Postpartum Depression Awareness

Perinatal or postpartum depression is comprised of major and minor episodes of depression that can occur during pregnancy all the way up to a year postpartum (Gavin et al, 2005). This form of depression is a serious condition affecting between 600,000-800,000 new mothers every year (Guille, Newman, Fryml, Lifton, & Epperson, 2013). This encompasses 15% to 20% of childbirths annually (Gavin, et al, 2005) with symptoms ranging from depressed moods to suicide (Miller & LaRusso, 2011). Because of the potential severity of postpartum depression, various studies have been conducted to uncover successful treatment measures in an effort to reduce the number of annual cases.

Formal depression screening has shown to be more effective in early detection than routine clinical assessment (Miller & LaRusso, 2011). Two common screening tools are the Edinburg Postnatal Depression Scale and the Patient Health Questionnaire-9 (Miller & LaRusso, 2011). These scales are questionnaires aimed to assess the feelings of new mothers in the first seven days postpartum. Results of these questionnaires help practitioners develop strategic plans to successful postpartum treatment. These strategies can include any combination of the following: antidepressant medication, psychotherapy, social support, nutrition plans and supplements, sleep and circadian rhythm training, breastfeeding decision support, and family planning (Miller & LaRusso, 2011).

Evaluation of each of the abovementioned items to determine deficiencies is key to successful treatment plans for new mothers who are suffering from postpartum depression. But before treatment plans can be successful, substantial awareness must take priority. A study conducted in Ontario, Canada found that only 5% of respondents acknowledged that harm to self or child, hopelessness/helplessness, or social isolation as common postpartum depression symptoms (Sealy, Fraser, Simpson, Evans, & Hartford, 2009). This is exceptionally alarming considering these are some of the more severe symptoms that potentially require immediate attention. The study also found that men, who are often representative of the social support demographic, were less aware of symptoms as well as sources for treatment and support. This can be problematic for women who are suffering as the chances of symptoms going unnoticed or untreated increase. Social awareness campaigns, open dialogue, and free education for expecting mothers and support networks during pregnancy are some measures that can be utilized to help alleviate the condition and its harmful outcomes.

Gavin, N., Gaynes, B., Lohr, K., Meltzer-Brody, S., Gartlehner, G., et al. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1), 1071-1083.

Gibson, J., McKenzie-McHarg, K., Shakespeare, J., Price, J., & Gray, R. (2009). A systematic review of studies validating the edinburgh postnatal depression scale in antepartum and postpartum women. Acta Psychiatrica Scandinavica, 119(5), 350-364.

Guille, C., Newman, R., Fryml, L., Lifton, C., & Epperson, C. (2013). Management of postpartum depression. Journal of Midwifery & Women's Health, 58(6), 643-642.

Miller, L., & LaRusso, E. (2011) . Preventing postpartum depression. Psychiatric Clinics of North America, 32 (1), 53-65.

A new addition to the family is supposed to be a joyful time. Though adjusting to a new lifestyle can be stressful, that stress often turns into something much more. Studies have been conducted to reveal potential stressors that contribute to a woman suffering from postpartum depression. One study in particular tested six different components from a large sample of women to determine possible contributors to the condition. The six probable stressors tested were: concern over mistakes, personal standards, parental expectations, parental criticism, doubts about action and organization, social support, and neuroticism. The evidence showed that the most influential stressor on women was their concern regarding mistakes as a new parent (Gelabert, Subira, Garcia-Esteve, Navarro, Plaza, et al, 2012). The rest of the stressors were seen as independent factors. Though they contributed to women who suffer from postpartum depression, they were not as significant as concern over making mistakes. Because these are common feelings, new mothers are often unaware that they are suffering from postpartum depression causing symptoms to go unnoticed or unattended to.

The lack of awareness, shortage of resources, and the deficient amount of open communication on the subject pose further problems in the treatment and prevention of postpartum depression. Women and physicians alike are failing to recognize the symptoms causing an under diagnosis of the condition. The relevance of postpartum depression has not been given the proper attention considering how frequently it occurs. Women are often unaware of their symptoms or avoiding the topic altogether given that postpartum depression is a mental health issue, which can often be a taboo topic with stigma attached. Furthermore, the communication between physicians and new mothers often does not include the actual likelihood of developing postpartum depression or resources that may be available. Without social awareness of the issue, open dialogue about the possibilities, and availability of resources, postpartum depression continues to increase in new mothers.

Alici-Evcimen, Y. , & Sudak, D. (2003). Postpartum depression. Primary Care Update for Ob/Gyns, 10(5), 210-216.

It is common for women to experience some mild mood changes during pregnancy or after the birth of a child. However 15% to 20% of women experience more significant symptoms of depression or anxiety. There are numerous symptoms that may occur during or after pregnancy and differ for everyone. McCoy identifies the following symptoms:

         Anxiety

         Mood swings

         Sleep problems

         Appetite changes

         Suicidal thoughts

         Lack of interest in or feeling disconnected from baby

         Thoughts of harming the baby

         Sluggishness

         Exhaustion

         Memory loss

         Sense of guilt or shame

         Sense of doom

         Scary or odd thoughts that repeat in your mind

         Irritability or anger

There is no one cause to this form of depression, but it is useful to understand the risk factors and predictive signs of postpartum depression because it means that it is possible to detect women that are at risk during pregnancy. Early detection means preventative care can be given. The most significant factors contributing to postpartum depression were socio–professional difficulties, damaging life events, depressive mood prior to delivery, early mother–child separation and negative birth experience (Righetti-Veltema, Conne-Perreard, Bousquet, & Manzano, 1998). While these are the most significant factors, the website Postpartum.net describes many other factors that can contribute to postpartum depression, for example mothers of multiples and women with a thyroid imbalance. It is important for those suffering to know that these symptoms are temporary and treatable.

Postpartum depression symptoms most often occur three to four months after the baby is born, however, they may occur before or after. Women often don’t think they have postpartum depression in part because the symptoms may appear months after birth. Once the symptoms do appear the progression of the symptoms depend on recognition, seeking help and the effectiveness of treatment. Most research on postpartum depression has been focused on the cause. Less is understood about progression. James McIntosh (1993) found in his research that a majority of depressed mothers did not seek help because of their perception of the cause of their depression, ideas about solutions, and reluctance to admit to experiencing emotional difficulty. 

Prevention and treatment of symptoms is available. The prognosis or likely outcome is that women will recover from postpartum depression with effective treatment. Treatment is unique for each woman. The experts at Postpartum.net explain that treatment can include self-care, social support, talk therapy or counseling, and medication when necessary. There is no defined timeframe for recovery because so much depends on detection, access to and the effectiveness of the treatment. 

 “Depression During Pregnancy and Postpartum.” Postpartum.net  n.p. n.d.  Web. 17 November 2014.

McIntosh, J. (1993). Postpartum Depression: Women's Help-seeking Behaviour and Perceptions of Cause.Journal of Advanced Nursing, 178-184.

Kathy and Gabe have a love life that is scripted for a Hollywood romantic comedy.  They wake up every morning with a positive attitude towards life and their love for each other. They enjoy breakfast after their morning workout.  Before leaving for work they kiss each other good-bye and take a moment look each other in the eyes to show their affection for each other. Kathy and Gabe work full time and have a jam packed social life but still take time to enjoy each other’s company. One year later, Kathy is pregnant. They are very excited.  The baby can’t come soon enough.  They are on the top of the world but suddenly after Kathy delivered their baby everything changed.  It’s been 6 months since Kathy and Gabe had their first child. Kathy wakes up with no motivation. She lost a significant amount of weight due to lack of appetite. Gabe feels that she has become more emotional since giving birth to their child. One night, Gabe came home and found Kathy in the bathroom crying while their child was screaming in his crib. Kathy is suffering from postpartum depression (PPD) and doesn’t even know it.

Kate Rope, writer of “New Study Reveals Disturbing PPD Statistics” claims that one in seven women have PPD in the year after they give birth.  These results are alarming and beg the question, what can be done?  A significant problem is that women that are suffering from depression often don’t know that they are suffering from postpartum depression.  Recognition and treatment rates of PPD are lower in pregnant and postpartum women (14%) than in the general population (26%) (Bennet 2010).  The problem is that there is a lack of information about PPD that would help women recognize and treat the illness.

This photo illustrates the symptoms of postpartum depression

Recent Public Interest / News Story

Our group chose to write about this popular main-stream article "Postpartum Depression and the New Mom" from “Everyday Health” because we really felt as if it expressed the key elements one should know regarding our topic, postpartum depression. Also, it was medically reviewed by Lindsey Marcellin, MD, MPH. Therefore, we can conclude that the information is accurate. This article focuses in on why some mothers get postpartum depression from certain factors such things as: history of severe premenstrual syndrome as well as history of trauma or abuse. It also explains specifically when woman can be affected by this illness, which is typically “any time from during pregnancy to one year after childbirth” (Krisha McCoy). The article does a great job at listing the main symptoms of postpartum depression, which include, but do not limit forms of anxiety, certain mood swings, having trouble sleeping and suicidal thoughts. Lastly we appreciate how the author includes advice on how to cope and move forward from this devastating time.  McCoy lists certain tips on how to treat the issue at hand such as taking “me time,” finding a support group and considering alternative treatments. The article was very enlightening and provided great examples/information. 

Recent Research Article

The article "Talking Postpartum Depression: Identifying and Overcoming Barriers Faced by Physicians and Patients in Communicating about Diagnosis and Treatment" by Anderson defines postpartum depression as a mental disorder difficult to recognize and diagnose for multiple reasons. It wasn’t until 2005 that postpartum depression became a conceptualized issue to be researched and studied. Since then, researchers have developed a clearer understanding of the effects, treatment, and early detection tools. The article discusses the CAUSE model and how it relates to an understanding of postpartum depression care. Of the five communication goals of the CAUSE model, awareness and understanding are the two explored in this article. The purpose of exploring these aspects of the CAUSE model in its relation to postpartum depression is to define a further need for filling the gap in research through more fields including the social sciences. Studying this condition through the eyes of communication research can greatly assist in early detection, diagnosis, and support.

References

Anderson, L. (2007). Talking postpartum depression: Identifying and overcoming barriers faced by physicians and patients in communicating about diagnosis and treatment. Conference Papers -- National Communication Association, 1.

McCoy, K. (n.d.). Postpartum Depression and the New Mom. Everyday Health.

Rope, K. (n.d.). New Study Reveals Disturbing PPD Statistics. Seleni.