Mental Health Support Through Fertility & Post-Partum

Christina Bjorndal, ND

Yes. I’m excited to be here with you. Thank you so much.

Aumatma Simmons, ND, FABNE, MS

I know that you had some struggles of your own with mental health. Can you share a little bit from your experience about what it was like as you were going through pregnancy and postpartum and what came up for you?

Christina Bjorndal, ND

Before conceiving my son, I already had many mental health challenges. The labels were bipolar disorder, type 1 psychosis, and has also had some suicide attempts. Anxiety and bulimia. Those were my major mental health issues, and I had worked on all of them.  I had my son. My pregnancy was amazing. Amazing pregnancy. You feel great. Usually, you feel great. I think the universe gave me a couple of days of nausea so I could just experience and appreciate what my patients go through. But for the most part, I had an amazing pregnancy and then postpartum, though there were lots of surprises there. There were lots of surprises I found myself in a depression. Actually, before the depression, I had a psychotic event. I think that was due to the lack of sleep with nursing. Then I did have a suicide attempt, which is very sad, I just talk about it now. I’ve been quite private about that for the protection of my son. What child wants to hear that? But he’s old enough now and knows about it. There were a lot of struggles postpartum for me. 

Aumatma Simmons, ND, FABNE, MS

Wow. That sounds challenging. Thank you for sharing. I know. I can’t imagine that it’s so easy to talk about, regardless of how your son feels about it. It sounds like there were some things early on, even before conception. Then do you feel like it was mostly aggravated by the hormonal shifts that are happening postpartum or the lack of sleep, which I think is like a real thing, sleep definition is going to throw anyone back. 

Christina Bjorndal, ND

Exactly. I believe that mental health and fertility are complex issues with numerous factors. There’s no magic bullet here. There’s no one magic piece of the puzzle.  If we just tweaked that, then everything would go away. I mean, I wish it was that simple, but it’s not. There were a multitude of factors. My husband had been working away for two weeks. be two weeks alone in a community that just moved to no support at all and, lack of sleep. I would say those were the two big ones: the community, the lack of sleep, and then the hormones, like what happens. I was good in the first period, like the first bit I got through, but. What other factors I’d say would be, I think, just the stress, like just knowing that you’re, I’ve never been in that position before caring for a newborn. It’s hard to predict how you’re going to be when you’ve never been in a situation before. It speaks to the power of living in the present moment because it’s easy to say, I’m going to be fine, I’m going to set myself up, etc. But the reality is that life shows up differently, and we have to be able to navigate it.

Aumatma Simmons, ND, FABNE, MS

Yes, absolutely. In your experience, what are some of the neurotransmitters that are informing or playing a role in our mental health during this period of our lives?

Christina Bjorndal, ND

The key one. If we take the fertility stage before conception, I find a lot of women are more depressed because they’re upset about the fact that they haven’t conceived yet. Working on serotonin and GABA is prevalent; those are the two main. But the key neurotransmitters overall that I emphasize are there’s seven of them—serotonin, GABA, dopamine, norepinephrine, epinephrine, and glutamate. The pre-fertility piece of the puzzle supports the inhibitory neurotransmitters from a mood perspective, i.e., depression, anxiety, and peace, then postpartum. 

Actually, because of the lack of sleep, there are more excitatory neurotransmitters that come forward. That’s your glutamate, your norepinephrine, and your epinephrine. It depends on the individual and their health history. It highlights the importance of taking a case. Given my health history and now, with hindsight 2020, I would have supported myself so much better in that sleep department, and those excitatory neurotransmitters just pushed me over the edge into mania and psychosis. Like you said, lack of sleep is going to affect all of us. Mental health, labels aside, it’s difficult for the best of us.

Aumatma Simmons, ND, FABNE, MS

Yes, absolutely. Have you found any ways to navigate this period with a little bit more ease?

Christina Bjorndal, ND

Which one are we talking about? The pre- or the post.

Aumatma Simmons, ND, FABNE, MS

The part of the lack of sleep, specifically.

Christina Bjorndal, ND

Yes. What happens super important is that we need to sleep when the baby sleeps and women are good, myself included. I was great at doing that for the first three months, but it was after that that we started to get in our heads a little bit about all the laundry piling up and the dishes that needed to be done, and the support was there. Like, the support is for most people. If you don’t have support, it’s super important to enlist support. Ask for what you need, even though you might not know what you need anyway. I have a great little handout I give to my patients, that says, Ask for a request after the baby’s born. It’s a checklist of things you can ask for. The challenge, though, is that I should change that to asking for requests for the first year after the baby’s birth. Not the first six weeks, three days, because it’s because people move on with their lives and they think you’re okay, and then you’re not okay, and then you don’t know how to ask for help at that point when you’re not okay.

Aumatma Simmons, ND, FABNE, MS

Yes, absolutely. asking for support, whether it’s from your partner, your community, your family, friends, whoever, or your neighbor.

Christina Bjorndal, ND

The guy standing at the bus stop, like whoever you can ask for help, and this is like I said at the beginning, you don’t know what you need until you’re in it. A lot of us, I think, as women, the ones that have been used to being overachieving and having it all together, have a hard time asking for help. I want to emphasize here that this is not a weakness. Your vulnerability is your strength. Lead with your vulnerability here. If you and so, yes, most people are there at the very beginning, in the early weeks months. But it’s sometimes these things settle in the year mark, the two-year mark even.  It truly does take a village here to raise a child. We’ve become so isolated in our society.

Aumatma Simmons, ND, FABNE, MS

Yes, we have. I think it’s so important, especially when we’re in that period of our lives where we’re about to have birth, give birth, or, like, get prepared for that postpartum phase. I feel like a lot of women and couples have struggled with fertility when it’s finally time to give birth, they’re already at the point of, it’s finally happening. It’s great. Everything’s perfect, like this. It’s a little bit surreal when you’ve been challenged by something so much and it’s finally coming to fruition. But it’s, always important to remember, like, this is just the beginning. That is the beginning of the rest of this. In so many ways, it feels like the end of, like, I think this fertility journey is over. I’m wondering if you have anything there. Then also, the other thing that I feel is, Sorry, I’m tearing up because I also had quite a journey after birth. I find that a lot of couples are in that postpartum period, feeling like their emotions are not valid or that it’s not okay to feel negative emotions because they should feel x-y-z about finally being able to have a child. Yes, I was just wondering if you could share any bits of wisdom there.

Christina Bjorndal, ND

There’s so much to unpack there.  It’s so true. I’ll summarize with this quote. Our suffering is equal to sadness; these negative emotions, or just the suffering disappointments, are equal to the gap between expectation and reality. We suffer when reality shows up differently than we expected it to. This is so important with the fertility piece because it’s all about making a baby. Let’s make this baby. What’s and then, that whole conversation about what’s wrong with me if I’m not able to make the baby, but assume you’ve made the baby. You’ve worked with Aumatma. You’ve got that baby conceived as all good; I’ll just take it a little sidestep. It’s so important to work with a naturopathic doctor through each trimester of your fertility, of your pregnancy because it doesn’t stop with conception. It starts with conception and then continues. You’re making a human being, so give it the right substrates to form a healthy baby, because what happens when we have this baby and it doesn’t show up the way we wanted it to?

Baby, it’s got a cleft lip. Maybe it’s got deformity; maybe you experience colic; maybe the baby never sleeps. Therein lies the, then we suffered because this wasn’t what we expected. We didn’t know what to expect. Having these conversations like clinicians need to be having more conversations about reality, not from a place of fear and, moving everyone into, stress, but just just openness about, Hey, this is the whole range of what you could experience. We don’t talk about the negative. Therefore, when it happens, we’re all shocked. Well, maybe if we were a little bit more open about the suffering that can happen, the stress that can happen, the loss of your mind when you haven’t slept, and then you think thoughts about harming your child. I mean, those are just the dark things we don’t discuss. We need to, because most of us, not most of us. I’ll just say that I had no great thoughts. Not great thoughts. What have I gotten myself into? I’m not going to be able to handle this. Why isn’t my child conforming? Why is this? What’s wrong with him? What’s wrong with me? You just spiral down. 

The more that you can learn to manage your mind and learn to be with your emotions; emotions themselves are only going to live, according to neuroscientists, for about 90 seconds to 2 minutes within you. It’s your thoughts that fuel them. There’s a practice that I teach that is basically where you have to learn to recognize what you’re thinking. Ask if it’s serving you, sabotaging you, hurting you, or helping you. Every thought you have is either in service of you or sabotaging you. Be mindful of your thoughts state: Allow those emotions because you’re the home for every emotion within you. You’re the container, you’re the vessel, you’re the one who lives in you, and they’re going to show up, and they need to be held by you, not shamed by you and stuffed and repressed and depressed and pushed down, and you expressed them and know that. Let’s normalize this conversation here. Now, it is normal to have negative thoughts after you give birth. Normal.

Aumatma Simmons, ND, FABNE, MS

Yes. There are many things there that are important in a lot of ways., I think. Any steps or things that people can do to address their mental, emotional, and spiritual well-being through this journey. Speaking about fertility through postpartum, If we just extend postpartum to like 18 years of your life, until your child leaves your home.

Christina Bjorndal, ND

If your child is one of my children, will stay until he reaches the age of fifty. I think we have to extend it a little longer than 18. But here we go. Yes, well, just to keep it short, I would say Read Beyond The Label, that’s the book that I’ve written. It talks about the ten steps to supporting your mental health with naturopathic medicine. One of the things in what I, again, as I said earlier in that fertility journey, is navigating it every time you get your period. How do you feel? When I’m working in fertility, I say to my patients, I know this is an extremely tall order that I’m asking of you, but I’m asking of you to be joyful when you get a period. Most of your patients are not joyful. Most people are upset. Darn. Another missed cycle, another missed opportunity. Now, when you move into that mindset, damn, another missed opportunity, you’re in status, and you get into a sympathetic or stressed state in your nervous system. That’s going to steal your progesterone, and that’s not going to support your fertility journey at all.

This is why you should be grateful for the magic and mystery of your body and the fact that you had a period. That’s miraculous; that’s to be celebrated, not the fact that you didn’t conceive that month. Look at it this way, though you want the best egg. You want the best egg. the one that gets missed, that’s awesome. Because the best egg is the one that’s going to conceive. get into that mindset. Super heart. I understand it. Important. Then there’s so much that you can do to work with your neurotransmitters and hormones. I mean, this is an exquisite symphony that’s happening in your body. What I will say is that if you have a history of mental health issues, it doesn’t matter. Whatever it is, please make sure you’re working on it and that your mental health is the most important thing. Because if that’s in line, in my opinion, your fertility will follow.

Aumatma Simmons, ND, FABNE, MS

Yes. I know that a lot of women and, more often than not, men are on a lot of medications that are to support, quote-unquote, mental health. Antidepressants, anti-anxiety medications, ADHD medications I’ve seen that very commonly. I’m just curious if you have thoughts on A, what people can do in that situation, and B, what are some of the downstream effects that are going to impact fertility, whether it’s nutrient depletion or something? Hey, this isn’t getting at the root of what’s happening with your mental health and may not be supporting you. Yes, I was just curious about that.

Christina Bjorndal, ND

Yes, it’s such an important piece. Medication depletes your nutritional status, and your nutritional status influences how you form an egg or the health of your sperm. Often, when you’ve been on medication, I’m not saying not to take medication; that’s fine. Take some medication. But here’s the thing: Medication should be used like we would use a cast if you broke your leg. We’re not going to leave that cast on for the rest of your life.  It’s normally a six-week process to wear a cast to fix a broken leg. You might need medication for an acute situation to help get you on some solid ground. But do you need to take it for the next five years? Because life moves on, circumstances change, and mental health is again multi-factorial, hormones play a role in mental health.

If you’re low in testosterone, depression. A guy goes to the doctor and gets diagnosed with depression. They look at it from a neurotransmitter perspective, give you a serotonin selective uptake inhibitor medication, it feels better, and it goes along. They never looked at that testosterone piece; low testosterone causes depression. Then you’re taking this SSRI. It depletes important nutrients that are needed for forming sperm, and your libido walks out the door like it’s just so complicated. Not complicated, but it’s multifactorial. There are lots of connections there. I think this is so important. You hit such an important point because women are often the ones that everyone’s focusing on in this journey, but men play an equal role. If your sperm cannot get to that fabulous egg that she’s making, we know she’s making an egg because she’s having her period every month and most likely is ovulating. She’s doing all she can. What are you doing, guys? You don’t just get to show up here. Your sperm has to be made properly. They got to swim, and they got to have the duration, like the motility. To get to that egg, it’s got to travel up to where the eggs are waiting. It’s got to get there. Like, what if your eggs are here and the sperm just dies there? You didn’t have enough energy to make the journey to mitochondrial health important. Anyway, that’s huge. I could rant on this for a while, but I won’t if that’s okay. But I can if you want to.

Aumatma Simmons, ND, FABNE, MS

Yes. If you have other pieces around like which nutrient deficiencies should be aware of, that would be super helpful.

Christina Bjorndal, ND

Well, the main one that I want for this SSRI class of medication is one that I just mentioned that affects mitochondria, which is coenzyme Q10. coenzyme Q10, all the B vitamins, folate, etc., magnesium, zinc—those are the main ones that get met that the SSRI needs to get used up in the metabolism of SSRI medications. then there are also sleeping pills that a lot of people are using. There’s a great lab that I don’t know if they have on their website, but I have the chart. It’s called SpectraCell, and they have a great chart that says, Do the medications you take deplete your nutritional status? There’s a public website called mytavin.com. You can just punch that in, and it will tell you everything. Yes, mytavin.com. I should check that it’s still around because I haven’t used it in the last year or so. But how have things changed? I mean, it’s very helpful.

Aumatma Simmons, ND, FABNE, MS

If it works. Awesome. Yes. I think that piece is important because I feel like it’s too often that men specifically don’t have concerns about what any medication means for their fertility, and it’s not even on the radar of so many doctors. You spoke about testosterone. I’ve seen so many guys being put on testosterone without a conversation of, Hey, this me? Like, shoot your sperm in the foot. Like, you may not have any sperm if you take this for too long. Like, those types of conversations are just not happening frequently enough. I do think that there needs to be more awareness around whatever medication you’re choosing and that it be aligned with your fertility, whether it’s now or in the future so that you can be aware and prepared for what may come.

Christina Bjorndal, ND

Absolutely. then do the work. Do the work around whatever it is, whatever the issue you had at that time that had you seeking support and being prescribed that medication. Remember, as we fast forward six months to a year into the future, you’re not the same person. Yes. revisiting that piece of the puzzle, do we need to keep taking this? If you’re no longer feeling. Here’s the thing. You might think, well, but I’m only feeling better because I’m taking the medication. That means you’re using a band-aid approach. You haven’t fixed anything. The goal isn’t to keep you on medication for the rest of your life, nor is it to keep you on supplements for the rest of your life. The goal is to build the foundational building blocks of health so that you can sustain your health yourself. An important point for men, too. I’ll just mention that my husband’s working on a mission to help support testosterone in men because, for lots of reasons, testosterone levels are declining in men. What they do with the reference ranges is they’ve changed them. They’ve lowered them over the years because you and I have been practicing for a long time, and over the last 20 years, reference ranges have been lowered for sperm count and testosterone. and you have to ask yourself, Why is that? Also concerning reference ranges, you want to be in the upper third of a reference range. If the reference range for testosterone is 8 to 30, some guys think they’re doing awesome, but when they’re at level 10, that’s not awesome.

Aumatma Simmons, ND, FABNE, MS

All.

Christina Bjorndal, ND

Are you having morning erections? This one is very simple—someone’s simple physiological measurement for yourself if you’re not. Men don’t know this young boy coming up from 20 to 35; they don’t realize that it’s not normal not to have a morning erection.

Aumatma Simmons, ND, FABNE, MS

Wow.

Christina Bjorndal, ND

Yes.

Aumatma Simmons, ND, FABNE, MS

Great pieces of nuggets here. Thank you so much for being with us today. Is there anything you would like to share on this topic or anything else that we haven’t talked about yet?

Christina Bjorndal, ND

There’s so much, I think, but what I would say is to make your mental health a priority and know that whatever happens in that postpartum period, the best medicine is prevention. Setting yourself up for success. Start talking to your friends who have children and your doctor. What did they go through? What would they have done differently in their postpartum period to support themselves now that they’re on the other side of that? Because I know for myself, I was very fearful to have another child because of my experience in those first three years postpartum with my mental health. When I thought I was solid, it was not. Challenging for me. Now I’ll tear up. 

But since the last since 2008, however many years—that’s 15 years—it’s been solid for the most part, with some wobbles. But that’s because, anyway, I won’t go into all that. The point is, it doesn’t have to be wobbly for you. That sets you up for success. We want not only the pregnancy but the post, like you said until the child is 18. You want that to be amazing. We could go on about how we used to do another summit about parenting and all of that, attachment parenting, and how to raise an amazing teen. I’ll just say this last thing. 

The other day I was thinking, I  braced myself for the teenage years because, in our culture, our society is quite negative about the teenage years. I’ve rephrased most of the years like it was terrific two, my son, the tremendous threes, and the fabulous fours. It was just an honest-to-goodness; it has been years since I experienced anything. There were no terrible twos or anything. It was incredible because I subscribe to the attachment theory of parenting. Anyway, I was walking and I had that thought, and then I’m like, wait a minute, he is 17 and a half, and I’m through the teenage years. There hasn’t been anything like that. I’m I got a little off a lot easier than my mom did with me and my brother. Anyway, thank you so much for having me.

Aumatma Simmons, ND, FABNE, MS

So good to have you, chat with you, and just gain all of your pearls. I appreciate you being here.

Christina Bjorndal, ND

I appreciate you so much. Thank you.