What is oxytocin?
Oxytocin is a neuropeptide made in the hypothalamus, a regulatory center in the brain. It is involved in labor and breastfeeding. It helps with uterine contractions and with milk letdown. It has been studied for its role in maternal child attachment and more generally social relationships in all mammals. Several studies have shown that the oxytocin system is disrupted in depression. And it is now being studied in postpartum depression.
How are oxytocin levels different in depression?
Studies show that plasma levels of oxytocin are lower in patients with depression. Lower levels measured during the third trimester of pregnancy has been correlated with postpartum depression. Lower levels during the first trimester have also been associated with PPD symptoms and impaired attachment between mom and baby. Mothers with lower levels of oxytocin are less affectionate and less responsive to their infants. In animal studies, this manifests as less grooming and pup-licking behaviors. In human studies, this manifests as less gaze and interaction with the baby, less affectionate touch, and less positive emotions. This is crucial because that relationship is so essential for an infant’s development and can also impact an infant’s oxytocin level.
Oxytocin, breastfeeding, and depression
Many of my patients who struggle with breastfeeding describe symptoms of depression. These include anxiety, guilt, and excessive fatigue. Studies also show this – women who have significant pain and difficulty with breastfeeding initiation or those who stop breastfeeding earlier than they planned have higher rates of depressive symptoms. The reverse is also possible – a woman with depression may, in turn, have more difficulty with breastfeeding.
Oxytocin is involved in milk let-down and the maintenance of lactation. If impaired, a woman may have difficulty with breastfeeding. And, if impaired, there is a higher risk of postpartum depression. Therefore, the difficulty with breastfeeding as a risk for postpartum depression is in part due to underlying oxytocin problems.
Can oxytocin be used to treat postpartum depression?
Oxytocin can be administered intranasally. Several studies have attempted this mode of treatment to see if symptoms of depression improve. The results have been quite inconsistent, in part likely because the studies are quite small. Therefore, right now it is too early to use oxytocin as a treatment for depression, but research is ongoing. It is possible we may soon also be able to use measurements of oxytocin levels to predict postpartum depression for certain women. That can help us institute measures to decrease that risk and minimize the potential for PPD development.
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Jobst, A. et. al. Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms. 2016. Arch Womens Ment Health 19: 571-579.
Moura, D., Canavarro, M.C., Figueiredo-Braga, M. Oxytocin and depression in the perinatal period – a review. 2016. Arch Womens Ment health 19: 561-670.