Postpartum depression: The mother, child and partner involvement Essay

Traditionally, postpartum psychiatric disorders have been divided into three categories depending on increasing degrees of severity: postpartum blues, postpartum depression and postpartum psychosis. Postpartum Depression (PPD) is thought to affect between 4 and 28% of all mothers. Despite its prevalence, it is not well understood.   It is the duration, severity and complexity of the symptoms that distinguishes PPD from the baby blues and postpartum psychosis (Romm, 2002). PPD can affect any woman, no matter what her age, economic status, or cultural background. Symptoms include madness, irritability, apathy, and intense anxiety, crying spells, worthlessness, and inability to make decisions or to concentrate. It can begin anytime during the first few days, weeks, or months after delivery. The specific cause is unknown but fluctuating hormone levels, exhaustion and stress may trigger. PPD, if left untreated could lead to postpartum psychosis characterized by delusions and hallucinations; they may become suicidal or have thoughts of hurting their baby. There are a lot of possible causes of PPD which include: doubt about the pregnancy, lack of support system, breast-feeding problems, sharp drop in estrogen and progesterone levels after childbirth, unresolved issues and any other stressful events. Signs and symptoms that may indicate that postpartum blues are actually PPD include: worsening insomnia, changes in appetite (poor intake), poor interaction with the neonate; views the neonate as a burden or problem, suicidal thoughts or thoughts of harming the neonate, feelings of isolation from social contacts and support systems, inability to care for self or neonate due to lack of energy or desire (Springhouse, 2007). A range of risk factors have been identified with the development of PPD, including a history of depression, difficult infant temperament, marital or partner relationship problems, child care stress, low self-esteem and poor social support. Postpartum depression is very treatable with counseling and/or antidepressant medications that are safe for nursing mothers (Riley, 2006). The child of a PPD mother Researchers have extended examination of PPD to include samples from various cultures and countries around the world. PPD disrupts maternal-infant interactions and children’s cognitive and emotional development. Withdrawn, disengaged, and intrusive maternal behavior patterns may result in fussy, aggressive, less affectionate and less responsive infants. Reduced vocalization and slower neurological growth and motor skills development have been documented among infants of depressed mothers. In response to growing incidence of PPD’s negative effect on infant development, investigators have begun to focus evaluating interventions to promote improved mother-infant relationships. Nurse investigators are also involved in testing better tools for early detection of PPD. The Postpartum Depression Screening Scale (PDSS) is a promising, 35-item self-report instrument to identify women who are at risk for PPD. Given the importance of PPD as a clinical problem, mental health evaluation of all postpartum women should be standard care (Fitzpatrick & Wallace, 2006). This depression often interferes with a woman’s ability to function. One of the major challenges in dealing with PPD has been early recognition. Undiagnosed PPD can result in tragedy, sometimes in a form of maternal suicide or infanticide that makes headlines. Early intervention is essential. In screening, it is important to recognize that women who have experienced a high-risk pregnancy, previous infertility, previous post-partum depression, and stressful labor and birth are at risks of PPD. A non-supportive partner or stress related to family, marriage, occupation, housing, or other events during pregnancy can also contribute to the risk of PPD. Also, women with past history of depression not related to pregnancy are at risk. Screening for PPD begins with prenatally with identification of potential risks. it is important that the woman at risk and/or diagnosed with PPD receive appropriate counseling, treatment, and support (Phillips, 2003). One clinical trial designed to test the efficacy of an interactive coaching approach delivered by trained home visiting nurse produced promising findings. The intervention had a positive effect on maternal-infant responsiveness among mothers. Subsequent research is needed with diverse samples to test additional interventions to reduce negative effects of maternal depression on child development. Inclusion of partners to examine family processes related to maternal depression was also recommended (Fitzpatrick & Wallace, 2006). The treatment   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Treatment is available for people suffering from depression, the most effective for moderate-to-severe cases generally being combination of biological and non-biological therapies. This usually means making use of both medication and psychotherapy. One key factor in the success if antidepressant medication is the willingness of patients to take it as prescribed. Compliance with prescribed medications is also important. Psychotherapy is educational in nature and involves helping patients develop an understanding of various problems, as well as new beliefs and behaviors, which can ultimately lead to more successful adjustments. Psychotherapy may be supportive in nature or crisis-oriented (Ainsworth, 2000). The high rate of depression and anxiety disorders in women of childbearing age should alert the primary care physician to consider PPD in the routine care of young and middle-aged women (Robinson & Yates, 1999). The partner of a PPD mother   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Research suggests that women’s relationships with their male partners are crucial to understanding PPD. According to studies, male partners are the primary sources of support in mother’s lives, and one of the main causes of PPD is seen as a poor relationship in which a woman’s partner fails to be sympathetic, understanding, or supportive in practical or emotional terms (Mauthner, 2002). The partner’s positive response to this problem could result to faster recovery of the mother and the safety of the child as well. References Ainsworth, P. (2000). Understanding Depression: Univ. Press of Mississippi. Fitzpatrick, J. J., & Wallace, M. (2006). Encyclopedia of Nursing Research: Springer Publishing Company. Mauthner, N. S. (2002). The Darkest Days of My Life: Stories of Postpartum Depression: Harvard University Press. Phillips, C. R. (2003). Family-Centered Maternity Care: Jones and Bartlett Publishers. Riley, L. (2006). Pregnancy: The Ultimate Week-By-Week Pregnancy Guide: Meredith Books. Robinson, R. G., & Yates, W. R. (1999). Psychiatric Treatment of the Medically Ill: Informa Health Care. Romm, A. J. (2002). Natural Health After Birth: The Complete Guide to Postpartum Wellness: Inner Traditions / Bear & Company. Springhouse. (2007). Maternal-Neonatal Nursing Made Incredibly Easy! : Lippincott Williams & Wilkins.