Puerperium And PND: A Case Study

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).

The authors discussed the need for effective treatments to address the high global rates of PPD and maternal depression up to two years after delivery (Letourneau et al., 2015, p. 1588). The research problem is the efficacy of TBPS in diminishing maternal depression up to two years postpartum (Letourneau et al., 2015, p. 1588). This problem arose due to three main factors; increased PPD and maternal depression rates, and existent theoretical frameworks about TBPS with early PPD.

It is commonly believed that dropping levels of oestrogen and progesterone trigger the depression that many new mothers feel.

Segre, A. R. (n.d.). Perinatal Depression: A Review of U.S. Legislation and Law. Retrieved from www.ncbi.nlm.nih.gov: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725295/

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 presence of risk factors does not guarantee that a woman will experience PPD, but it may indicate that the health care provider should pay a little more attention to possible signs and symptoms of depression. Known risk factors include depression or other mental illness prior to, and during, pregnancy, a family history of depression or other mental health disorders, a history of substance abuse, the age of the mother, financial concerns, lack of a support system, and being a single parent (Camp, 2013). In the presence of risk factors it is important for the health care provider to educate the woman on ways to

Post Partum depression causes a new mother to become depressed to a severe extent. PPD causes its patients to fall to an uncomfortable mental state. PPD patients feel discouraged, hostile,

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

Thurgood, Avery and Williamson published an article in the American Journal of Clinical Medicine (2009). According to their review, they found that many cases of PPD may remain undiagnosed due to constraints such as time and concerns about the social acceptability of screening. But the majority of undiagnosed cases are probably due to the social stigma of being labelled an “unhappy mother”, (Kabir et al., 2008) not to mention the public image of PPD. Upon formal screening, many women scoring in a depressive range fully admit to being depressed, understanding that their symptoms are neither minor nor transient. But they reject the term “postpartum depression” because this implies to them that their feelings are caused by their babies (Lumley,

Omegas have been thought to play a role in perinatal depression by affecting depression neurotransmitters and receptors in the brain. Furthermore, analysis has shown that n-3 PUFA levels are decreased in depressed individuals in contrast to individuals not depressed. A double blind, randomized, placebo controlled study was conducted for 6 weeks. The participants had to meet the DSM-IV criteria for major depression and be within the timeline of third trimester to six months postnatal. The participants were required to score greater or equal to 13 on the EPDS, or greater than 14 on the Hamilton Depression Ration scale HDRS or greater than 25 on the Montgomery Asberg Depression Rating Scale. The study had 13 randomly assigned to the

Everyone experiences some unhappiness in his or her lifetime whether it is a specific situation or not. It becomes more serious when the cause is a form of "depression." It is a fact that women experience depression about twice as much as men (1). These causes specifically for women can be complex and so are the solutions (3). A common syndrome affecting an estimated 3% to 8% of women in their reproductive years is called Premenstrual Dysphoric Disorder (PMDD) (4). PMDD is specifically known as a mood disorder of severe depression, irritability, and tension with symptoms worsening a week or so before a woman's menstrual period and usually settling out afterwards (5). PMDD can be devastating to

Postpartum depression (PPD) exists as a part of the spectrum of major depression, coded with a modifier for postpartum onset which is defined as an episode of depression, mania, or

used three different tests: the Mini-International Neuropsychiatric Interview, the Edinburgh Postnatal Depression Scale and the Montgomery-Asberg Depression Rating Scale. These are psychiatric-based multiple choice tests and do not consider outside factors in the patient’s life or the subjectivity associated with such an assessment (Sheehan,1998; Cox,1987; Psychiat 1979). Provided the complexity of depression as a mental disorder, the limitations from these assessments could be overcome through the use of brain scans (“NIH Research Matters”, 2013). The women were split up into three groups: past depression, current depression and no history of depression. A quantitatively biological assay such as an MRI could divide these groups in a more objective and pronounced

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.