What to Ingest when Youre Expecting: A Primer on Integrative Women's Mental Health

Abstract: The pregnancy and postpartum period is a time in a woman's life where they have the most interaction with healthcare providers and a time where new onset psychiatric symptoms are most common, yet there remains a degree of discomfort using mainstream interventions with this patient population.

There are numerous reasons why a patient might desire integrative care for mood symptoms; these include (but are not limited to) limited or partial efficacy of psychotropic medications, a desire for a “natural approach”, intolerable side effects, and, in pregnant patients, fear of harmful effects on either the pregnancy or the fetus. While many of our mainstream interventions are known to be fairly safe in pregnancy it is the responsibility of the treating clinician to engage in a well rounded, evidence based discussion about pharmacological, psychotherapeutic, and alternative treatment interventions.

The use of these alternative treatments extends before and beyond pregnancy, including premenstrual dysphoric disorder and perimenopause. Special medical considerations such as cancer diagnosis and treatment can drastically alter the timeline and impact of these phases as well as their respective psychiatric presentations.

Most clinicians are not well versed on the evidence behind the effectiveness of alternative treatments, leading to potential underutilization of these low risk and helpful approaches. The established literature for many alternative interventions does not focus on safety or efficacy during pregnancy. While most alternative options are likely harmless, they may come with potential interactions or negative side effects that are important to consider in the context of a holistic treatment plan.

As clinicians get more comfortable with presenting alternative treatments backed by evidence, patients will be more willing to try them. This discussion may prompt a change in the standard of care where alternative treatments are more routinely used as adjuncts and help patients achieve full symptom remission.





Throughout this series of loosely connected mini talks, we will focus on the available evidence for efficacy and safety of alternative interventions in women and highlight areas for future research, focusing especially on perinatal mental health, cancer patients, menopausal symptoms, and libido. We will use audience polling, case based discussions, and personal experience throughout these talks to assess background knowledge and enhance audience interaction.



Dr. Vangala, who splits her time between general C-L and reproductive psychiatry, will introduce the session and provide an evidence-based overview of supplements and nutraceuticals (20 min)

Ms. Ableman, a first year medical student who majored in nutrition science, will discuss dietary interventions for women’s mental health focusing on the change in nutritional needs in pregnancy and menopause (17 min)

Dr. Cinderella, a community-based general C-L psychiatrist, will present on “interventional” integrative approaches such as light box therapy, reiki, yoga and other movement-based approaches (17 min)

Dr. Mojtahedzadeh, a psycho-oncologist, will focus on integrative and holistic approaches to mental health treatment in cancer patients (17 min)

We will end with a brief Q&A session (4 min)

Content Contributors: N/A

Diversity, Equity, and Inclusion: Our general session has presenters from different institutions working in drastically different settings; we also have a first year medical student who majored in nutrition science (Ms. Ableman) to provide additional perspective on this vital issue. Women have traditionally been under-represented (or frankly excluded during pregnancy) from FDA medication and safety trials. This trend unfortunately continues with non-pharmacologic interventions, without the benefit of postmarketing surveillance. Through our presentation, we will consolidate what efficacy and safety data exists and highlight the need for ongoing research.