The Effects Of Bright Light Therapy On Improvement Of Postpartum Depression Essay

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).

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/

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.

Postpartum depression (PPD) affects at least 10-20% of new mothers. However, the true incidence may be much higher due to the fact that screening is not considered to be a standard practice, leaving PPD undetected and untreated in many women (Schaar & Hall, 2014). Postpartum depression not only negatively affects the mother; it also has a negative impact on the infant. For this reason, it is important for the health care providers caring for pregnant and postpartum mothers to screen them for risk factors associated with PPD, as well as educate them on ways to lessen their chances of getting PPD. It is also important for the health care providers to screen for PPD with a standardized tool like the Edinburgh Postnatal Depression Scale (EPDS), and to take action in treating it when it is suspected or diagnosed.

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

According to the North Carolina Clinic, they have a research program to understand why women go through depression during pregnancy, and after childbirth. The research program

The Center for Disease Control estimates that 1 in 20 people suffer from depression (2014). Although widely recognized and somewhat easy to diagnose, depression is an ignored and almost hidden, disease. In women, the statistics are especially grim for those who are pregnant or were recently pregnant. A great number of women suffer from postpartum depression; an illness which is often overlooked, misdiagnosed and untreated. Postpartum depression (PPD) has been defined as an emotional disorder that occurs in an estimated 10-15% of all women after childbirth (Liberto, 2010). Postpartum depression not only impacts the mother, but can cause long-term psychological challenges for the baby and create emotional turmoil for all family members.

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

In the United States and many other countries many women do not seek for treatment because they have many concerns and fear about medications. Depressed breastfeeding women concern about the exposure of the infants to medications. Also postpartum depression can lead to a suicide. Postpartum has been linked with some neurotransmitter such as dopamine and serotonin, but research continues working on that. Therefore, it’s very important to inform mothers about postpartum depression, so they will be able to recognize any sign and seek for help. Postnatal depression can be identified by the use of screening tools or interview schedule to diagnose women who are at high risks, then as result of these methods they can receive an adequate and early intervention using psychological and psychosocial interventions, as well as psychopharmacological interventions (Mallikarjum

This can affect the confidence of the new mother in caring for her new baby. Post partum depression is seen in 80% of women who gives birth but in most women the symptoms resolve within 2 weeks. If the symptoms last longer than that, it is recommended that she should be screened for Post partum depression. Studies have shown that children of mothers with postpartum depression displays problems with social emotional and cognitive development and these changes are visible in children as young as 3 months old. Early detection and treatment of postpartum partum depression is crucial to the physical and emotional well being of the mother and baby .It is important to know the signs and symptoms of the condition and intervene appropriately. Antidepressants are commonly used as the first treatment option for adults with moderate to severe depression, but there is little evidence on whether antidepressants are an effective and safe choice for the treatment of this disorder during this period. Serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are

However, there are risk factors that may influence someone getting postpartum depression. “Younger mothers are at an increased risk for PPD compared to those who give birth later in life. Other factors that increase the risk a woman will experience PPD after giving birth include financial troubles, relationship problems with a spouse or partner, physical abuse, and tobacco use”. (Black & Tish). According to the National Institute of Mental Health, “the drastic drop in the hormones, estrogen and progesterone, following childbirth may lead to chemical changes in the brain which can cause mood swings.” On top of this change in hormones the mother is recovering from childbirth and may be faced with physical exhaustion. Current research has demonstrated that a compilation of stressors such as biochemical, genetic, and psychosocial may attribute to the development of this mental disorder. Other risk factors for development of postpartum depression include symptoms of depression before or after pregnancy, bipolar disorder, medical complication during childbirth, and family history of postpartum depression. (2015 Postpartum) It is important to know the risk factors for postpartum

Antenatal or antepartum depression accounts for “around 13% (of pregnancies)” (Leigh, B. & Milgrom, J., 2008). Although the prevalence of depression during pregnancy is fairly high, it is often underreported, not reported, and oft left under or untreated. These expectant mothers frequently do not receive the care and treatment they so desperately need. A better understanding of the causes and outcomes of these particular patients is needed to ensure they get the help they need. The consequences of not receiving care are “far-reaching, affecting not only the mother but her infant, and their relationships” (Leigh & Milgrom, 2008).

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.