Dear Dr. Roach: I鈥檝e heard that there are issues with the enzymes, proteins and chemicals that are found in animal meat and plant matter. Somehow, I鈥檓 told, it affects a woman鈥檚 brain and makes her go crazy when they鈥檙e mixed together. Somehow, this mixture possibly causes postpartum depression. I鈥檓 told it鈥檚 better to eat either plant matter or animal tissue, but not both mixed together. Is there any plausibility to this assumption?
C.H.
Interaction among the environment (including diet), the body and the mind is complex, so I cannot say for sure the theory is completely fallacious, but I think it probably is completely wrong. Worse, it could give women who suffer from postpartum depression a greater sense of guilt than they may already have.
It鈥檚 thought that 10 per cent or so of women will experience depression after pregnancy, and symptoms may start before delivery of the baby or after delivery, usually within the first month. Risk factors include a history of depression, major stressful events during pregnancy and lack of financial or social support. While the cause is unknown, changes in hormones around pregnancy and delivery are thought to be important.
Postpartum depression is different from 鈥減ostpartum blues,鈥� which is mild symptoms of depression, such as difficulty sleeping (that is not due to the baby), poor energy, difficulty concentrating and feeling down. These symptoms generally get better in a few days and are gone by two weeks.
In women with postpartum depression, the symptoms are more severe, last at least two weeks and often include feelings of guilt, loss of pleasure and thoughts about self-harm. PPD is common enough that it is appropriate for clinicians to screen all new mothers for this condition. It is underrecognized, serious and treatable. While I wish it could be prevented with a simple diet change, I don鈥檛 believe that.
Finally, I advise you that the word 鈥渃razy鈥� has no place in discussing mental disorders.
Dear Dr. Roach: I have a patent foramen ovale (hole in the heart). Recently, I heard on a radio show that people with a hole in the heart are more susceptible to strokes. Is this true? If so, how can I prevent it?
E.
There are several types of defects in the heart muscle that are called 鈥渉oles in the heart,鈥� and the most common one is the patent foramen ovale (which is Latin for 鈥渙pen oval-shaped window鈥�). It occurs when the normal opening between the left and right atrium 鈥� necessary in a developing fetus because the oxygen to a fetus comes from the mother through the placenta, not from the lungs 鈥� fails to close after birth like it should. A PFO is very common: 25 to 30 per cent of the population has one. Most people with them never develop problems.
It is true that people with a PFO are at higher risk for stroke. It is thought that a blood clot, which would otherwise go into the lung (and surprisingly not cause much trouble most of the time), can go through the patent foramen ovale and then into the brain, causing a stroke. This is not a common finding, though, and the increased risk of a stroke in people who haven鈥檛 had one is so small that treatment, such as surgical repair, often is riskier than leaving it alone. People with a PFO and no history of stroke do not need repair or further evaluation. Prevention of stroke is the same as it is in everybody else: careful control of high blood pressure if necessary; avoid smoking; eat a healthy diet; and get regular moderate exercise.
People with a stroke for no identifiable reason and a PFO may benefit from surgical closure.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
