By: Centers for Disease Control and Prevention | April 19, 2021

By Uma Naidoo | December 07, 2018 | Updated March 27, 2019

"The human microbiome, or gut environment, is a community of different bacteria that has co-evolved with humans to be beneficial to both a person and the bacteria. Researchers agree that a person’s unique microbiome is created within the first 1,000 days of life, but there are things you can do to alter your gut environment throughout your life.

Ultra-processed foods and gut health

What we eat, especially foods that contain chemical additives and ultra-processed foods, affects our gut environment and increases our risk of diseases. Ultra-processed foods contain substances extracted from food (such as sugar and starch), added from food constituents (hydrogenated fats), or made in a laboratory (flavor enhancers, food colorings). It’s important to know that ultra-processed foods such as fast foods are manufactured to be extra tasty by the use of such ingredients or additives, and are cost effective to the consumer. These foods are very common in the typical Western diet. Some examples of processed foods are canned foods, sugar-coated dried fruits, and salted meat products. Some examples of ultra-processed foods are soda, sugary or savory packaged snack foods, packaged breads, buns and pastries, fish or chicken nuggets, and instant noodle soups.
Researchers recommend “fixing the food first” (in other words, what we eat) before trying gut modifying-therapies (probiotics, prebiotics) to improve how we feel. They suggest eating whole foods and avoiding processed and ultra-processed foods that we know cause inflammation and disease.


But what does my gut have to do with my mood?

When we consider the connection between the brain and the gut, it’s important to know that 90% of serotonin receptors are located in the gut. In the relatively new field of nutritional psychiatry we help patients understand how gut health and diet can positively or negatively affect their mood. When someone is prescribed an antidepressant such as a selective serotonin reuptake inhibitor (SSRI), the most common side effects are gut-related, and many people temporarily experience nausea, diarrhea, or gastrointestinal problems. There is anatomical and physiologic two-way communication between the gut and brain via the vagus nerve. The gut-brain axis offers us a greater understanding of the connection between diet and disease, including depression and anxiety.
When the balance between the good and bad bacteria is disrupted, diseases may occur. Examples of such diseases include: inflammatory bowel disease (IBD), asthma, obesity, metabolic syndrome, diabetes, and cognitive and mood problems. For example, IBD is caused by dysfunction in the interactions between microbes (bacteria), the gut lining, and the immune system.


Diet and depressionA recent study suggests that eating a healthy, balanced diet such as the Mediterranean diet and avoiding inflammation-producing foods may be protective against depression. Another study outlines an Antidepressant Food Scale, which lists 12 antidepressant nutrients related to the prevention and treatment of depression. Some of the foods containing these nutrients are oysters, mussels, salmon, watercress, spinach, romaine lettuce, cauliflower, and strawberries.

A better diet can help, but it’s only one part of treatment. It’s important to note that just like you cannot exercise out of a bad diet, you also cannot eat your way out of feeling depressed or anxious.
We should be careful about using food as the only treatment for mood, and when we talk about mood problems we are referring to mild and moderate forms of depression and anxiety. In other words, food is not going to impact serious forms of depression and thoughts of suicide, and it is important to seek treatment in an emergency room or contact your doctor if you are experiencing thoughts about harming yourself.
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Suggestions for a healthier gut and improved mood
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• Eat whole foods and avoid packaged or processed foods, which are high in unwanted food additives and preservatives that disrupt the healthy bacteria in the gut.
• Instead of vegetable or fruit juice, consider increasing your intake of fresh fruits and vegetables. Frozen fruits without added sugars/additives are a good choice too.
• Eat enough fiber and include whole grains and legumes in your diet.
• Include probiotic-rich foods such as plain yogurt without added sugars.
• To reduce sugar intake at breakfast, add cinnamon to plain yogurt with berries, or to oatmeal or chia pudding.
• Adding fermented foods such as kefir (unsweetened), sauerkraut, or kimchi can be helpful to maintain a healthy gut.
• Eat a balance of seafoods and lean poultry, and less red meat each week.
• Add a range of colorful fresh fruits and vegetables to your diet, and consider choosing certain organic produce."

"Pregnancy puts a lot of strain on your body, including at bedtime, which is why finding the best pregnancy pillow is so essential for many women.

Find a little relief for those aches and pains by sleeping with a pillow that’s designed to cradle and comfort your pregnant shape. The latest pregnancy pillows come in a wide array of sizes and shapes to fit your particular needs, whether you’re looking to alleviate back pain or to find a positioning solution as a stomach sleeper

From full-body styles to wedges, the options are plentiful. Some favorite brands include Boppy and Leachco, but they’re not the only brands to shop for some of the best pregnancy pillows available in 2020. Below are seven pregnancy pillows we recommend for an amazing night of sleep."

Moonlight Slumber Comfort-U Total Body Support Pillow​

"​The Comfort-U Pillow by Moonlight Slumber cushions every curve of your aching body with Fusion Foss fiber. It feels soft and stays soft, but it also provides support where you need it most with its classic “U” shape. This is the perfect pregnancy pillow if you want to feel like you’re engulfed in a giant cloud. ($99.95; amazon.com)"

​Boppy Total Body Pillow in Ringtoss

"Women who had Covid while expecting experienced guilt, shame and unhealthy levels of stress."

"Kate Glaser had chalked up her exhaustion to being 39 weeks pregnant and having twin toddlers in the house. She also wondered whether her flulike symptoms were a sign that she was about to go into labor. But when she woke up one morning with a 100.4-degree fever, she called her doctor and got a rapid Covid-19 test.

Two nurses came to deliver her results to her in the waiting room. They were dressed in full gowns, masks, face shields and gloves.

“I knew by the eerie silence and the way they were dressed that I was Covid positive,” she said. “It was an emotional moment; I felt really disappointed and shocked and, as a mom, I felt a lot of guilt. What did I do wrong?”

Glaser, who lives in the Buffalo, N.Y., area, returned home and isolated from her husband and the twins in her bedroom, where she spent hours mentally replaying all her activities leading up to the positive test result. She also made a public post on her Facebook page about her positive status, and what she was feeling — guilt, embarrassment and panic. The post went viral, and Glaser started hearing from women around the world who were pregnant and worried about Covid-19. The majority of the of the 2,300 comments she received were supportive; a few were harshly critical.

“I was going down a rabbit hole of guilt and stress,” Glaser said, adding that for her, as much as the physical symptoms were bad, the mental stress of Covid was much worse.

Prolonged stress can have real consequences on pregnant people even outside of a pandemic and has been tied to low birthweight, changes in neurological development and other health impacts in children. And the pressure associated with a positive Covid-19 test increases these mental health risks.

The anxiety is not without reason. As of November 30, there have been more than 42,000 cases of coronavirus reported in pregnant women in the U.S., resulting in 57 maternal deaths. U.S. health officials have said pregnancy increases the risk of severe disease for mother and child, and being coronavirus-positive in late pregnancy may increase the rate of preterm birth.

Prenatal care and birth plans are also disrupted by a positive test result. “Women are expressing so much fear about being infected, but also about going to the hospital, delivering and being separated from their child,” said Laura Jelliffe-Pawlowski, an epidemiologist who is the primary investigator of HOPE COVID-19, a new study that focuses on the well-being of women who are pregnant during the pandemic.

The study launched in July and will follow more than 200 women around the world, from pregnancy to 18 months postpartum, to understand how Covid-19 and the pandemic response impacts pregnancy and infant health outcomes.

Dr. Jelliffe-Pawlowski and her team have analyzed the data from the first group of women, and they are finding “absolutely incredible” levels of stress and anxiety. “Sixty percent of women are experiencing nervousness and anxiety at levels that impede their everyday functioning,” she said, citing preliminary data. “There are a number of women, particularly lower-income women, expressing how hard it is to choose to stay in a job that puts them at risk versus quitting the job and not having enough food for their baby.”

Nearly 70 percent of the participants reported feeling worried about decreasing family income and more than 22 percent worried about food insecurity (though none had experienced it at the time of the survey). Dr. Jelliffe-Pawlowski worried that women were not necessarily getting the psychological care they needed: “If you can’t feed your family, seeking out mental health care is not your top priority.”

She also said more than 84 percent of women reported moderate to severe anxiety about giving birth during a pandemic. “Many women do not want to get tested because they will be stigmatized or separated from their baby or not allowed to have people in the room to support them,” she said. She added that similar visiting rules often hold true for babies in the NICU after being born preterm during the pandemic: Only one parent can be present in a 24-hour period. “It’s heart-wrenching to see families go through those choices.”

Dr. Jelliffe-Pawlowski is particularly interested in how stress impacts births and long-term outcomes for children as psychological stress is highly associated with preterm birth. After the attacks of September 11, 2001, the risk of preterm births almost doubled for people living near or working at the site of the fallen towers. She’s also concerned about long-term effects of stress and anxiety on maternal bonding during the pandemic.

Margaret Howard, a psychologist at Women & Infants Hospital in Providence and postpartum depression researcher at Brown University thinks it is absurd for pregnant women who test positive for an infectious virus to bear any guilt or stress associated with their diagnosis: “Are moms in a special category where they are expected to not get Covid? What about a sinus infection? Hay fever? Cancer? Why is Covid a moral failing for mothers?”

When Erica Evert, a pregnant mom in northern Virginia, received her postive Covid-19 test result, it didn’t make sense. She was near the end of her pregnancy, and hadn’t left the house in four and a half months, except for ob-gyn appointments to check on the baby.

“My first thought was, is this a false positive? I feel fine. And my second reaction was to start bawling,” said Evert. She was scheduled to have a cesarean section with her second baby and the test was merely a formality — until it was a life-changing event.
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The hospital gave her a choice: She could deliver the next day and be treated as a Covid-19 patient — separated from her baby with no skin-to-skin contact, per the hospital’s policies. Or she could wait 10 days from the date she received the positive test result and deliver with her regular plan. She had four hours to make a choice she wasn’t expecting. “I kept thinking: am I going to make a decision that results in my child dying?” said Evert."

By Penny Simkin| October 27, 2009

"Author/lecturer, doula, childbirth educator, Penny Simkin, PT, talks about pain in labor and the concept of "when pain becomes suffering."

By Penny Simkin| Oct 30, 2015

"Author and educator, Penny Simkin offers an introduction to the serious topic of traumatic childbirth including symptoms of PTSD and suggestions for facilitating postpartum recovery from a traumatic birth experience. 

Traumatic childbirth occurs in as many as 25-34 percent of all births. Approximately one-third of those women may develop Posttraumatic Stress Disorder (PTSD). 

For more information, visit pattch.org. Penny is one of the founders of PATTCh, Prevention and Treatment of Traumatic childbirth, whose vision is "a world where women, infants and families, experience optimal physical and mental health in pregnancy, childbirth, and the postpartum period." 

Research on this condition is only about 10 years in the making. 

By Julie Revelant 

"When I had my first child six years ago, I was grateful breastfeeding turned out to be, for the most part, a smooth ride. 

After a visit with the hospital lactation consultants, who showed me the best breastfeeding positions and gave me the support I needed, I was on my way, and continued to breastfeed exclusively for the next 12 months. 

In those early months, though, I'd experience something odd-and often frightening-that I never told anyone about. When my daughter latched on and my milk let down, an intense feeling of anxiety, panic, and doom would wash over my entire body. For a brief moment-about 20 to 30 seconds-I had a sudden irrational fear that something bad was going to happen. 

And as quickly as the feelings came, they went. 

It was always unsettling and, at times, scary, but becuase I had struggled with anxiety for as long as I could remeber, I chalked it up to biology and hormones. 

When I gave birth to my second child two years later, I wasn't surprised those same feelings surfaced once again. It was still unsettling, but thankfully, it didn't affect my ability to breasfeed her for 13 months. 

Yet it continued to nag at me, and as a health journalist, I wanted to know why I'd often write about breastfeeding, and when I asked my sources if this was common, most of them had no idea what I was talking about. Then one day, I spoke with a lactation consultant and she told me what I had experienced  was real and it had a name: D-MER: Dysphoric Milk Ejection Reflex.  

By Sara Petersen| February 12, 2020 at 11:30 AM EST

"He only sleeps if he's being held," I told my pediatrician at my son's 2 week checkup. "Or," I paused, fearful of shame, "in the swing."

Without looking up from his doctor computer thing, my pediatrician immediately lectured me about safe sleep and SIDS. When I told him we had tried everything and nothing else worked and sleep deprivation had plunged me into postpartum depression after the birth of my two older kids, he lectured me about therapy. When I told him I was on Zoloft and in  weekly communication with my therapist, he told me to hang in there. 

I left the office in tears, feeling unsupported, feeling as though I had no workable options, and mostly feeling as though I was somehow wrong, that I was a bad mother. 

To many mothers, my story is simply another drop in the bucket of ways our health-care system abandon mothers. Babies recieve at least six well-visits with their pediatricians in the first year of life. The mothers of those babies, whose bodies and emotional lives have been entirely upended, recieve one well-visit. 

I was lucky enough to turn to my postpartum doula after that demoralizing appointment, and together, we had a nuanced conversation on how to attend to my son's sleep safety while also prioritizing my own sleep needs so I could show up for my family and feel like myself. 

But far too many mothers are left unsupported and exhausted, desperate for sleep."

How women find the strength to endure multiple pregnancy losses

February 9, 2020| By Meghan Holohan

"Soon after getting married, Jenn and Phil Tompkins learned they were expecting a baby. Tompkins had always dreamed of being a mother and wanted to start her family as soon as possible. At six weeks pregnant, she excitedly announced it on Facebook. 

"It's not a fantastic thing to do on multiple levels because once you announce it, not everyone gets the un-announcement," Tompkins, 43, of Freeport, Pennsylvania, told TODAY Parents. 

When Tompkins went to her eight week ultrasound, she worried when the technician kept asking her questions. 

"She asked if we were sure on our date, which I thought was a weird question, and she turned the screen away and said she had to come back," Tompkins explained. 

The tech returned with the doctor and they shared the news. 

"The baby stopped developing and did not have a heartbeat," Tompkins said. "That day our world changed." 

The doctor advised the couple wait for Tompkins body to heal before trying again. Soon after, Tompkins got pregnant again and miscarried. A third time, Tompkins became pregnant and lost the baby. After her third miscarriage, her doctor recommended she visit a maternal-fetal specialist who could test the couple to try to understand why the miscarriage kept happening. Before they even tried any treatments, Tompkins became pregnanct again." 

Grieving patients are encouraged to see and hold their stillborn infacnts--and in some cases even bring them home. 

By Meredith Goldstein

"The photos, shared by Kangatraining Austrailia show the hardworking nurses in Neonatal Intensive Care Unit (NICU) in Germany doing what they do best-loving and caring for needy babies.

As any babywearing mama, or dad, will know, all babies love to be held close and carried, with the movement soothing them and often putting them to sleep."

Photo: Katherine Streeter for NPR

​Menopause Can Start Younger Than You Think: Here's What You Need To Know

By Emily Vaughn & Rhitu Chatterjee

"Would you recognize the signs that your body is going through the big hormonal changes that lead to menopause? Here's what to look for-and what you can do about it."

"Sarah Edrie says she was about 33 when she started to occasionally get a sudden, hot, prickly feeling that radiated into her neck and face, leaving her flushed and breathless. "Sometimes I would sweat. And my heart would race," she says. The sensations subsided in a few moments and seemed to meet the criteria for a panic attack. But Edrie, who has no personal or family history of anxiety, was baffled.

She told her doctor and her gynecologist about the episodes, along with a few other health concerns she was starting to notice: Her menstrual cycle was becoming irregular, she had trouble falling asleep and staying asleep, and she was getting night sweats. Their response: a shrug.

It wasn't until Edrie went to a fertility clinic at age 39 because she and her partner were having trouble conceiving that she got answers. "They were like, 'Oh, those are hot flashes. It's because you're in perimenopause,' " she says.
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If you haven't heard the term "perimenopause," you're not alone. Often when women talk about going through menopause, what they're really talking about is perimenopause, a transitional stage during which the body is preparing to stop ovulating, says Dr. Jennifer Payne, who directs the Women's Mood Disorders Center at Johns Hopkins University."

HOW PUBERTY, PREGNANCY AND PERIMENOPAUSE AFFECT MENTAL HEALTH

Listen to the four podcasts below:

"January 14, 2020 • NPR's Morning Edition explores the key reproductive shifts in women's lives — puberty, pregnancy and perimenopause — and how the changes during those times could impact mental and emotional health."

"​January 16, 2020 • Women with a history of depression and anxiety are at a higher risk of having a flare-up during the time leading up to menopause. And getting doctors to take the issue seriously can be challenging."

"​January 15, 2020 • Nearly 1 in 7 women suffers from depression during pregnancy or postpartum. But very few get treatment. Doctors in Massachusetts have a new way to get them help."

"​January 17, 2020 • NPR's Rachel Martin talks to menopause expert Dr. JoAnn Pinkerton, division director of the Midlife Health Center at the University of Virginia, who answers listeners' questions."

​By Sarah DiGregorio

"If eating is about pleasure, at least for me, cooking is about control. Knowing how to make onions sizzle gently in oil and start to go limp, then transparent, then light brown, then sweet and dark. It’s a transformation that’s entirely predictable, a product of muscle and sense memory. If I pay attention in the kitchen, if I am careful, nothing goes wrong.

When I was pregnant, I worked at Food & Wine magazine. Editing recipes, the biggest part of my job at the time, is a meticulous and satisfying exercise in imagining all the mistakes that could be made in a kitchen and then trying to prevent them.

It was 90 degrees out as my stomach started to swell, but in the office we were cooking and tasting crunchy escarole salads, potato gratin, roasts and gravy, butter cookies and layer cakes. Summer at a monthly cooking magazine is about Thanksgiving, and then the holidays.

I liked to think of my daughter growing plump and happy and smart on everything I ate. Though I’d cut out alcohol, raw fish and cured meats, I ate everything else the test kitchen produced, imagining that this was the embryonic beginning of giving her a healthy, pleasurable relationship with food and her body. “Eating for two” is an irritating phrase, but I saw it as the first benefit of being alive that I could share with her.
Despite my well-laid plans, it turned out the placenta was failing.
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My daughter was not, actually, living the fetal high life. My body was keeping all that good food for itself — the snow-white slice of coconut layer cake, the bitter sautéed winter greens. First she fell off her growth curve and then, a fetus slowly starving, her body ground to a halt. She was not safe inside me, so the doctors took her out nearly 12 weeks early, an emaciated, shivery bundle, a 1-pound 13-ounce creature of skin and bones."

By Angela Ceberano

"What if there was a way to systematically fight every single fear you have?

Angela has worked in public relations for over a decade, gaining invaluable experience and contacts throughout the industry. In the last ten years, Angela has represented some of the biggest international celebrities and brands. At 28 she saw an opportunity to create a new-school PR agency that was obsessed and addicted to results. Angela began Australian based Flourish PR in February 2010 and the business has grown from a home office into a busy dynamic agency. Angela runs a dedicated team of publicists and creatives who are new school thinkers in the world of PR."

​This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

By: Dr. Wendy Suzuki, Ted Talk

Wendy Suzuki is researching the science behind the extraordinary, life-changing effects that physical activity can have on the most important organ in your body: your brain.

"What's the most transformative thing that you can do for your brain today? Exercise! says neuroscientist Wendy Suzuki. Get inspired to go to the gym as Suzuki discusses the science of how working out boosts your mood and memory -- and protects your brain against neurodegenerative diseases like Alzheimer's."

Setting meaningful goals can help manage symptoms of anxiety and depression. By setting meaningful goals, you eliminate feelings of being lost or stagnant in life and create a clear path for achieving your goals. This clear path and your connection to the "why" will help you stay motivated by keeping your focus on achieving such a meaningful goal. You'll have the ability to visualize your success.