Human mentality is a subtle and complex phenomenon, and psychological health can be largely defined by multiple social and cultural factors, as well as the personal and physical ones. In addition, some types of mental disorders and adverse conditions can be strongly associated with such demographic factors as gender. Postpartum depression (PPD) is one of them. As the name of the condition suggests, this type of depression occurs in females after childbirth. Similarly to the regular type of depression affecting people from diverse backgrounds and at distinct stages of life, PPD development can be triggered by many psycho-social stressors.
However, the feeling of guilt and worry about the inability to care for their babies is usually the major cause why females may feel depressed in the period that is commonly expected to be the happiest in every mother’s life (Institute for Quality and Efficiency in Health Care [IQEHC]). The major peculiarity of PPD in terms of its adverse effects is that it is detrimental to both the mother and the newborn child. For this reason, prevention and timely treatment of the condition are of great importance. To understand various PPD-related issues more deeply, multiple factors contributing to PPD, its effects, and possible treatment methods will be reviewed in detail in the following paragraphs.
Psycho-Social Factors of PPD
Childbirth and parenthood can be regarded as normal psychological and physiological stressors that might induce symptoms of mental illness in some women. During childbirth, a female undergoes a lot of substantial mental and physical changes. When the woman cannot efficiently cope with the changes, she experiences the state that is called PPD. It is characterized by melancholy, feeling of guilt, anxiety, social self-isolation, sleeping and eating disorders, high level of self-distrust regarding the ability to take care of a newly born child (Patel et al. 535).
PPD regularly “begins within four weeks of childbirth and may continue for several months or even a year” (Ahmad et al. 766). Hormonal imbalance may be one of the causes of the distress in the postnatal period. At the same time, the depressive state can also be triggered by various challenging circumstances in personal life and social environment. Depression in its general form is associated with poverty and uneven distribution of wealth and resources in society. It is possible to say that a more serious situation can usually be observed in culturally diverse communities associated with repeated cases of discrimination on the racial and gender basis. In this way, in the USA, the prevalence rates for maternal depression among low-income women and women from minority groups can be twice as high as for white women.
Ahmad et al. note that “stressful life events such as abuse, poverty, poor relationships, death of a loved one or looking after a dependent family member can trigger depression” (766). Moreover, as it was already mentioned above, emotional and physical stress related to the need for taking care of the baby’s wellness and health also provokes the feeling of tension and contributes to PPD development. The combination of these factors is core to PPD development.
Biological Factors
The major biological causes of depression are related to the improper functioning of chemical and neural mediators in the brain because they impact the limbic system, which is responsible for the regulation of emotions, feelings, reactions to stress, and physiological stimuli (Pandya et al. 634). Every individual has hundreds of chemical mediators, but only three biogenic amines are associated with depression: norepinephrine, dopamine, and serotonin. For instance, it is observed that a low level of dopamine or serotonin may provoke depression (Pandya et al. 640). Nevertheless, the researchers did not yet come to a solid conclusion in the investigation of mediators’ functioning – depression may occur as a result of changes in those mediators and their composition, or the disorder itself provokes these changes. Scientists tend to believe that the biochemical processes in the brain are inevitably reflected in human behavior and vice versa.
Researchers also continue to accumulate evidence showing the heritable characteristics of the disease. As stated by Norhayati et al., the cases of depression in family history increase the risk of its development (35). Other biological factors of mental disorder occurrence include neuroendocrine regulations (thyroid dysfunction or adrenal gland dysfunction, etc.) associated with malfunctions of hormone emissions; long-term alcohol or drug abuse; and physical diseases that may lead to changes in chemical reactions in the brain (AIDS, Anemia, hyper/hypothyroidism, chronic infections, diabetes, malignant tumors, etc.) (Pandya et al. 640; Hage and Azar 1).
PPD Effects on Children
“Untreated maternal depression can have a negative effect on child development, mother-infant bonding, and risk of anxiety or depressive symptoms in infants later in life” (Patel et al. 534). The concept of bonding is usually applied to describe a mother’s initial reaction to her infant. Bonding develops through physical contact with a child, breastfeeding, or communication. The early interactions help an infant to recognize its mother and develop a psychological attachment to her. The concept of attachment primarily refers to children because the quality and style of their attachment to caregivers influence the course of early development and has the long-term impacts on their socio-emotional performance, psychological well-being, and cognitive abilities across the lifespan. Moreover, the active parent-child interactions may significantly facilitate the neonatal cognitive, neurological, and motor development (Alves 26). However, women with severe forms of PPD may feel extremely passive and reluctant to interact with their children. Thus, the prevention of chronic and severe depression in mothers is essential.
Prevention and Treatment
Prevention strategies often include various educational courses such as Relaxation, Encouragement, Appreciation, Communication, Helpfulness (REACH) program. The REACH content focuses on “the development of effective communication skills to manage relationship conflicts before and after the birth of the baby, expectations about motherhood, stress management, ‘baby blues’ vs. depression, development of a support system, development of healthy relationships, goal setting, and psychosocial resources for new mothers” (Phipps et al. 192). Such prevention strategies aim to raise mothers’ awareness of parenthood-associated issues and prepare them to cope with stress better. It is worth noticing that in order to increase the efficacy of educational prevention programs, they should be culturally adapted to recipients’ needs, health beliefs, and interests (Phipps et al. 192).
As for the treatment of chronic and severe PPD cases, before the implementation of intervention practices, the health care provider must detect potential premises of the problem and select medical methods targeting the causes of depression because the manifestation of depressive symptoms depends on individual characteristics of patients and requires thorough examination. For example, if depressive symptoms develop as side effects of endocrine malfunction or other physical disorders including brain impairment, the pharmacological treatment is suggested. Nevertheless, physicians are usually reluctant to prescribe breastfeeding women with medication and antidepressants because a significant portion of drug compounds may be transferred to their babies (IQEHC).
More conservative methods of treatment can be suggested to avoid this risk. For example, engagement in sports and moderate physical activities can significantly reduce the symptoms of PPD. Such unconventional and complementary methods as meditation and massage can have some effect as well although it may not be proven by recent research evidence. Along with pharmaceutical treatment, patients can be prescribed with cognitive and behavioral therapies. They are proved to be effective methods of treatment in both the general population and patients with various physical diseases contributing to depression – they help raise patients’ awareness, increase acceptance of healthier lifestyles, and enhance the overall quality of life.
Conclusion
PPD can be a lonely experience especially if a woman has no sources of emotional and psychological support and assistance with parenting. Moreover, women may be reluctant to discuss their problems with others and sometimes can even be unable to discern symptoms of depression in themselves as PPD may progress silently. However, considering that even a light form of depression manifesting in bad moods and melancholy can affect interpersonal, and family relationships in a negative way, those affected by it should address for professional help to get back to normal psychological state and improve functionality. Intervention is especially important if the woman has a chronic condition, which may lead to the emergence of suicidal thoughts and result in substantial harm to her own health and the well-being of her close ones including the newborn baby. It is important to remember that PPD does not last permanently, and with adequate support, the mother can accelerate the recovery progress.
Works Cited
Alves, Pedro Ferreira. “Vygotsky and Piaget: Scientific Concepts.” Psychology in Russia, vol. 7, no. 3, 2014, pp. 24-34.
Hage, Mirella P., and Sami T. Azar. “The Link between Thyroid Function and Depression.” Journal of Thyroid Research, vol. 2012, 2012, pp. 1-8.
Institute for Quality and Efficiency in Health Care. ” Pregnancy and Birth: Depression After Childbirth – What Can Help?”PubMed Health. 2016, Web.
Norhayati, M. N. et al. “Magnitude and Risk Factors for Postpartum Symptoms: A Literature Review.” Journal of Affective Disorders, vo. 175, no. 3, 2015, pp. 34-52.
Pandya, Mayur et al. “Where in the Brain Is Depression?” Current Psychiatry Reports, vol. 14, no. 6, 2012, pp. 634–642.
Patel, Milapkumar et al. “Postpartum Depression: A Review.” Journal of Health Care for the Poor and Underserved, vol. 23, no. 2, 2012, pp. 534-542.
Phipps, Maureen G. et al. “Randomized Controlled Trial to Prevent Postpartum Depression in Adolescent Mothers.” American Journal of Obstetrics and Gynecology, vo. 208, no. 3, 2013, pp. 191-192.