Clinical Depression In Women

Postpartum depression is one of the most common complications of childbearing with an estimated prevalence of 19.2% in the first three months after delivery (1). Depressive episodes (major and mild) may be experienced by approximately half of women during the first postpartum year (1). Characterized by depressed mood, loss of pleasure or interest in daily activities, feelings of worthlessness and guilt, irritability, sleep and eating disturbances (2), its etiology is multi-faceted and complex (3;4).

Often the time after birth is a filled with joy and happiness due to the arrival of a new baby. However, for some mothers the birth of a baby leads to some complicated feelings that are unexpected. Up to 85% of postpartum woman experience a mild depression called “baby blues” (Lowdermilk, Perry, Cashion, & Alden, 2012). Though baby blues is hard on these mothers, another form of depression, postpartum depression, can be even more debilitating to postpartum woman. Postpartum depression affects about 15% (Lowdermilk et al., 2012) of postpartum woman. This disorder is not only distressing to the mother but to the whole family unit. This is why it is important for the nurse to not only recognize the signs and symptoms of a mother with postpartum depression, but also hopefully provide preventative care for the benefit of everyone involved.

Postpartum psychiatric disorders, particularly depression, has become the most underdiagnosed complication in the United States. It can lead to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development (Earls, 2010). Over 400,000 infants are born to mothers that are depressed. One of 7 new mothers (14.5%) experience depressive episodes that impair maternal role function. An episode of major or minor depression that occurs during pregnancy or the first 12 months after birth is called perinatal or postpartum depression (Wisner, Chambers & Sit, 2006). Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others (Postpartum Depression). The six stages of postpartum are denial, anger, bargaining, depression, acceptance and PTSD. These stages may affect any women regardless of age, race, ethnicity, or economic status. However only a physician can diagnose a woman with postpartum depression. It does not occur because of something a mother does or does not do, it’s a combination of physical and emotional factors. After childbirth, the levels of hormones in a woman’s body quickly drop; which may lead to chemical changes in her brain (Postpartum Depression). Unbalanced hormones may trigger mood swings.

Postpartum depression, which is the most prevalent of all maternal depressive disorders, is said to be the hidden epidemic of the 21st century. (1) Despite its high prevalence rate of 10-15% and increased incidence, postpartum depression often goes undetected, and thus untreated. (2) Nearly 50% of postpartum depression cases are untreated. As a result, these cases are put at a high risk of being exposed to the severe and progressive nature of their depressive disorder. (3) In other words, the health conditions of untreated postpartum depression cases worsen and progress to one of their utmost stages, and they are: postpartum obsessive compulsive disorder, postpartum panic disorder, postpartum post traumatic stress, and postpartum psychosis.

Despite the physical changes that a woman is to expect during her pregnancy, a major concern that requires attention is a period of expected feelings of depression that a woman may encounter known as baby blues. Although normal, and expected baby blues can lead into post partum depression that involves a myriad of emotions and mood swings. If not addressed postpartum depression can lead to a more severe form of baby blues known in the clinical world as postpartum non-psychotic depression that requires professional intervention. The therapeutic goal during this time is to prevent the new mother from committing suicide where she poses a danger to both herself and her newborn.

Postpartum depression (PPD) is a major event occurring in eight to fifteen percent of the woman population after delivering their child (Glavin, Smith, Sørum & Ellefsen, 2010). The symptoms and causes of PPD are similar to depression symptoms in other periods of life (Glavin et al., 2010). These symptoms may include feelings of helplessness and hopelessness, loss of interest in daily activities, sleep changes, anger or irritability, loss of energy, self-loathing, reckless behavior and concentration problems. These symptoms may lead to other factors that are detrimental to the child bearing and rearing family.

Mental health has become an important factor in a persons well-being and is recognized as having the same importance as physical health. The mental health of a person can determine how they act in society. Their mood and behavior can be severely affected in ways that family or friends don’t understand. A mood disorder that has a significant affect on family members is called postpartum depression. Postpartum depression is a mood disorder that occurs in women who have given birth a few weeks prior. This mood disorder is diagnosed after two months or even longer, new mother can be continuously sad throughout the day and feel as though not having a connection with their baby. Doctors are not able to know which mother will have postpartum depression

According to two recent studies, 7-13% of all postpartum women suffer from depression. Even more alarming, the prevalence of postpartum depression (PPD) in mothers who have pre-term infants rises to 30-40% according to a recent review (Robertson E, Grace S, Wallington T, Stewart DE., 2004; Schmied V, Johnson M, Naidoo N, et al., 2013). Mood and anxiety disorders, specifically PPD, are severe, yet common complications in women of reproductive age. Undertreated depression in postpartum women is associated with health risks for both the mother and infant, making the goal of euthymia a top priority in the care of postpartum women. Current practice regarding PPD focuses on the triad approach of early detection and prevention, the use of pharmacotherapy, and the use of psychotherapy. However, the treatment of mental illness during pregnancy requires weighing the benefits of pharmacological treatment for the mother, to the risk of the medications on the growth and development of the fetus as well as the theoretical risks associated with undertreated depression. However, many studies are showing that the risks of postpartum depression to both the mother and infant significantly outweigh the risks of pharmacological treatment during pregnancy. Also, due to the ethical issues surrounding trials of pharmacotherapy during pregnancy, further research to determine evidenced-based methods of treatment are still necessary. The most important intervention to date is a

Depression is a major public health problem that is twice as common in women as men during the childbearing years. Postpartum depression is defined as an episode of non-psychotic depression according to standardized diagnostic criteria with onset within 1 year of childbirth (Stewart D., et. al, 2003, p. 4). For women aged 15 to 44 years around the world, Postpartum Depression is second to HIV/AIDS, in terms of total disability (World Health Organization, 2001). Depression has a profound impact on parameters of interpersonal behavior. Post-Partum depression

“Postpartum depression affects 10% to 20% of women after delivery, regardless of maternal age, race, parity, socioeconomic status, or level of education”.( Consise) Postpartum depression is a major depression episode that occurs after childbirth affecting not only the mother but also the child and family members. After the delivery of the placenta extending for about six weeks this is considered as as the postpartum period. This a critical period for the mother and new born physiological and psychological because the woman’s body is returning to a non-pregnant state in which hormones, sleep parttters, emotions and relationship are changing. Therefore, up to 80% of mothers experience the "baby blues during the first week in which

One of the most devastating impact that postpartum depression can have on a mother is to interfere with the ability to care for her child. That is an instant blow to the bonding process. Mothers who suffer from postpartum depression start to feel inadequate as a parent. They have very little interaction with their infant. Quite often they will make less eye contract with their infant as well as, they display less examples of mother-child contact and positive interaction as compared to mothers who don’t have depression. A mom who has postpartum depression shows less affection toward their infant and they also are less sensitive and nurturing. At this stage the infant will sense the tension and anxiety the parent is feeling and in return they will withdraw from their parent. The interaction between mother and child at the early phase of a child’s life is very critical to the evolution of a child.

If left untreated, postpartum depression can interfere with parents-child attachment and cause family problems later on in life. For mothers, untreated postpartum depression can last for months or up to years, sometimes becoming a chronic depressive disorder. Even when treated, postpartum depression increases a woman 's risk of future episodes of major depression. For fathers, postpartum depression can have a ripple effect, causing emotional damage for everyone close to a new baby. According to the Mayo Clinic Staff, “When a new mother is depressed, the risk of depression in the baby 's father may also increase”. New dads are already at a highly risk of depression, whether or not the mother is affected. Children of parents who have untreated postpartum depression are most likely to have emotional and behavior problems, such as sleeping and eating disorders, excessive crying, and attention-deficit/hyperactivity disorder (ADHD). And will also delay in language development.

Only in recent history have significant strides been made to understand and treat postpartum depression. While the psychiatric disorder was written as long ago as 700 BC, by Hippocrates, it was not officially recognized as a medical diagnosis until the nineteenth century. Even in today’s society, individuals tend to harbor ill feelings toward postpartum depression, likely due to cultural beliefs and miseducation. According to the U.S National library of medicine postpartum depression is “moderate to severe depression in a woman after she has given birth, occurring soon after delivery or up to a year later”, (U.S National Library of Medicine, 2014). Women have been most widely identified as being impacted by postpartum depression, and for decades, research has focused on them, with limited data related to males. However, recent studies focusing on male postpartum depression, not only prove that men are affected by the disorder; potentially to the same extent as women, but also suggest that there is a likely correlation between either parent having the condition, and it consequently affecting both parents. Recent studies have found that, “prenatal and postpartum depression was evident in about 10% of men in the reviewed studies and was relatively higher in the 3- to 6-month postpartum period. Paternal depression also showed a moderate positive correlation with maternal depression” (Paulson and Bazemore, 2010, p. 1961). Given this

Postpartum depression is the most common psychological complexity that occurs after childbirth (Bakhshizadeh, 2013). This form of depression has been reported to be as high as 20% (Asltoghiria, 2012). The mother will begin to experience postpartum depression between the birth of the infant and 6 to 8 weeks later (Bhati, 2015). Depending on the person, the typical length of postpartum depression ranges anywhere from two weeks to two years in length (Posmontier, 2010). It is thought that postpartum depression affects mothers of multiples at a greater incidence than mothers whom birth just one child, and the chance increases with the number of children in a multiple birth. Evidence shows that the older the mother’s age at the time of birth, shows there is no notable increase in the risk of being diagnosed with postpartum depression. Another factor that is thought to have an influence on the diagnosis of postpartum depression is income within the household. A study shows that as income goes down, the risk of having

A mother who struggles with depression post-partum is likely to expose her baby to more harmful effects. Gerhardt (2015) states that the baby of a depressed mother can find it difficult to cope with or get over stress, or they may be more fearful (p. 21). These babies also may respond to others with depression themselves, as their mother may be neglectful in their care (Gerhardt, 2015, p. 36). One of the reasons for this is because of their cortisol levels, which can fluctuate situationally. However, in infants this can affect their development (Gerhardt, 2015, p. 83) as well as their immune system (Gerhardt, 2015, p. 118), and is evidence that a mother with depression can have a significant impact on her child well beyond when the depression occurs. Additionally, Gerhardt (2015) notes that, “When they grow up, these babies of depressed mothers are highly at risk of succumbing to depression themselves.” (p.