Postpartum Depression in relation to Family Health
Introduction
Maternal mental health problems pose a major social, human and economic burden on infants, women, society and their immediate families, and it also, generally presents a major health challenge to the public. Overall mental disorders prevalence is however similar in women and men, the mental health for women however requires more special considerations this is in reference to the likelihood of women suffering mainly from anxiety and depression and the mental health impact issues on the child rearing and child bearing process.
During the first year and pregnancy virtually all women are prone to develop maternal mental disorders but, migration, poverty, direct exposure to violence example sexual, domestic or gender based, extreme stress, conflict and emergency situations, low social support and natural disasters all generally contribute to specific disorder increase. Initially, the term postpartum depression has been used covering all depression symptoms that are associated with childbirth. This is however incorrect if used in relation to a disease that has varying degree of symptoms and severity since it tends to over-generalize the illness. Postpartum depression common categorization divides the disease into three main depression types, that are mainly dependent on divergent symptoms; postpartum depression, baby blues and postpartum psychosis. The maternal disorders consequences during pregnancy are exhibited when the woman is likely to sleep or eat well and as a result may adequately fail to gain weight. She also tends to avoid prenatal care attendance and may also fail to seek help during birth. She will also tend to use substances that are harmful such as cigarettes, alcohol and drugs and may try to kill or injure themselves. The raised stress hormones during the maternal mental illness process may also add to the negative physical effects exhibited by the mother, this may tend to predispose her to pre-eclampsia, maternal high blood pressure, difficult or early deliver and on the babies who are developing, who may still be small for the infant age. In older children in the family the maternal mental disorder effects may include abuse,neglect and slower emotional,social and cognitive development which may include higher rates of behavior and school problems. Marital relationship may also be seriously affected by the maternal mental illness, especially in the cases of serious or prolonged mental disorder. These may include spousal abuse or marriage disruption by either partner. It is with this above understanding of the subject issue and its psychosocial effects on the family that this article seeks to address the impact it has on family health, determinants of health and their relevance to the subject issue, and nursing strategies that can be used to address the issue.
Health issues posed by the maternal mental disorders and their significant effects on the family can be exhibited by the numerous studies that have shown that the postpartum depression directly affects the women and children that are affected by it this is according to a research done in 2009 by Greig,J a community nurse in his published article Postnatal depression linked to child behavioral problems states that in the boys whose mothers have postpartum depression symptoms three quarter of them exhibited behavioral problems like distractibility and hyperactivity, mainly as they begin school. On the other hand the same research when done on girls revealed that their teachers considered them well-adjusted, and due to this it is evident that the effect of the disorder is more on the male child and this not only affects the close relationship to the mother but also the child’s development and growth. A study done on health care and nursing in 2010 by Lindgren K, entitled relationships among, prenatal depression, maternal-fetal attachment and health practices in pregnancy, revealed that for the parents who are depressed their children tend to exhibit signs of insecure attachment as compared to those not from parents not maternally depressed and this attribute tends to follow them as they develop which tends to affect how they interact with others and their peers. The postpartum disorder can also affect the partner and mother relationship within the family which also affects the other family members health since it can cause a strain on the family relationship and interaction especially in cases where young children are involved, this intrusion in the family bonds is an important factor since the effects of the depression can cause the children to be irritable, anxious and depressed which affects their overall health this is according to research done in 1998 by Borrill ,J a community nurse in his article on preventing and detecting postnatal depression (Ferber SG,et al,2008).
Postpartum depression main causes are somewhat disputed, in that the subject has two divergent schools of thought one of them being psychosocial and the other biological. One biological explanation lies in the hormonal changes after the childbirth,it states that the hormones greatly fluctuate and due to this drastic change many believe that it is a contributor to the postpartum depression.in that the hormonal change experienced around the fifth day peak the disturbance of the moods and they influence the emotional arousal, responses and reinforcements in women. The psychosocial aspect of the postpartum depression explanation states that the child birth process does not only physically affect women but its effects are also psychological in that the realization caused by the child birth of the evident role changes mainly on the woman’s roles to a mothers , in that they have to transit to a life of responsibility, emotional attachment and less freedom can have effects like depression when the coping or adopting to the new roles become overwhelming to the individual. Other psychosocial factors that have been linked tothe postpartum depression include chronic life strains, stressful life by the mother, deaths by close relations, daily hassles, unwanted pregnancy and everyday hassles during the pregnancy period(World Health Organization, ,2008).
Early interventions and identification improve for most women the long term prognoses of postpartum depression. Substantial evidence and success have also been found for implementing preemptive treatment, evidence that suggest psychological or psychosocial interventions also help with addressing the postnatal depression issue after birth. These described issues include telephone-based peer support, home visits, and interpersonal psychotherapy. It has been established that a large part of the treatment lies on the prevention aspect that is influenced by how an individual understands the risk factors and in this aspect there is a large contribution that the entire medical community can add as they undertake their roles in treating and identifying postpartum depression. The physicians can also screen the patients to determine whether they are at risk of acquiring the postpartum depression. Also, insisting on proper nutrition and exercise appears to play a significant role in depressed mood and postpartum prevention in general. Numerous journal and scientific studies support the postpartum depression notion as being treatable by implementing various practical methods. In that the postpartum depression (PPD) can be treated or identified by mitigating the problems root cause, including additional help with childcare, increased partner support and cognitive therapy other effective non –professional interventions can also be implemented. For many women from diverse cultures postpartum depression is a major health issue and in this aspect different ways of detecting and isolating the depressive symptomatology in those women who recently gave birth also help in addressing the issue, however the postpartum depression development requires adequate programs to be able to effectively screen for the PPD. Decisions need to be made based on the evidence regarding the health care system issues such as cost-effectiveness, policies for referral, and potential harm. In addition, the most effective screening test that not only has good specifity and sensitivity but is easy and quick to interpreted, culturally sensitive, and readily incorporated into practice. Preliminarily auspiciously research suggests postpartum depression is susceptible to all interventions of treatment and this provides a development rationale for an effective screening program. A few randomized and well-designed controlled trials however have been effectively conducted to guide policy and practice recommendations but further research is still adequate before any evidence based programs are considered for wide implementation. According to the above interventions it is certain that no single certain aetiological pathway exists by which postpartum depression is developed in women, and with this understanding it is also clear that a single treatment/prevention modality application will be effective for all women (Stewart R.et, al 2008).
Conclusion
There is still some controversy regarding the postpartum depression causes and this stresses on the importance of conducting more research in order to make a definitive conclusion. As seen in the debate between the psychological and biological causes of the illness but regardless of the cause other underlying risk factors are also associated with the increased development of the PPD. In this manner detection of the PPD should be given priority since it is the key to helping the affected families and women. The availability of remedy options for the postpartum depression which include support services like telephone support and public health nurses visits. Psychological counseling that include relaxation therapy, interpersonal therapy and pharmaceutical intervention. The understanding that childbirth is a very traumatic and sometimes emotional event for the women, theirfamilies and partners lays the foundation that the effects of postpartum depression should not be underestimated and by evaluation the best mode of treatment can be found.
Reference
World Health Organization, (2008)Maternal mental health and child health and development in low and middle income countries. Report of the WHO meeting. Geneva,
Ferber SG, Feldman R, Makhoul IR. (2008)The development of maternal touch across the first year of life.Early Human Development.2008;84:363–370. [PubMed]
Stewert R. Maternal and child nutrition (2008). Maternal common mental disorder and infant
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