We have previously discussed the importance of treating depression during pregnancy, given the potential consequences on the developing infant and the delivery. This article focuses on one specific type of treatment – massage – as a means of managing the symptoms of depression.
Massage as a form of treatment can be quite varied, and includes different techniques – Swedish, Chinese, Shiatsu, and others. No one technique has been demonstrated to be superior in pregnancy, so I recommend choosing the one that feels best for you.
Massage treats many different conditions, not just depression. It has been studied as a way to target chronic pain, headaches, and stress. Massage works through the following mechanisms:
- It mediates the hypothalamic pituitary adrenal axis, which includes the cortisol response (the body’s stress hormone), as well as have effects on neurotransmitters such as serotonin and dopamine (two key neurotransmitters targeted by antidepressant medications, in fact).
- Additionally, massage creates a therapeutic relationship between the masseuse and client, and this relationship, like other therapeutic relationship such as with a psychotherapist, also has known positive effects on mood and mental health.
- Finally, touch brings about changes in the oxytocin hormone, which has immediate comfort effects.
Countering Depression with Massage
Pregnancy massage has been shown to decrease symptoms of depression and stress, decrease postpartum depression rates, as well as decrease rates of prematurity and low birth-weight (both potential complications of depression in pregnancy). It has been studied as a primary treatment as well as in combination with other forms of treatment such as psychotherapy.
One way to involve both parents is partner massage. A study found that the partners (fathers) who gave pregnant women a massage also reported lower levels of stress and anxiety. Given the heightened risk of depression in fathers during pregnancy and postpartum (See: Postpartum Depression in Dads), this is an intervention that can help both parents. This investigation also found that both partners report an improved relationship. This last finding could be related to the fact that improved depression in both partners will help the relationship as well as to the fact that setting time weekly for this intimate and health promoting activity also creates a more robust relationship.
Selecting the right provider
While many of the studies of massage as a treatment for depression are small, and those with pregnant women smaller, the initial data are quite encouraging. I recommend massage to my pregnant patients to help with mood symptoms, anxiety, stress, and pain. One important element to keep in mind when selecting a practitioner is to ensure that individual is qualified, well-trained, and with a good reputation to ensure no complications and a positive experience. In California, there is the California Massage Therapy Council, for example, which certifies massage therapists. There is a similar organization in each state, and you can check their website to determine if your clinician is certified. You can also ask your practitioner about their credentials and licensure.
Finally, keep in mind that the first therapist you work with may not be the best fit for you, but try not to get discouraged. Like any relationship, it may take several attempts to find that right fit for you.
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Field, T. et. al. Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships. (2008) Journal of Bodywork and Movement Therapies 12: 146-150.
Field, T. et. al. Massage therapy effects on depressed pregnant women. (2004) Journal of Psychosomatic Obstetrics & Gynaecology 25(2): 115-22.
Hou, W-H. et. al. Treatment effects of massage therapy in depressed people: A meta-analysis. (2010) Journal of Clinical Psychiatry 71(7): 894-