://www.naples.net/~nfn03605).  According to my work, this low DHEA 
results in the reduced cerebral hemispheres found in schizophrenia.  
Now, it is known that schizophrenia usually occurs in late teens or 
early twenties.  My work suggests that the "availability" of DHEA can be 
affected by two major hormones, cortisol and testosterone.  I think 
cortisol evolved to directly counter the effects of DHEA.  (The 
explanation of this is too lengthy for this post.)  I think testosterone 
causes DHEA to increase the use of DHEA for testosterone target tissues. 
 So, I think that stress  (cortisol) and puberty (testosterone in both 
sexes) causes the availability of DHEA to decrease.  In some 
individuals, whose cerebral hemispheres have not fully developed due to 
low DHEA, this is a time for the appearance of schizophrenia.  (It is 
known that, while stress does not cause schizophrenia, stress (cortisol) 
often triggers it.

Now, in some women who have low DHEA affecting the development of their 
cerebral hemispheres, the decline of DHEA, postpartum, may induce 
psychosis.  In schizophrenics and people with AIDS, both of which 
exhibit low DHEA, the basal glanglia exhibit increased activity, along 
with reduced prefrontal lobe activity (Am. J. Psychiatry 1985; 142: 564 
and Science 1988; 239: 587).  The prefrontal lobes control the impulses 
of the lower areas of the brain, in which one finds the basal ganglia.  
If women whose prefrontal lobes are underdeveloped give birth, I think 
it quite possible that they could loose control and harm or even murder 
their infants.  The midbrain contains more receptors for testosterone 
than the cerebral hemispheres (which include the prefrontal cortex).  
This means to me that "athletic" women may produce more testosterone and 
this effect may cause their midbrains to be more active relative to 
their frontal lobes.  I think it is possible that this may explain what 
you report, above.  These women may loose control and act on it, rather 
than simply show less aggressive symptoms of psychosis.  This could also 
explain lack of bonding.

My work suggests that people, who are prone to infections, are low DHEA. 
 The decline in DHEA of the first birth could result in increased 
infections.  Since the immune system will compete with the brain for the 
available DHEA, the infections could aggrevate already low DHEA and 
possibly induce postpartum depression or psychosis.

I hope this answers this set of questions."

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