Treatment of Postpartum Mood Disorder in Iran

In Iran’s health care system, there is no program specifically for the screening of postpartum mood disorders (PPMD). Lack of structured, widespread family education and psychotherapy programs focusing on PPMD, together with denial, helplessness, and cultural barriers, are factors that contribute to the misery of mothers trying to seek help. PPMD treatment can include pharmacotherapy and psychological and social support (1). A focus on ritual practices such as prayer and almsgiving for depression is influenced by Islam. A variety of postpartum rites, such as prescribed confinement periods (which normally range from 30 to 40 days), balanced diet, and practical and emotional support from family members and a traditional birth attendant, are practiced in Iranian communities. Although none of these customs were originally intended to relieve PPMD, they potentially provide social and emotional support for new mothers who are at risk of PPMD.

Complementary/alternative/traditional therapies are also used for care and treatment of PPMD. Some medicinal plants (such as saffron, rose, geranium, and Asperugo procumbens) and foods (such as fish, garlic, milk, oregano, mint, and spinach) are considered to have antidepressant effects and are prescribed by traditional doctors (2–5).

One of the rare traditional rites for treatment of depressed mothers in the southern part of Iran is called Zar, in which lay women go to practice mindfulness meditation. The pregnant or postpartum woman is accompanied by a traditional midwife and stays on a campus near the sea for 3 to 14 days. The traditional midwife massages the woman with an ointment that contains 21 kinds of herbal medicines. On the last day, the patient asks the traditional healer, who has a stick in her hands, to help raise the jinnee or “Al” (a fearful creature who is the persecutor of the parturient woman) from her body.