Postpartum Depression And Postpartum Psychosis

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).

“In 1858 postpartum psychosis was determined by organic factors and constituted a disease entity” (Swyer 1232). To understand whether Margery Kempe had postpartum depression, psychosis, or a different mental illness like depression after her first child, readers have to look at the symptoms Margery Kempe showed and the symptoms of each illness. To start, depression is the least serious and can happen to anyone. Wiessman and Olfson said that women tend to be more depressed than men and can begin early in adolescence years, “around 13 to 15 years of age, and is maintained throughout life. There is a peak in first onsets during the childbearing years and a decrease in onsets after age 45”and that “depressed

On June 20, 2001 Andrea Yates shocked the nation when she drowned all five of her children in Texas. The press and the public speculated about what could cause a mother to murder her own children. Two words became a significant part of her legal team’s defense: “postpartum depression” (Cohen). A public dialogue was opened and the issue of postpartum depression saw a significant shift in awareness. This new era of enlightenment would be considerably different from the earlier history of post-partum depression and some of the shame that surrounded it. Beyond Andrea Yates, other women have increased the prominence of the mental disorder in the public’s eye, with some doing so with optimistic rather than damaging behavior. Yet, even with the increased awareness, there has not been a considerable change in the number of women treated for postpartum depression, which is still subject to many stigmas in today’s society. Despite this, much has altered in the how postpartum is viewed over the past decade and a half, which gives hope for a future where mothers will receive the full care and support they need to combat the disorder.

Maternal mental health (MMH) disorders occurs in one out of 10 women during pregnancy and within the first year after birth (Maternal Health, 2016). Current law in California states no requirement for perinatal or postpartum screening. AB 244 proposes to create a pilot program to increase the healthcare providers capacity and training to manage MMH conditions to serve pregnant and postpartum women up to one year after delivery (California Legislative Information, 2017). The purpose of this paper is to increase management of MMH disorders, support of bill AB 244 and Assemblymember Cristina Garcia’s opinion, how a bill becomes a law, and how nurses can impact current law.

To assess the mothers’ postpartum psychiatric difficulties the Postpartum Depression Screening Scale (PDSS; Beck & Gable, 2000) was used. Prior to treatment, mothers completed a self-report questionnaire packed comprised of the Brief Symptom Inventory (BSI; Derogatis, 1993), the Parenting Stress Index-Short Form (PSI-SF; Abidin, 1995), and the Maternal Self-Report Inventory-Short Form (MSI-SF; Shea &

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.

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

Society must realize postpartum depression is treatable and manageable. Depression of any kind is a serious illness that requires not only further study, but a shift in thinking so it is less misunderstood and more widely recognized. Early identification of PPD symptoms must be increased in order to alleviate the tremendous burden this illness causes on families and new mothers and while current diagnosis practices are expanding to include earlier identification and increasing successful treatment, it is critical that the medical community work together to expand and add to the prevention of postpartum depression. In conjunction with a greater tolerance and understanding of this mostly hidden disease, perhaps depression will no longer be such a hidden and misunderstood mental

The word postpartum means "after birth”. Postpartum psychosis which is also known as “Postnatal onset bipolar disorder” is a severe mental illness with sudden onset of psychotic symptoms following childbirth. The common symptoms of a woman with this diagnosis would be; extreme mood swings, hallucinations or having irritable outburst. I suffered from all symptoms. It’s been 3 years and 8 months since my diagnoses. I was living in a nightmare, locked in an imaginary cage; afraid of what I would do to my son if I was alone with him. I decided to seek help and was placed into an intense outpatient program called “Maternal outreach mood services” at El Camino Hospital. It is a group based program where we’d meet four days a week from eight in the morning till one in the afternoon. In the group we’d work on self-care, realistic expectations of motherhood, stress management and enhancing mother- baby attachment. I would also meet with my psychiatrist once or twice a week to discuss my progress. Throughout this journey, my husband; Jay, my mother, and my friend Paula would switch shifts with one another to stick with me so I wouldn’t be alone with my son until I was ready. Speaking from personal experience, the program saved my life. I built up the courage to talk freely about my feelings and thoughts floating around in my head because let’s face it, telling a friend over coffee that my breast pump was talking to me

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

Estimates of the prevalence of postpartum depression range from 13% to 19% (O 'Hara & McCabe, 2013). However, major depressive episodes may go undiagnosed in 65% of pregnant women ( (Ko, Farr, Dietz, & Robbins, 2012). It is important for pregnant women and new mothers to undergo depression screening to be diagnosed and treated early if they are experiencing any symptoms of depression. Depression during pregnancy is associated with a higher risk of inadequate nutrition, poor weight gain, inadequate prenatal care, preterm birth, surgical birth and low birth weight babies (Wirz-Justice, et al., 2011). The newborns have a higher rate of neonatal intensive care admissions and increased risk of cognitive, emotional, and behavioral disorders (Wirz-Justice, et al., 2011).

Now when it comes to the baby, they can also be affected by Postpartum Depression. It ranges from Physical Development problems to confidence and Social Issues. Physical development problems can occur when the mother fails to interact and even play with the child that encourages growth, “Recent studies have shown that children whose mother suffered from postpartum depression are more likely to fall behind in development (Postpartum Living).” If the mother isn’t there encouraging her baby to coordinate its self or muscle deployment that cause negative physical growth. “A mom suffering from postpartum depression is more likely to overlook simple, everyday actions that are very important in satisfying her baby’s physical needs, such as steadying

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).