Julia J Rucklidge, University of Canterbury; Elena Moltchanova, University of Canterbury; Roger Mulder, University of Otago, and Siobhan A Campbell, University of Canterbury

Antenatal depression affects 15% to 21% of pregnant women worldwide. It can influence birth outcomes and children’s development, as well as increase the risk of post-natal depression.

Current treatments like therapy can be inaccessible and antidepressants can carry risks for developing infants.

Over the past two decades, research has highlighted that poor nutrition is a contributing risk factor to mental health challenges. Most pregnant women in New Zealand aren’t adhering to nutritional guidelines, according to a longitudinal study. Only 3% met the recommendations for all food groups.

Another cohort study carried out in Brazil shows that ultra-processed foods (UPF) accounted for at least 30% of daily dietary energy during pregnancy, displacing healthier options.

UPFs are chemically manufactured and contain additives to improve shelf life, as well as added sugar and salt. Importantly, they are low in essential micronutrients (vitamins and minerals).

The consumption of these foods is concerning because a nutrient-poor diet during pregnancy has been linked to poorer mental health outcomes in children. This includes depression, anxiety, hyperactivity, and inattention.

Increasing nutrients in maternal diets and reducing consumption of UPFs could improve the mental health of the mother and the next generation. Good nutrition can have lifelong benefits for the offspring.

However, there are multiple factors that mean diet change alone may not in itself be sufficient to address mental health challenges. Supplementing with additional nutrients may also be important to address nutritional needs during pregnancy.

Micronutrients as treatment for depression

Our earlier research suggests micronutrient supplements for depression have benefits outside pregnancy.

But until now there have been no published randomised controlled trials specifically designed to assess the efficacy and safety of broad-spectrum micronutrients on antenatal depression and overall functioning.

The NUTRIMUM trial, which ran between 2017 and 2022, recruited 88 women in their second trimester of pregnancy who reported moderate depressive symptoms. They were randomly allocated to receive either 12 capsules (four pills, three times a day) of a broad-spectrum micronutrient supplement or an active placebo containing iodine and riboflavin for a 12-week period.

Micronutrient doses were generally between the recommended dietary allowance and the tolerable upper level.

Based on clinician ratings, micronutrients significantly improved overall psychological functioning compared to the placebo. The findings took into account all noted changes based on self-assessment and clinician observations. This includes sleep, mood regulation, coping, anxiety and side effects.

Both groups reported similar reductions in symptoms of depression. More than three quarters of participants were in remission at the end of the trial. But 69% of participants in the micronutrient group rated themselves as “much” or “very much” improved, compared to 39% in the placebo group.

Participants taking the micronutrients also experienced significantly greater improvements in sleep and overall day-to-day functioning, compared to participants taking the placebo. There were no group differences on measures of stress, anxiety and quality of life.

Importantly, there were no group differences in reported side effects, and reports of suicidal thoughts dropped over the course of the study for both groups. Blood tests confirmed increased vitamin levels (vitamin C, D, B12) and fewer deficiencies in the micronutrient group.

Micronutrients were particularly helpful for women with chronic mental health challenges and those who had taken psychiatric medications in the past. Those with milder symptoms improved with or without the micronutrients, suggesting general care and monitoring might suffice for some women.

The benefits of micronutrients were comparable to psychotherapy but with less contact. There are no randomised controlled trials of antidepressant medication to compare these results.

Retention in the study was good (81%) and compliance excellent (90%).

Beyond maternal mental health

We followed the infants of mothers enrolled in the NUTRIMUM trial (who were therefore exposed to micronutrients during pregnancy) for 12 months, alongside infants from the general population of Aotearoa New Zealand.

This second group of infants from the general population contained a smaller sub-group who were exposed to antidepressant medication for the treatment of antenatal depression.

We assessed the neuro-behavioural development of each infant within the first four weeks of life, and temperament up to one year after birth.

These observational follow-ups showed positive effects of micronutrients on the infants’ ability to regulate their behaviour. These results were on par with or better than typical pregnancies, and better than treatments with antidepressants.

Infants exposed to micronutrients during pregnancy were significantly better at attending to external stimuli. They were also better able to block out external stimuli during sleep. They showed fewer signs of stress and had better muscle tone compared to infants not exposed to micronutrients.

They also displayed greater ability to interact with their environment. They were better at regulating their emotional state and had fewer abnormal muscle reflexes than infants exposed to antidepressant medication in pregnancy.

Reassuringly, micronutrients had no negative impact on infant temperament.

These findings highlight the potential of micronutrients as a safe and effective alternative to traditional medication treatments for antenatal depression.

The prenatal environment sets the foundation for a child’s future. Further investigation into the benefits of micronutrient supplementation would gives us more confidence in their use for other perinatal (from the start of pregnancy to a year after birth) mental health issues. This could provide future generations with a better start to life.

We would like to acknowledge the contribution of Dr Hayley Bradley to this research project.

Julia J Rucklidge, Professor of Psychology, University of Canterbury; Elena Moltchanova, Professor of Statistics, University of Canterbury; Roger Mulder, Professor of Psychiatry, University of Otago, and Siobhan A Campbell, Intern Psychologist, Researcher – Te Puna Toiora (Mental Health and Nutrition Research Lab), University of Canterbury

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Our personalities are generally thought to consist of five primary factors: openness to experience, conscientiousness, extroversion, agreeableness and neuroticism, with each of us ranking low to high for each.

Those who rank high in extroversion, known as extroverts, typically focus on their external world. They tend to be more optimistic, recharge by socialising and enjoy social interaction.

On the other end of the spectrum, introverts are more likely to be quiet, deep thinkers, who recharge by being alone and learn by observing (but aren’t necessarily shy).

But what if you’re neither an introvert or extrovert – or you’re a bit of both? Another category might fit better: ambiverts. They’re the middle of the spectrum and are also called “social introverts”.

What exactly is an ambivert?

The term ambivert emerged in 1923. While it was not initially embraced as part of the introvert-extrovert spectrum, more recent research suggests ambiverts are a distinct category.

Ambiverts exhibit traits of both extroverts and introverts, adapting their behaviour based on the situation. It may be that they socialise well but need solitude and rest to recharge, and they intuitively know when to do this.

Ambiverts seems to have the following characteristics:

• good communication skills, as a listener and speaker
• ability to be a peacemaker if conflict occurs
• leadership and negotiation skills, especially in teams
• compassion and understanding for others.

Some research suggests ambiverts make up a significant portion of the population, with about two-thirds of people falling into this category.

What makes someone an ambivert?

Personality is thought to be 50% inherited, with the remaining being influenced by environmental factors and individual experiences.

Emerging research has found physical locations of genes on chromosomes closely aligned with extroversion-introversion traits.

So, chances are, if you are a blend of the two styles as an ambivert, one of your parents may be too.

What do ambiverts tend to be good at?

One area of research focus in recent decades has been personality type and job satisfaction. One study examined 340 introverts, extroverts and ambiverts in sales careers.

It has always been thought extroverts were more successful with sales. However, the author found ambiverts were more influential and successful.

They may have a sales advantage because of their ability to read the situation and modify their behaviour if they notice a customer is not interested, as they’re able to reflect and adapt.

Ambiverts stress less than introverts

Generally, people lower in extroversion have higher stress levels. One study found introverts experience more stress than both ambiverts and extroverts.

It may be that highly sensitive or introverted individuals are more susceptible to worry and stress due to being more perfectionistic.

Ambiverts are adept at knowing when to be outgoing and when to be reflective, showcasing a high degree of situational awareness. This may contribute to their overall wellbeing because of how they handle stress.

What do ambiverts tend to struggle with?

Ambiverts may overextend themselves attempting to conform or fit in with many social settings. This is termed “overadaptation” and may force ambiverts to feel uncomfortable and strained, ultimately resulting in stress or burnout.

But personality traits aren’t fixed

Regardless of where you sit on the scale of introversion through to extroversion, the reality is it may not be fixed. Different situations may be more comfortable for introverts to be social, and extroverts may be content with quieter moments.

And there are also four other key personality traits – openness to experience, conscientiousness, agreeableness and neuroticism – which we all possess in varying levels, and are expressed in different ways, alongside our levels of extroversion.

There is also evidence our personality traits can change throughout our life spans are indeed open to change.

Peta Stapleton, Associate Professor in Psychology, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.