Research published in 2014 shows that:
genetic variation in the oxytocin receptor gene (OXTR) has been implicated in anxiety, depression and related stress phenotypes
You can read more about this and other research on oxytocin, social anxiety and depression in this blog post: Oxytocin and social anxiety, pyroluria and depression?
New research published in the current issue of the journal Frontiers in Genetics now shows that a marker in the blood can identify women who might be at particular risk for postpartum depression (and presumably postpartum anxiety too). This is a genetic variation in the oxytocin receptor gene (OXTR).
Here are some excerpts from the study:
Postpartum depression (PPD) affects up to 19% of women, negatively impacting maternal and infant health.
Reductions in plasma oxytocin levels have been associated with [postpartum depression] /PPD and heritability studies have established a genetic contribution. Epigenetic regulation of the oxytocin receptor gene (OXTR) has been demonstrated and we hypothesized that individual epigenetic variability at OXTR may impact the development of [postpartum depression] /PPD and that such variability may be central to predicting risk.
These data indicate that epigenetic variation that decreases expression of OXTR in a susceptible genotype may play a contributory role in the etiology of PPD.
You can read the complete study abstract here: Interaction between oxytocin receptor DNA methylation and genotype is associated with risk of postpartum depression in women without depression in pregnancy and the full paper here
Here is an extract from the press release:
We can greatly improve the outcome of this disorder with the identification of markers, biological or otherwise, that can identify women who may be at risk for its development,” said Jessica Connelly, an assistant professor of psychology at University of Virginia, who is the senior author of the study. “We know that women who have experienced depression before pregnancy are at higher risk of developing depression in the postpartum period. However, women who have never experienced depression also develop postpartum depression. These markers we identified may help to identify them, in advance.
You can read the full press release from the University of Virginia here: Researchers uncover blood markers to identify women at risk for postpartum depression
The oxytocinergic system is important for both the mother and her child. From a research paper published last month in Anxiety and Depression:
Maternal postpartum depression carries long-term detrimental effects on children’s well-being
when maternal [oxytocin] / OT was medium or low, child [oxytocin] / OT response was negatively impacted by maternal depression
when maternal [oxytocin] / OT was high, child [oxytocin] / OT was unaffected, suggesting that maternal [oxytocin] / OT functionality buffers the effects of depression on the child
You can read the abstract here: Maternal Depression and Child Oxytocin Response; Moderation by Maternal Oxytocin and Relational Behavior
It would be wonderful to see oxytocin levels and OXTR gene testing being done in women planning to have children, especially if they have a history of depression and anxiety, or if there is a family history of depression and anxiety (postpartum or otherwise).
If you’ve had either tested please share in the comments.
It would seem like the use of pitocin during delivery might be a factor. I wonder if they even accounted for the role of pitocin in PPD!
Apparently Pitocin does not cross the blood brain barrier, in theory, but who knows…
Hi GWTW
I’m sure it is a factor for some women.
Per this 2014 paper – BEYOND LABOR: THE ROLE OF NATURAL AND SYNTHETIC OXYTOCIN IN THE TRANSITION TO MOTHERHOOD (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3947469/)
Synthetic oxytocin [pitocin] is widely used throughout labor and postpartum care in modern obstetrics. Yet research on the implications beyond labor of maternal exposure to perinatal synthetic oxytocin is rare
Research questions abound regarding the long-term implications of manipulating the oxytocin system during childbirth – an intricate transitional window of time for both mother and infant.
Thanks for the link! Will check it out!
Being a L&D nurse for over 30 years, I witnessed the change from Oxytocin Stress test (where IV was started and Pitocin given until contractions started, to monitor fetal response, fetal wellbeing) to Nipple stimulation stress test. So simple, a fetal monitor placed with baseline FHR/Variability, then she simply rubbed her nipples until contractions started, and they always did. NO IV’s, and when she stopped rubbing, the contractions went away. My suggestion to increase oxytocin is simply to rub nipples every day, or use brush (as I do with my daily morning dry brushing head to toe, while watching the sun rise). Its free, and I can usually get my husband to help, and rub his as well to get his Oxytocin working too.
I am VERY concerned about the cavalier use of pitocin in hospital births. The medical establishment’s use of pitocin and the opiate cocktail of epidurals seems to be used in a high percentage of births without any thought to the potential long-term consequences (which are not studied and obviously unknown at this time). It’s not that these two tools might not be necessary some of the time (because sometimes births are complicated and may need some assistance), but certainly not the majority of the time. Expectant parents get absolutely no unbaised information about the potential risk of these drugs for the immediate labor/birth and certainly no information from the hospital that these meds could potentially affect the neurological/psychological health of the mother and/or baby. As a natural childbirth educator, my students really have to work hard to avoid these drugs in a hospital birth even when things are going normally.
I can’t wait to read these studies, Trudy. Thank you so much for posting them. There are a lot of things which can affect postpartum depression. I think number one on the list is that mothers in the U.S. usually have no support system in place and get next to no maternity leave. In countries where women have the support of their families (meaning other women to support them, feed and care for the mother/baby pair during the transition to motherhood) postpartum depression is very rare. It’s nice to study about oxytocin, but maybe a few cultural changes would make a big difference — if only we could use the money that spent on studies to support new families instead, maybe that would make a big difference : )
Susan
Thanks so much for sharing your concerns about the “cavalier use of pitocin” and epidurals. I agree it is very concerning and we appreciate your efforts as a natural childbirth educator and helping women be aware of the potential issues.
Do you have stats on how frequently pitocin is used? and the issues you have seen with it’s use?
I love your proposed solution: cultural changes to have support systems in place! How wonderful!
I would have to add (and I’m sure you’ll agree): being well-nourished before falling pregnant (for both mom and dad)
This is me. My first born was Csection and I have never been the same. I lost all interest in sex and spent the rest of my life depressed. I had a tubal following my second birth, vaginal, thinking it was because I feared getting pregnant. But nothing seemed to help. I am now 59 and nothing has changed, I am depressed/anxious, I have health issues etc. I am concerned because my daughter is now planning to get pregnant. I worry about that. So what is a person to do about this? How can you turn this around or prepare?
Hi Candy
I am sorry to hear this.
Having the OXTR variation is just one possible contributing factor but you could both get checked for this (via 23andme). Having the variation/polymorphism doesn’t necessarily mean it’s expressing and you’ll have issues.
There are many nutritional/biochemical aspects to postpartum depression and anxiety and ways to help – I address this here: Nutritional interventions in postpartum depression and anxiety https://www.everywomanover29.com/blog/nutritional-interventions-postpartum-depression-and-anxiety/
My advice for anyone wanting to fall pregnant is to be well-nourished and free of toxins before falling pregnant. This means working with a nutritionist who is an expert in pre-pregnancy preparation. And then, as Susan says, provide post-partum family support.
For you, I would not give up hope of finding a solution for your anxiety and depression.
I forgot to mention that I don’t know if I had pitocin. I don’t think so but not sure. Is it used routinely? Does it get used for c section? Don’t know.
Hi Candy
According to this article by Chris Kresser: “Official U.S. figures state a 22.3% induction rate in 2005, which is more than double the rate in 1990. In Australia rates were 25.6% in 2005, and close to 20% in England (2005) and Canada (2002).” http://chriskresser.com/natural-childbirth-vi-pitocin-side-effects-and-risks/
Is this OXTR gene something I can find in my 23 and me data? I have long wondered if my oxytocin levels are low and why. Thanks for the info.
Hi Sharon
You’ll see it in the raw data file as rs53576.
23andme have a blog post about it too: http://blog.23andme.com/23andme-research/snpwatch/snpwatch-we-care-a-lot/
“Studies have suggested that people who are either AA or AG at are more sensitive to stress and have reduced social skills compared to individuals who are GG”
I’m going to do a blog post/survey to see how often we see the AA/AG when someone also scores high on the pyroluria questionnaire https://www.everywomanover29.com/blog/pyroluria-questionnaire-from-the-antianxiety-food-solution/
I’d love to hear if you are AA or AG and your pyroluria score? And why you have long wondered if your oxytocin levels are low?
You can also test oxytocin levels: Dr Woeller uses the Meridian Valley Lab 24-hr urinary oxytocin test which, according to them “is the best method to capture the pulsatile peaks and valleys of oxytocin production.” You can order the test (and interpretation) via his testing site Lab Tests Plus (links are on this blog https://www.everywomanover29.com/blog/oxytocin-social-anxiety-pyroluria-autism)
Hi Trudy – it turns out I am GG. I thought I might have oxytocin issues b/c I’ve noticed that I do not feel great love towards my family -even my children. Yes I love them but I’ve never had the strong physical feeling of love (except immediately after my dtr was born. On the pyroluria questionnaire I scored 21 out of 29 for most common symptoms. Since the anxiety summit I have been taking zinc and B6 as well as the methylfolate and B12. Thank you for hosting the summit – I have learned so much.
Hi Trudy, ever since falling pregnant with my son 5years ago I have never quite felt the same. I had pre natal depression and then post natal depression. My ferritin levels were really low and then only discovered this late on in the pregnancy. I now suffer with GAD I am generally very fit and healthy. I have spoken with my gp about this many times and all they ever suggest is anti depressants. I tried sertroline 50mg and I had a really bad reaction to it so I don’t see them as an option now. I have seen a naturopath and a medical herbalist, they have both helped but it is still there. Please can you suggest anything that I can do or take that would help? Any tests that I could have maybe? I have had 5 years of it now and enough is enough. Look forward to hearing from you.
Thanks
Emma
Emma
Sorry to hear this. I’d address the low ferritin to start (and why it’s low – heavy period, low iron diet, gluten issues etc). We need iron to make serotonin and GABA.
I’d also look at the amino acid questionnaire https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution and consider trials of tryptophan and/or GABA
Post partum anxiety and depression can also be related to low zinc/high copper so I’d address this too – zinc is also needed to make serotonin and GABA.
This article was really important for me. Bingo! I finally understand what happened to me 25 years ago: I had my first child, no contractions, after 15 days passed to the end of term of my pregnancy I was obliged to accept to induce contractions as I had none. After that I experienced 9 months of very severe post- partum depression that was not treated as at that time post-partum depression was only during the first few days so ” it could not be”. I used to be a very positive person and I became frightened and insecure and I never recovered completely. Since then I was never again the same person. I had my 2 nd child, no contractions again but this time the depression was not so severe. I became really different after this and I wonder what test/ treatment I should do to
Al
I’d find a functional medicine practitioner and get a full work up done looking at cholesterol, iron/ferritin, zinc, magnesium, vitamin D etc. And do all the basics (like no gluten, gut health, no sugar etc) and look at pyroluria and low serotonin/low GABA.
Dr Walsh talks more about postpartum in his interview next week so do tune into that one
Doctors tried to induce delivery of me in 1955. My mothers sister was a nurse and her husband a ob/gyn (along with their friend, my mothers ob/gyn). The reason… My aunt was in town and they thought it would be a good idea. It didn’t work. They said I refused to come out. I was born 5 weeks later with normal delivery. I was a painfully shy and clinging to my parents legs for many many years. The family joke was that I just didn’t want to come out, that my behavior outside the womb mirrored my behavior inside.
So reading this is a big aha for me. Makes sense.
Jaci
I’m glad you’re getting answers! If you still find shyness/social anxiety to be an issue I encourage you to look into pyroluria (https://www.everywomanover29.com/blog/pyroluria-questionnaire-from-the-antianxiety-food-solution/) and amino acids (https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/)
This is a huge help to me , my first baby 24 years ago came out very fast and in 2 pushes I had a wonderful time bonding. My second baby 22 years ago I had an epidural and severe post pardom 3 nervous breakdowns that lasted 6 weeks in bed panic attacks crying and shaking no energy. I finally gave in to taking Paxil and then cipralex been a very nervous driver and passé go and never been quite the same
Christy
Sorry to hear this but glad this blog is helpful. Even if you don’t know if you have variations in the OXTR gene, it’s always worth looking into nutritional factors such a low GABA and low serotonin, plus diet (no gluten, no sugar, no caffeine, no alcohol), adrenal health, blood sugar control, gut health, toxins, low zinc/high copper (very common postpartum) and so on. My book “The Antianxiety Food Solution” is a great place to start and this blog is a wealth of information (use the search feature). Here is an article on low serotonin https://www.everywomanover29.com/blog/tryptophan-worry-head-ruminating-type-anxiety/
It’s never too later to find solutions!