Bright Light, Acupuncture, and Yoga for Perinatal Depression
There are promising findings, but more studies are needed.
Posted Jul 26, 2019
This is the third and final post in a series on complementary and alternative medicine (CAM) approaches to perinatal depressed mood. In previous posts, I reviewed the limitations of available mainstream treatments of depressed mood during pregnancy and evidence for select supplements, including omega-3 fatty acids, folate, and other natural supplements.
In this post, I briefly review research findings for bright light exposure therapy, acupuncture, exercise, massage, and yoga.
Bright Light Exposure Therapy
Findings of studies on bright light exposure for perinatal depressed are inconsistent; however, most studies report positive findings. Three placebo-controlled studies reported beneficial effects of bright light exposure in pregnant, depressed women treated daily with one hour of early-morning, full-spectrum bright light for at least three weeks. In all three studies, bright light exposure was significantly more effective than the placebo condition (dim light) (Oren et al 2002; Epperson et al 2004; Wirz-Justice et al 2011).
A different study found no response difference in pregnant women exposed to bright light versus dim light (Corral et al 2007). It is important to note that all four studies were small. Bright light exposure is generally well tolerated, although some individuals report nervousness or insomnia, and there are rare case reports of hypomania in individuals diagnosed with bipolar disorder.
Findings of sham-controlled studies on acupuncture for depressed mood are also inconsistent (Smith, Hay and Macpherson 2010). Two sham-controlled studies on traditional acupuncture for depression during pregnancy yielded positive results (Manber et al 2004; Manber et al 2010). A small study found no response difference between women treated with traditional acupuncture and electroacupuncture (Chung et al 2012).
Exercise and Massage
Many depressed individuals who engage in regular aerobic activity reported improved mood; however, research findings are inconsistent (Chalder et al 2011; Krogh et al 2010; Mota-Pereira et al 2011). Few studies have examined the mental health benefits of exercise for perinatal depressed mood, and the results are mixed (Norman et al 2010; Heh et al 2008; Dritsa et al 2008). The optimal type, frequency, and duration of exercise for depressed mood have not been established.
Like acupuncture and exercise, findings on the mood-enhancing effects of yoga for perinatal depressed mood are inconsistent. Some studies report significant reductions in the severity of depressed mood with regular yoga practice, while other studies report no differences in outcomes between women practicing yoga and women on a waitlist (Uebelacker et al 2016; Davis et al 2015; Muzik et al 2012; Field et al 2013; Buttner et al 2015).
It is possible that differences in outcomes reflect different styles of yoga, diverse samples and sample sizes, and the use of self-reported or non-standardized measures of mood in many studies. Additional studies are needed to determine whether specific styles of yoga are more effective than others, as well as the frequency of yoga practice that may yield the greatest antidepressant benefits.
Untreated or undertreated depressed mood during pregnancy or following childbirth has serious health consequences to the mother, the unborn fetus, and the newborn. As discussed in the first post in this series, taking an antidepressant during pregnancy may result in toxic effects on the fetus and delays in early childhood development. At the same time, the majority of complementary and alternative (CAM) approaches used to treat this condition are supported by inconsistent research findings.
Pending future research findings establishing which treatments are safest and most beneficial, these circumstances invite open-minded consideration of the range of conventional Western medical and CAM modalities aimed at maximizing treatment response while minimizing risk to the pregnant woman, the fetus, and the newborn child.
As is broadly true in mental health care, "one size fits all" does not apply to the treatment of perinatal depressed mood. The most appropriate treatment—whether it is an antidepressant, a natural supplement, yoga, acupuncture, exercise, or a combination of two or more conventional and CAM approaches—should be individualized to match the unique symptoms and preferences of each person and determined on a case by case basis.