Part 6 of 6. Depressive disorders can occur at any stage of life, including during pregnancy and the postpartum period. There is nothing shameful about depression and if you or someone you know is experiencing depressive symptoms, talk to your health care provider right away. Several studies have investigated the effects of massage on depression during these periods and those findings are listed below.
Major depression, or major depressive disorder (MDD), occurs when excessive sadness interferes with a person’s ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Hallmark symptoms of MDD are a prolonged period of profound sadness with deep hopelessness and a loss of self-esteem accompanied by a decreased interest or pleasure in most activities or loss of interest in interpersonal relationships.
Prenatal depression is a depressive disorder that occurs during pregnancy (also called antenatal depression). Approximately 14% of women experience depression during pregnancy. Depression during pregnancy can be a precursor to postpartum depression if not properly treated.
Postpartum depression (PPD) is a depressive disorder that begins after childbirth and lasts beyond 6 weeks. Approximately 10-15% of childbearing women experience various degrees of PPD. Symptoms of postpartum depression are the same as those of MDD, with the addition of a lack of concern for or even negative feelings toward her child/ren. Some women express over concern her child/ren.
Most often, treatment for pregnancy-related depression consist of prescription drugs such as antidepressants along with cognitive behavioral therapy (CBT). Some prescription drugs can be used while the mother is breastfeeding, with little risk to the baby.
Massage Therapy & Prenatal/Postpartum Depression – If your client is pregnant, be sure follow treatment protocols for her specific trimester (first, second, or third). If she has given birth, follow treatment protocols for postpartum massage. Also, be sure to screen for DVT until week 10 postpartum.
The overall effect of massage should be nurturing and relaxing.
Massage decreased prenatal depression, reduced stress and anxious behaviors (1-3), lowered cortisol (1,2) and norepinephrine levels, and increased dopamine and serotonin levels (2). Depressed pregnant women who received massage reported less leg and back pain (2,3). Women who combined CBT and massage therapy experienced greater decreases in depression, anxiety, and reductions in cortisol levels compared to women who did not receive massage during CBT (4). Field (5) found that pregnant women diagnosed with major depression who received massage by their significant other experienced lowered depression during pregnancy and this effect extended into the postpartum period.
Massage may also help newborns when their mothers are dealing with depression while they are pregnant. Depressed women who were massaged while pregnant experienced fewer childbirth complications such as prematurity and babies with low birth weight when compared to the non-massaged group. Also, their newborns performed better on the Brazelton Neonatal Behavior Assessment (2,5).
Foot reflexology massage reduced fatigue, stress, and depression in postpartum women (6). Onozawa (7) found that both support group meetings and combining support group meetings with infant massage classes decreased postpartum depression, but only the massage group significantly improved the interactions between mother and infant. Additionally, the American Pregnancy Association promotes prenatal and postnatal massage for decreasing depression (8,9).
Be prepared to take a comfort break or stop before the scheduled time if the client is feeling emotionally overwhelmed and begins to cry.
Articles and Journals Referenced:
- Field, T., Grizzle, N., Scafidi, F., et al. (1996). Massage and relaxation therapies’ effects on depressed adolescent mothers. Adolescence. 31(124). 903-11.
2. Field. T., Diego, M., Hernandez-Reif. M., et al. (2004). Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol. 25(2).115-22.
3. Field, T., Diego, M., Hernandez-Reif, M., et al. (2009). Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behav Dev. 32(4). 454-60.
4. Field. T., Diego, M., Hernandez-Reif. M., et al. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. J Bodyw Mov Ther. 16(2). 204-9.
5. Field, T., Deed, O., Diego, M., et al., (2009). Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women. J Bodyw Mov Ther. 13(4):297-303.
6. Choi, M.S., Lee, E.J. (2015). Effects of foot-reflexology massage on fatigue, stress and postpartum depression in postpartum women. J Korean Acad Nurs. 45(4):587-94.
7. Onozawa, K., Glover, V., Adams, D., et al. (2001). Infant massage improves mother-infant interaction for mothers with postnatal depression. J Affect Disord. 63(1-3). 201-77.
Susan Salvo is a board certified massage therapist with 30+ years of experience. Susan is passionate about massage therapy and massage education. You can contact her at firstname.lastname@example.org.