Are You Feeling Depleted?

Before having kids, I had a lot of energy and felt very healthy. But now, with a 4 year old and a baby, I'm run down, I get colds frequently, and my menstrual cycle has gotten more intense. My doctor's sympathetic but says I'm fine. What do you think?

We think you are trying your hardest and that you feel the way you do for very concrete, physical reasons. Understanding them gives you clarity and sends guilt packing. Plus it points you toward effective ways to feel less stressed, stay energetic and healthy, and build teamwork and intimacy with your mate.

Think about it: motherhood is profoundly fulfilling. But it is also the most relentlessly stressful and demanding activity most women - or men! - will ever do.

"The hardest job in the world" gets done day after day for twenty years or more. And it's all the more demanding the more kids you have, or if any of your children have special needs like a challenging temperament, disability, or health problem.

Some dads are great: they're engaged with the kids, do their fair share around the house, and are loving with their wife. But let's face it: many are not. The average mom works about twenty hours a week more than her partner, regardless of whether she's drawing a paycheck. And if you're rearing your children essentially alone, as do one in five mothers, you're getting little to no help from a partner at all.

Plus most mothers are living today in a world that is vastly different from the hunter-gatherer culture that humans are adapted to for raising a family. In a tribal or village setting, a mom's life moved at the pace of a walk with her children nearby. She was surrounded by other mothers or relatives who could lend a hand with her kids, her stresses were intermittent instead of chronic, and the delicate biological machinery of reproduction wasn't exposed daily to man-made chemicals. Sure, we're not proposing a return to the Stone Age, but there is no way around the harsh fact that today's frantic pace, lack of supportive community, scary culture, need to juggle work and home, toxic pollutants that even appear in breast milk, etc. all wear on a mother's body and mind.

It all adds up over time. You're pouring out more and handling more stresses, but taking less in. It's no wonder if you feel used up, emptied out - in a word, DEPLETED. Besides being a psychological experience, depletion occurs in the bodies of many, many mothers. Laboratory tests commonly show that mothers have dangerously low levels of key nutrients and that important bodily systems (e.g., hormonal, immune, gastrointestinal, nervous) have become disturbed.
As a result of all these factors, scientific studies have found that motherhood (and an increasing number of children) raises a woman's risks for:

* Thyroid disease
* Nutritional deficits
* Autoimmune conditions
* Intensified PMS
* Type II diabetes
* Fatigue
* Depression
* Some kinds of cancer
* Gallbladder and kidney disease
* A shortened lifespan

This is a sobering list of health problems! To be sure: Motherhood is NOT itself a medical issue. But its physical and psychological consequences often impact a woman's mental and physical health, and her marriage - leading to billions of dollars in health care expenses and lost productivity in the country as a whole. Even just everyday experiences of feeling frazzled, weary, irritable, overwhelmed, blue, or let down wear on a mother's well-being and cast a dark cloud over a time that should be so wonderful.

If fatherhood exposed men to similar risks, there'd be a national outcry. But since these involve "just" women, they are taken for granted.

Our society glorifies the wonderful side of motherhood, but it doesn't want to look at the challenges. For example, new moms fall off the radar of the health care system a couple months postpartum - as if bearing and rearing children made no long-term difference. Articles in popular magazines for mothers rarely go beyond chirpy proclamations that all problems can be solved with stuff like low-fat casseroles or clever tricks with a screaming baby. And compared to other Western, industrial nations, America ranks dead last in family leave and other family-friendly policies.

This blind spot - or worse, denial - in our national consciousness makes many moms think that feeling run down must be their own fault in some way. Consequently, they delay (or never do . . . ) the self-care, thorough check-ups, or firmly speaking up for themselves with their partner that would reverse the downward slide of depletion.

It's a pity, since there are so many research-proven ways to lower stress, replenish your body, heal the health problems common among mothers, get more help from your mate, and nurture a lasting and loving marriage after children. They're summarized in our book, Mother Nurture (endorsed by Christiane Northrup, MD, and other experts on women's health), and we'll also be exploring this territory in future columns.

Meanwhile, you can start feeling better by simply knowing that you are not alone, that objective factors have brought you to this point (not a personal failing!), and that there are plenty of good ways to improve your health, your mood, and your marriage after children. Whether you're feeling just a little bit worn out - or even that you're running on empty - try this simple suggestion: Commit to doing one simple thing for your own health or well-being for three days in a row, and on the third day, decide if you want to keep doing it.

We wish you the best!

(Rick Hanson is a clinical psychologist, Jan Hanson is an acupuncturist/nutritionist, and they are raising a daughter and son, ages 12 and 14. With Ricki Pollycove, M.D., they are the authors of Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships, published by Penguin. You can email them with questions or comments at info@nurturemom.com; unfortunately, a personal reply may not always be possible.)

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Preventing Type II Diabetes

We've got two kids, ages 1 and 3, and I'm about 20 pounds heavier today than I was before my first pregnancy. I feel run-down and often a little blue, so I "feed my sweet tooth" probably more than is good for me. I'm a little worried about where all this is going . . . .

Honestly, you should be a little worried. The average mother is about 10 pounds heavier than a comparable woman without children, moms tend to eat high-carb quick foods on the run, and mothers are at heightened risk for Type II diabetes - all of which are related.

Type II diabetes is a serious illness that is rising dramatically. Essentially, it's a condition in which the body has grown increasingly insensitive to the hormone, insulin, which makes it harder and harder to get "fuel" into the cells where it's needed, so the body produces more and more insulin, which just makes the cells even more oblivious to it, in a vicious cycle.

When this happens, you feel run-down and you're vulnerable to many of the nasty consequences of standard, "juvenile" diabetes, including JAN SAY. And even if you don't develop full-blown Type II diabetes, partway there is a syndrome of insulin insensitivity that has many of the problems of diabetes in a milder form.

So preventing Type II diabetes is a smart thing to do! And it will make your family eat better and help keep your kids off that slippery slope themselves, since Type II diabetes is increasingly found among teenagers. You knock out Type II diabetes with a one-two punch: maintain normal (= LOW) insulin levels, and keep your body sensitive to it. Here's how:

Maintain low levels of insulin:

* Eat a low carbohydrate diet - Low carbs mean low blood sugars. Plus, the protein that you're eating instead of carbohydrates will raise blood sugar levels only gently, and help them stay there stably for a long time. If you are particularly concerned about Type 2 diabetes, all major sugar sources (including honey and fruit juice) and grain products should be eliminated.
* When you do consume carbohydrates, eat only those with high fiber content - Fiber helps spread out the effects of sugar, reducing its negative impact. Carbs with lots of fiber include vegetables, beans, and legumes.
* Exercise routinely - Moderate exercise tends to lower blood sugar and insulin levels, and it also helps our cells maintain their sensitivity to insulin. For example, thirty minutes each day of brisk walking is enough to have a major impact on your blood sugar levels - and, of course, on your health in general.
* Lower your stress - When your stress level rises, so do your stress hormones, including cortisol and adrenaline. When these go up, so do your levels of blood sugar and insulin. So managing stress is important in the prevention of diabetes. This is a big topic, but the headlines are:
o Take an honest look at your life and how you could slow down and do less. Really!
o Throughout your day, take little moments to relax, such as by a big breath or just looking out the window for a few seconds.
o Cultivate some kind of regular practice - like a craft, meditation, yoga, inspirational reading, journaling, playing music - that is calming and self-nurturing.
o Reach out to people you like; research has shown that time with friends really helps lower stress (and especially for women).
o Routinely imagine that positive experiences are soaking into you, becoming a part of you, a resource inside that you can draw on for soothing and encouragement.
* Maintain (or attain) your optimal weight - Excess weight correlates with diabetes. One reason is that many causes of being overweight - such as a high carbohydrate diet and little exercise - also lead to diabetes. Additionally, growing evidence indicates that certain fat tissues may generate biochemical processes that contribute to diabetes.

Support high insulin sensitivity through consuming:
* Chromium - Take 500 mg/day.
* Lipoic acid (also called alpha-lipoic acid) - Take 100-300 mg/day.
* Omega-3 oils - Although these are present in fatty fish, you'd be prone to mercury poisoning if you ate enough to get all the omega-3's you need. Therefore, use a high-quality supplement that has been "molecularly distilled" and take enough to consume 500 mg/day of an ingredient called EPA (shown on the label).

These supplements can be found in your local health food store (or on our website, www.NurtureMom.com). The other benefits of these natural substances include decreased risk of cardiovascular disease, a sunnier mood, and improved liver function.

So, follow these important steps, and your risk for diabetes will radically decrease!

(Rick Hanson is a clinical psychologist, Jan Hanson is an acupuncturist/nutritionist, and they are raising a daughter and son, ages 12 and 14. With Ricki Pollycove, M.D., they are the authors of Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships, published by Penguin. You can email them with questions or comments at info@nurturemom.com; unfortunately, a personal reply may not always be possible.)

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Mothers and PMS

Since becoming a mom, I've begun experiencing more intense PMS. Is this normal? And what can I do?

Yes, studies have shown that having children increases the chance of having more intense PMS. While it's not going to put you in the hospital - though the prospect of that kind of rest may sometimes sound pretty good! - PMS can have a significant impact on your mood, sense of worth, irritability, and relationships many days a month. But happily, there's a lot you can do about it:General Well-Being

This is the foundation of hormonal health. Make the basics a priority: protein with every meal, regular vitamin/mineral/essential-fatty-acid supplements, sleep over housework, cultivating personal practices that feed your innermost being, and a relentless focus on lowering stress. Exercise

One study showed that women who participate in sports experience less PMS than those who don't. Regular massages can help as well. Diet

Consume less (or no) sugar, salt, refined carbohydrates, caffeine, alcohol, and dairy products. Increase your intake of fruits, vegetables, and other fiber-rich complex carbohydrates. Additionally, there are two kinds of foods with natural chemicals that can help with PMS: the cruciferous vegetables (e.g., broccoli, Brussels sprouts, cabbage) and soy products. Supplements

On top of a generally healthy diet-and consistent supplementation of essential fatty acids, vitamins, and minerals (especially calcium)-adding intensive daily doses of one or more of the nutrients below could bring greater balance to your menstrual cycle, particularly if that nutrient is lacking in your body:

# Vitamin B6 - Take as 100 mg pyridoxine (or 50 mg of pyridoxal-5-phosphate) an hour before eating breakfast or taking supplements containing minerals

# Vitamin E - Take 800 IU

# Magnesium - Take 800-1000 mg, ideally as magnesium glycinate; decrease if there is soft stool or diarrhea

Additionally, some women benefit from the essential fatty acid GLA found in evening primrose oil, especially for breast tenderness.Herbs

# The Chinese combination formula Dan Zhi Xiao Yao San - Follow the instructions on the bottle, or from your acupuncturist.

# The single herb, Dong Quai, is found in most Chinese formulas for women's health problems, and you can try it individually (in a 1:5 tincture, 1 teaspoon 3 times a day), although it's generally best in a formula.

# The Western herb, Vitex agnus-castus (chasteberry), has been shown to be helpful for PMS, but do not take it if you are using oral contraceptives. Try a standardized extract containing 0.5 percent agnuside, taking 175-225 mg/day.

Natural Hormones

The research evidence is mixed for using progesterone to reduce PMS, perhaps because this hormone is a factor for a subgroup of women. If you explore this option, we recommend you do so under the care of a licensed health care provider. Western medicine

If you try some of the suggestions above and your PMS remains moderate to severe, consider asking your physician about:

# Oral contraceptive agents (OCAs)-a.k.a. "the pill"

# Fluoxetine (Prozac, Serafem)-and perhaps other antidepressants-that can sometimes relieve the depressed mood some women have with PMS, and perhaps other discomfort as well

We wish you the best!

(Rick Hanson is a clinical psychologist, Jan Hanson is an acupuncturist/nutritionist, and they are raising a daughter and son, ages 12 and 14. With Ricki Pollycove, M.D., they are the authors of Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships, published by Penguin. You can email them with questions or comments at info@nurturemom.com; unfortunately, a personal reply may not always be possible.)

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Preventing Colds and Flus

Both my toddler and his big sister seem to have a runny nose half the year, particularly during the winter. And their dad and I also have a cold more often than we'd like. Any advice?

Studies show that women are more prone to colds and flus after having children - and kids themselves are exposed to germs continually in childcare and preschool. So it's smart to take up arms against those microbial invaders!

Of course, check with your doctors, especially if a cold/flu is intense or prolonged, or accompanied by a significant fever. But on your own, there are plenty of things you can do. Just adapt the ideas below - which include what moms and dads can do for themselves - for kids, depending on their age and weight.

Step 1 - Turbocharge your immune system to prevent illness in the first place:

* Get as much sleep as possible
* Exercise routinely
* Do what you can to lower your stresses (which suppress your immune system)
* Minimize exposure to contagious people (to reduce demands on the immune system)
* Eat protein with every meal
* Eat lots of fresh vegetables
* Minimize sugar (which depresses immune system function)
* Take a multi-vitamin/mineral supplement - Ideally, get a really good one from a health food store or our website, www.NurtureMom.com, that recommends four to six pills a day. For kids, look for flavored tablets or liquid.
* Take an essential fatty acid (EFA) supplement (which contains the "good fats") - Unless you are a strict vegetarian, we recommend high-quality fish oil that has been molecularly distilled to remove mercury (these days, to get all the EFAs you need from eating fish, you'd consume too much mercury, alas). Take about 1000 milligrams/day.

If you don't want to take fish oil, consume about 1 tablespoon/day of flax oil in salad dressings or other nonfrying uses; also be sure to take both a multi-vitamin and B-vitamin complex in order to digest the flax oil properly.

Step 2 - If you feel a cold coming on, or it's already breached your defenses:

* Vitamin A - This is the single best intervention we've come across for colds and flus. Use mycellized vitamin A in liquid form or vitamin A from cod liver oil in gel caps. At the beginning of a cold, take 50,000 International Units (IU) a day for three to five days; do not take more than that since it could be toxic for you. (One drop of vitamin A is about 5000 IU.)

WARNING: Pregnant women or women who have any possibility of becoming pregnant over the next several months MUST NOT TAKE DOSAGES OVER 5000 IU/day, which can lead to birth defects.
* Vitamin C - Routinely take one to two grams a day. Increase to four to ten grams/day at the first sign of a cold (but decrease if you develop diarrhea) and maintain that dose for the duration of the illness before dropping back down.
* Zinc - Often taken as a lozenge for a sore throat.
* Echinacea - Take at the first possibility of an infection (e.g., your son's best friend just got a bad cold) or sign of the sniffles. This herb comes in several forms, just follow the dosage instructions on the packaging. (If you use a liquid tincture, dilute it in a little water unless you want a numb tongue!)
* Chinese herbs - The formula, Gan Mao Ling, can reduce the symptoms and duration of a cold. It's often available in little black "BB" size pills, which are relatively easy for kids to take. Another formula, Bi Yan Pian, is especially good for flus.
* Homeopathy - This approach relies on being able to identify the correct remedy matched to an individual's exact symptoms. When it works, it's very evident, so if you try a remedy and do not feel noticeably better within twenty four hours, you should probably switch to another one. The most common remedies for the flu are:

§ Oscillococcinum - Take this general-purpose remedy as soon as you're exposed to infection or start to feel symptoms. It typically comes in small vials which can be divided into three or four doses. Initially take one dose every hour, and after three doses, decrease to about three doses per day.

§ Bryonia Alba and Gelsemium Sempervirens - These are similar to one another, and some homeopaths recommend that people alternate them. However, a subtle distinction is that Bryonia is more appropriate for a particularly irritable person, while Gelsemium would be more for the flu victim whose dominant experience is fatigue. Also, Bryonia is used when a person feels worse if she moves, so symptoms like "it hurts when I cough" might lead you to that remedy. Either of these remedies can be used in a potency called "30C," which will be on the bottle following the name, and can be taken every hour for a few hours, then reducing to three times per day.

§ In general, a good plan is to start with the Oscillococcinum at the very beginning, and then if a flu still develops, try Gelsemium or Bryonia.

To Your Health

Besides being an uncomfortable experience, a cold or flu in either your child or yourself can be one more draining experience that tips you further toward developing the Depleted Mother Syndrome, so it's important to do everything you can to prevent them. The best long-term cure for frequent colds and flus is to optimize your own health and well-being. If there is any question about that, we heartily recommend using our book, Mother Nurture (Penguin, 2002), to feel less stressed, stay energetic and replenished, and build teamwork and intimacy with your mate - all of which will help get you through the winter, and beyond, in great shape.

(Rick Hanson is a clinical psychologist, Jan Hanson is an acupuncturist/nutritionist, and they are raising a daughter and son, ages 12 and 14. With Ricki Pollycove, M.D., they are the authors of Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships, published by Penguin. You can email them with questions or comments at info@nurturemom.com; unfortunately, a personal reply may not always be possible.)

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Low Carbs for Mothers

We've got two kids, ages 1 and 3, and I'm about 20 pounds heavier today than I was before my first pregnancy. I feel run-down and often a little blue, so I "feed my sweet tooth" probably more than is good for me. I'm a little worried about where all this is going . . . .

Honestly, you should be a little worried. Sorry!
The average mother is about 10 pounds heavier than a comparable woman without children, moms tend to eat high-carb quick foods on the run, and mothers are at heightened risk for Type II diabetes - all of which are related.

Type II diabetes is a serious illness that is rising dramatically. Essentially, it's a condition in which the body has grown increasingly insensitive to the hormone, insulin, which makes it harder and harder to get "fuel" into the cells where it's needed, so the body produces more and more insulin, which just makes the cells even more oblivious to it, in a vicious cycle.

When this happens, you feel run-down and you're vulnerable to many of the nasty consequences of standard, "juvenile" diabetes, including cardiovascular disease. And even if you don't develop full-blown Type II diabetes, partway there is a syndrome of insulin insensitivity whose problems include fatigue, sugar cravings, and excess weight. So staying off the slippery slope of insulin problems - or simply avoiding the poor nutrition of the high-sugar, high-carb, "supersized" standard American diet which has made us the most overweight nation in the world - are all smart for a mother.

# The key is the low-carb diet that is so often in the news these days. It's the diet we're designed for through millions of years of evolution. During almost all that time, there was no consumption of grains, milk products, or refined sugar. People very similar to us ate mostly animal proteins, vegetables, and nuts. Basically, that's the low carb diet. Here's how to do it: Have protein with every meal. Make that protein source - chicken, beef, fish, tofu, cheese, almonds, rice and beans, etc. - the centerpiece of the meal.
# Eat tons of vegetables.
# Use starchy vegetables - like potatoes, yams, sweet potatoes, beets, carrots, legumes, beans - as your major source of carbohydrates.
# Consume grains in moderation, and as much as possible, in their "whole" form (e.g., whole wheat, brown rice). Minimize pasta, pizza, bread, bagels, etc.
# Eat no more than one or two pieces of fresh fruit a day. Fruit does have a fair amount of carbohydrates, but it also has lots of important nutrients.
# Keep sugar low. Look at the food labels and try to keep your sugar consumption below 25 grams a day, or as close as possible. (There are about 45 grams of sugar in a Coke. Oops.)
# Drink only moderate amounts of wine or beer - or none at all.
# Eat healthy fats. Avoid the trans-fats found in partially hydrogenated oils (margerine) and deep fried foods. Consume low amounts of saturated fats (e.g., butter, cream, fat in hamburger). Use virgin olive oil for cooking.

(Rick Hanson is a clinical psychologist, Jan Hanson is an acupuncturist/nutritionist, and they are raising a daughter and son, ages 12 and 14. With Ricki Pollycove, M.D., they are the authors of Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships, published by Penguin. You can email them with questions or comments at info@nurturemom.com; unfortunately, a personal reply may not always be possible.)

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Super Nutrients for Mothers

I'm not sick or anything, but I sure feel run down. What can I do - that's simple and easy, since I've got an infant, a toddler, and a preschooler (yikes!) - to feel better?

First, there are the basics that everyone knows - and our own mothers kept telling us - like getting regular exercise, making sleep a priority (over housework!), taking at least a little time for yourself every day, eating a balanced diet, limiting sweets, and getting regular check-ups to rule out serious health problems.
On top of this foundation, each mother needs certain key nutrients - especially since every mom is susceptible to getting physically depleted (as we explain in our book, Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships).
If you make sure to get these nutrients routinely, you're definitely going to feel better. It may take a few months, because it takes a while to get nutrients back into the body, especially minerals. That's why you have to stick with it, and not expect an overnight miracle. But when you stay the course, nurturing your own body while you nurture your family, you will likely experience a dramatic improvement in your health and well-being!

So here's what you need to do: 1. Eat protein with every meal, especially breakfast - Protein contains the amino acids that are the building blocks of the body; for example, tryptophan is required to make the neurotransmitter, serotonin, and increasing serotonin levels is the aim of Prozac, etc. Protein also helps regulate blood sugar levels, which helps prevent Type II diabetes and makes it easier to shed excess pounds.

2. Routinely take a basic MultiVitamin/MultiMineral supplement containing iron - Use a supplement that recommends four to six pills a day (rather than a one-a-day like Centrum) because getting all the minerals you need into a single pill would require one the size of a golf ball. You can get a good "multi" or any of the other nutrients named in this column at your local health food store or from our website (specially chosen for mothers): www.NurtureMom.com. And in addition to this multi, take the other supplements described just below.

3. B-Complex - The B vitamins assist literally thousands of metabolic functions, including lifting your mood and preventing depression. Take one a day.

4. Vitamin C - This helps detoxify your body, turbocharge your immune system, and many other wonderful things. Take one to two grams a day. Increase to four to ten grams/day at the first sign of a cold (but decrease if you develop diarrhea) and maintain that dose for the duration of the illness before dropping back down.

5. Calcium and Magnesium - These minerals promote healthy bones (helping prevent osteoporosis), healthy sleep, and a healthy mood. They are often available in a combined supplement. Each day, take 1000 to 1500 milligrams of calcium and 400 milligrams of magnesium.

6. Taurine - This amino acid helps soothe frazzled nerves (among other good things), but it is drained out of your body during both pregnancy and breastfeeding. Take 500 milligrams a day.

7. Essential fatty acids (EFAs) - These are the "good fats" that are needed for a healthy heart and brain. Increasing your intake of one type of EFAs-omega-3 oils found in fish and flax oil-can help prevent cardiovascular disease, rheumatoid arthritis, asthma, diabetes, and depression. It can also make your hair and skin more moist; dryness, including dandruff, is a potential sign of omega-3 deficiency. And pregnant or breastfeeding women can help the optimal development of their child's brain by getting substantial amounts of these important oils.
Take about 1000 milligrams/day of a fish oil supplement that has been "molecularly distilled" for purity; make sure you take enough to get at least 400 milligrams/day of a key ingredient called DHA, which will be listed on the label. (Some people prefer flax oil to fish oil due to being a vegetarian. Unfortunately, most people lack some of the enzymes or co-factors needed to convert flax oil into the long-chain fatty acids your body needs, which already exist in fish oil. If you do choose to use flax oil, make sure you're taking a good multi-vitamin/multi-mineral supplement as well, for the co-factors it contains.)

To Your Health!

(Rick Hanson is a clinical psychologist, Jan Hanson is an acupuncturist/nutritionist, and they are raising a daughter and son, ages 12 and 14. With Ricki Pollycove, M.D., they are the authors of Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships, published by Penguin. You can email them with questions or comments at info@nurturemom.com; unfortunately, a personal reply may not always be possible.)

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