Postpartum Depression: A Case Study

Postpartum depression can have serious consequences for the health of both mother and child. Indeed, a recent study of 10, 000 postpartum women found 19.3% of women with postpartum depression had considered hurting themselves (5). In the United Kingdom suicide is the leading cause of maternal death in the postpartum period (6). Even in less severe cases, postpartum depression may compromise caregiving practices (e.g., are less likely to use car seats, breastfeed, or ensure that their child receives up to date vaccinations); (7;8) and maternal-infant bonding (e.g., are less responsive to their infants, engage in less face-to-face interactive play and participate in fewer enrichment activities); (7;9;10). These factors may be partly responsible for delayed cognitive, intellectual, social, and emotional development of the child (11-15). Given the negative consequences of postpartum depression, prevention and treatment is imperative.

The impact of postpartum depression causes a mother to frequently feel exhausted, emotionally empty, and guilty because she cannot show love to her baby. The mother feels overwhelmed by feelings of harming her baby and may lack the emotional energy to relate to her newborn, which prevents her from perceiving the baby’s attempts to communicate. Depressed mothers are less likely to play with, read to, or even breastfeed their baby and tend to be inconsistent in their care causing a disruption in the bonding process. Many mothers are embarrassed to get help out of shame. Postpartum depression also has an extremely high impact on the newborn. Katja Gaschler (2008) states, “three-month-old infants of depressed mothers look at their mothers less often and show fewer signs of positive emotion than do babies of mentally healthy mothers” (p. 65). Postpartum depression during the first few months of life may also cause negative effects on a child’s development including: social problems (difficulty establishing relationships, social withdrawal, and acting out destructively); behavioral problems (temper tantrums, sleep problems, hyperactivity, and aggression); cognitive problems (walking and talking late and learning difficulties); and emotional problems (low self-esteem and anxiety). The family as a whole is also greatly impacted by

Borra, C., Iacovou, M., & Sevilla, A. (2015). New Evidence on Breastfeeding and Postpartum Depression: The Importance of Understanding Women 's Intentions. Maternal & Child Health Journal, 19(4), 897-907. doi:10.1007/s10995-014-1591-z

Twenty-four mother-infant dyads completed all aspects of the study. Of those 24, 18 were Caucasian, 22 were married, eight of them had an annual family income of $50,000 to $74,999, and seven had an annual family income of over $100,000. Also 16 of the participating mothers had a graduate degree. Not only is the sample size very small, but the demographics of the mothers is greatly disproportionate. With the majority of mothers being caucasian, educated, middle class, married women, the sample size does not accurately represent the majority of the population who lives in relative poverty and cannot afford to seek help. About half of the mothers had a history of depression and were taking or had just started taking antidepressant medication when they first enrolled. Considering the size of the sample, all the mothers should have been either prescription drug users, or not, but not both. Prescription drug treatment for any depression significantly changes perceptions of mood, skewing the results, and there is not enough women in the study to make a concise prognosis.

I believe that mental health is not well discussed, or known, in today’s culture. People could struggle with mental health daily and others could have no idea. There are many different types of mental health issues, and one specific issue that is rarely discussed is postpartum depression. Postpartum depression is a specific type of depression that new mothers can experience after the birth of their child. (Schacter, Gilbert, Wegner, Nock, 2012). The changing hormones a mother can experience directly after birth cause this condition. Postpartum depression can cause a mother to feel sad, guilty, and even experience thoughts of suicide. Postpartum depression may be discussed in the text, but the causes and even the treatments are not.

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.

The birthing process generally leaves women with overwhelming joy and happiness. However, some women do experience a period of postpartum blues lasting for a few days or at most a couple of weeks but goes away with the adjustment of having a baby (Postpartum Depression, 2013). A condition called Postpartum Depression Disorder (PPD) leaves a dark gray cloud over 10-20% of woman after birth that is recognized in individuals 3 weeks to a year after the delivery of their baby (Bobo & Yawn, 2014). PPD leaves new mothers feeling lonely, anxious, and hopeless (Bobo at el, 2014). Postpartum Depression is a cross cutting disorder that can affect any woman after the delivery of a baby regardless of race, socioeconomic status, age, or education level (Postpartum Depression, 2013). Although this disorder affects more than 10% of women the article Concise Review for Physicians and Other Clinicians: Postpartum Depression reports that less than half of women with PPD are actually diagnosed with this condition (Bobo at el, 2014). It is important that postpartum women and their support systems receive education on what PPD consist of and ways to recognize the signs and symptoms of PPD so that a diagnosis is not overlooked. Early diagnosis is important because early recognition and treatment of the disorder yields for better results when treating individuals with PPD. In this paper I will deliver information about PPD based on recent literature,

As mental health in America is finally being addressed and more research is seen, it is important to look at the potential causes or correlations that lead to common diagnoses for patients. According to Brummelte and Galea (2010), “depression affects approximately 1 in 5 people, with the incidence being 2-3x higher in women than in men.” Postpartum depression (PPD), a subset of this debilitating disease, has an estimated prevalence rate of 13-19% with another estimated 50% that are undiagnosed (O’hara and McCabe, 2013). As a whole, it has the same symptoms as major depressive disorder but diagnosis occurs within 0-4 weeks of giving birth (American Psychiatric Association, 2013). Part of this lack of diagnosis is due to a multitude of healthcare

There are times when new mothers are misdiagnosed and are given a lesser form of this depression. This is called having the baby blues, which is when a new mother experience’s mood swings, and anxiety. These symptoms can last one or two weeks after giving birth, where postpartum depression can continue on for months at a time. Even with baby blues having such a shorter time frame even after 2 weeks’ these new mothers are not being diagnosed correctly. In Mental Heath of Teen Mom Matters, Shiloh gives her experience “My son was crying and it was like the noise of scratching a chalkboard” (Reese p. 1) A new mom can face all these difficulties and my feel as though they do not have a maternal attachment to their

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

Postpartum depression is a mood disorder in females that is known to be present within the 4 to 6 weeks after childbirth (Battle et al). This condition is the most common complication after childbirth (Mosses-Kolko et al.,2009).Studies have shown predictors which lead to postpartum depression such as maternal childhood maltreatment and lifetime posttraumatic stress disorder (PTSD)in pregnancy (Seng 2013).A variety of factors exist among certain subgroups of women that may lead to postpartum depression. Postpartum depression affects approximately “one out of eight of the more than four million women who give birth in the United States every year”(Kruse et al. 2013a). The estimation of PPD in the US, UK, and Australia is from 7% to 20 % (Fitelson

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

Mothers who have brought into this world a blessing have been preparing themselves for a big change in their life. They have been learning and educating themselves about how to be a good mother. Many mothers find it really hard to transition from being an independent woman without children to becoming a mother (Corrigan, Kwasky, & Groh, 2015). Adapting to motherhood can be a drastic change, and usually creates challenges that lead to feeling overwhelmed (Leger & Letourneau, 2015). When a newly mother begins experiencing stress or becomes emotional then there can be a possibility that they can encounter Postpartum Depression (Leger et al., 2015). Postpartum depression can be seen and experienced in many different ways, it all varies on every mother (Corrigan et al., 2015). Many different mental health issues can be seen including baby blues, postpartum depression, postpartum obsessive-compulsive disorder, and the most serious, postpartum psychosis (Tam & Leslie, 2001).