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Outside Parenting

Personal trainer and Mum of 4 Laura talks to us about the role of exercise in the treatment of PND

Laura Haldane
Director of Sonning PT
Level 3 Personal Trainer
BA Human Movement Kineseology UTS

The Role of Exercise in Treating PND

So many people have opinions on mental health difficulties and how to treat them. If you are having cardiovascular problems, it seems unlikely that your friends would offer their advice on diagnosis and treatment: yet mentioning Post Natal Depression equates to your whole mothers group, neighbors and relatives weighing in on how to treat your symptoms and how to make it “go away”.
Lately discussions have been centred on exercise and whether or not it can be a viable treatment for PND
A quick review of the research on the role of exercise in treating PND will provide some clarity as to its effectiveness.
Regular exercise has been proved to have an antidepressant effect in both general and clinical populations. The question is, does this translate to women experiencing PND?
The controlled trials that have been carried out in this area are few and far between. Two small, randomized trials were conducted in Australia, with a view to looking at the role of pram walking as an adjunctive treatment for PND. The results showed that exercise was indeed effective as a treatment, especially as new mothers are often reluctant to take medication when breast feeding their infants.  It is worth noting that adherence to the exercise programs in this trial were 73% which is similar to clinical populations when trialing antidepressant drugs.
Uncontrolled research and GP observational surveys were also reviewed and all of these found that mothers deemed at risk of PND reported increased motivation, self confidence, and that participants felt more relaxed and fitter following the exercise. These same surveys however also reported that the chance to discuss issues with other mothers were more important to the general feeling of well being of the participants. It seems that a group exercise solution where the mother’s can chat and participate in fitness would be ideal.
How and why does exercise work?

Any theory as to the mechanisms for how exercise improves mood are speculative. There has been no study to date that has looked at the actual pathway that occurs in depressed patients successfully treated by exercise.
The most common and widely held belief by the general population is the “increased endorphin” theory. This theory has very little clinical support, but for some reason remains popular in unscientific communities.
Psychological results that follow exercise are more likely to explain its role in treating PND. Self esteem and self-mastery would likely cause positive self-evaluations, and improvements in physical appearance can be regarded as positive cues to mood elevation, especially when many new mothers experience negative feelings about their bodies after giving birth.
Some researchers have hypothesized that exercise can serve as a distraction from their daily stress. The new mothers may find that exercise is a useful tool in gaining objectivity and focusing on something other than their current circumstances.

More Trials Needed

Although encouraging, the trials used to investigate the effects of exercise on PND are limited. The two controlled trials suggested that woman suffering from PND symptomology may gain psychological benefits from undertaking exercise, as did the observational evidence, which also concluded that community based programmes were acceptable to post partum women.
It seems, due to the reluctance of new mothers to take drug interventions and the limited availability of psychological therapies, exercise does have a role to play in treating PND.
More large-scale studies are required to investigate whether exercise is effective with all ranges of mothers who suffer from PND, and studies to determine type, time and intensity of exercise used, would be helpful from a prescriptive perspective.
Should Exercise be used by itself or in conjunction with Drugs?

Drugs have been reported to be effective in treating PND in one small trial, but their effectiveness in the general population of depressed people translates that they are the best tested and proven treatment for PND so far. The reluctance of many mothers to take antidepressants post partum suggests that we need to find alternative methods to treat PND. Psychological counseling has also been proven to reduce the symptoms of postnatal depression, however the availability of these private or group discussion groups is often irregular or untimely for new mothers.
Exercise is not the cure all treatment for PND. It has limitations, such as adding another chore to a new mother’s list, which can add to their feelings of abject failure if it doesn’t get completed. Lack of motivation to exercise can often occur in people experiencing mental ill health; so actually beginning the exercise may provide quite a challenge.
 Along with counseling based interventions, if exercise can be added into the routine of a new mother, the majority of them will see real improvement in mood and self esteem over a 12 week period. Continual Psychological evaluation should occur throughout this time and drug therapies should be included where needed.
For those new mothers experiencing severe PND or Post Partum psychosis, exercise alone would not be an effective treatment and would need to be used in conjunction with the other mentioned methods of treatments.
Email Laura

Rebecca's experience of exercise

Exercise before and after having a baby 

Mummy Vlogger @mrsemilynorris recently posted on YouTube about an app called 8fit. As someone who has zero willpower I didn't look at this app as something I would use as it's an app where you control how many workouts you do and when (the hard bit) what they do is provide the short workouts that you follow on your phone.  After a few failed attempts to get to a gym class and struggling to find a PT I downloaded the app taking advantage of the free 30 days offer and haven't looked back since. You answer a few short questions then you are ready to go with your first workout. 

Why this app works for me

  • I don't have to leave my home/arrange childcare
  • I don't have to get changed
  • The workouts are short
  • I can do more (or less) at the click of a button 
  • I'm close to a loo at all times (thanks post baby incontinence!)
  • It's cheap
  • There is no joining fee and I can cancel whenever I want to
  • Every workout is different
  • It travels with me so no excuses
  • I can track my workout history & results
  • And I'm already feeling a difference


Before having a baby/being pregnant I regularly attended exercise classes such as Les Mills classes or yoga and Pilates. Exercise was such a big part of my life it has helped me to make new life long friends... teachers, other attendees etc. I've done 26 mile walks for charity, sponsored spin classes and yoga weekends. I wasn't happy with my body but then I think most women aren't but I was confident in it.

I knew returning to exercise would be tough after having a baby but I had NO idea how tough both mentally and physically.  After having my baby I wasn't able to excerise firstly due to a episiotomy and tear (and childbirth isn't easy on your body) but also mentally the thought of exercise when I was fat and frumpy was the last thing on my mind. Putting on Lycra leggings and a sports bra with a Tena lady wasn't doing it for me. And lastly I didnt want to excerise. I lost a lot of weight very quickly when I was ill with PND, my anxiety and depression seriously affected my appetite so I lost a lot of weight very quickly so as I got better I didn't think I really needed to worry about exercise.

Now 18 months on, I not only need to exercise I am craving it but the fear of incontinence in a class, the embarrassment I feel when I see myself in the mirror, the lack of time now I work full time and finding an hour to myself every week is a luxury and finally lack of energy because I still suffer from disturbed sleep all stop me stepping into a gym.  I know to most this will seem like an essay of excuses but it's honestly how I feel. 

So I began to research exercising in my own home. I looked at workout dvds, exercise cards and finally  exercise apps. My favourite and easiest to use whilst being most effective was 8fit.

It is another thing to add to my already very busy life but it is one that should have little impact on my time but benefit me both physically and mentally so it is definitely heading towards the list of my priorities. Lets see how I get on! Watch this space.... 
Link to 8fit