Postpartum Depression Presentation

P O S T P A R T U M D E P R E S S I O N By: Hannah Hargrave, Yaning Hu, Ira Son, Rebecca Stockwell, Arya Washington.

HISTO RY.

W H AT I S P O S T PA R T U M D E P R E S S I O N ? Defining Postpartum Depression: Postpartum depression (PPD) is a severe mood disorder affecting mothers shortly after childbirth. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), classifies it under "Depressive Disorders" and outlines specific criteria for its diagnosis (American Psychiatric Association, 2013). PPD symptoms include persistent sadness, hopelessness, fatigue, changes in appetite and sleep patterns, and difficulty bonding with the newborn (American Psychiatric Association, 2013) https://www.tiktok.com/@rebeccamariestockwel l/video/7296156623242939691.

H I S T O R I C A L O V E R V I E W O F P P D : • The history of PPD is marked by significant milestones and evolving societal perceptions. Historically, PPD was often misunderstood and stigmatized, but recent decades have seen significant progress in recognizing and defining it as a mental health disorder (Johnson & Miller, 2008). • In the late 19th century, German psychiatrist Emil Kraepelin introduced the term "depressive states" to describe various forms of melancholia characterized by persistent low mood. This term laid the groundwork for understanding mood disorders, including PPD (Johnson & Miller, 2008). • The history of PPD is marked by both high-profile cases and a predominant portrayal of the condition as primarily affecting middle-class, heterosexual, married women (Martinez et al., 2000). In recent years, high-profile cases such as Andrea Yates and Mine Ener have raised public awareness about the severe consequences of untreated PPD. These cases illustrate the extremes of PPD but also highlight how privileged individuals are more likely to access treatment and support. The prevalence and severity of PPD among vulnerable populations, such as low-income women, women of color, and single mothers, are often underrepresented in publicTreatment for PPD largely mirrors that of general depression but with a particular focus on the unique challenges of motherhood. • Narratives • .https://www.tiktok.com/@rebeccamariestockwell/video/72961566232429 23307.

INSIGHT.

L E V E L S O F P O S T P A R T U M D E P R E S S I O N S Y M P T O M S • Baby Blues - “Postpartum Blues (baby blues) is a term used to describe mild mood changes and feelings of worry, unhappiness, and exhaustion that many women sometimes experience in the first 2 weeks after having a baby. Baby Blues can be experienced by up to 80 percent of pregnant and childbirth women. Mothers who experience Baby Blues also often cry and often feel anxious for fear of not being able to take care of their baby properly (Sipasulta et al.,2023).” • PPD -Mothers with PPD will also feel hopeless and less passionate about life. Difficulty building a bond with the baby also arises with the thought that the mother is not able to carry out her role well. Mothers with PPD also experience shame, guilt, and decreased self-esteem. In addition, mothers with PPD also find it difficult to feel happy about the birth of a baby and are often gloomy. • Postpartum Psychosis - “Postpartum psychosis is the final stage in postpartum depression signs and symptoms last longer and are more serious. Confusion and disorientation, obsessive thoughts about your baby, hallucinations and delusions, sleep disturbances, paranoia, trying to harm yourself or your baby (Sipasulta et. al.,2023).”.

H O W A R E T H E Y D I F F E R E N T F R O M E A C H O T H E R ? ❖ Baby Blues is believed to be caused more by physiological changes experienced by mothers after giving birth, and their intensity is influenced by psychological factors. While PPD is more influenced by psychosocial factors such as excessive stress experienced by the mother. ❖ Baby Blues and PPD are distinguished by the length of time symptoms last. Baby Blues usually last only a few days and last up to 2 weeks at most. Meanwhile, PPD symptoms are experienced for at least 1 month and can last up to 1 year. ❖ Baby blues is a milder disorder than PPD and it generally goes away on its own ❖ PPD may require special treatment.

H O W D O E S I T C O N N E C T T O T H E L I F E P E R S P E C T I V E C O U R S E ? Postpartum depression typically occurs during a significant life transition , the birth of a child. This is a major developmental milestone in the life course of individuals and is associated with various challenges and adjustments. Postpartum depression can occur at different times in a person's life course, affecting how they manage life events. For instance, it can influence decisions about family planning and career progression..

PREVALENC E.

P R E V A L E N C E • General Statistics and Why Postpartum Depression (PPD) is concerning: ❖“Postpartum depression affects 13% of all women” (Maxwell et. al., 2019). ❖Approximately one in eight women showed symptoms of depression and one in fifteen were diagnosed with major depression one year postpartum (Bai et. al., 2023). ❖The statistics of PPD has significantly grown from 6.4% to 56.9% during the COVID-19 pandemic. This was due to the growing rates of isolation due to the lack of social support, which negatively impacted PPD symptoms during recent years (Low et.al., 2023)..

P R E V A L E N C E : P P D ' S I M P A C T O N F A M I L I E S ➢ Mothers during the postpartum stage involve dramatic changes to their physical appearance and new pressures of being a parent. This vulnerable time creates a significant amount of stress, which makes them more susceptible to developing mental health problems (Low et. al., 2023). ➢ PPD is correlated with mothers having poor mental health support, constant conflicts within family and marriages, intimate partner violence (IPV), and not receiving adequate social support from partners, families, and friends” (Xayyabouapha et. al., 2022). ➢ The adverse effects of PPD consist of the following (Maxwell et. al., 2019) 1. Poor health 2. Issues during mother-child bonding 3. Future problems during childhood education This Photo by Unknown author is licensed under CC BY..

I M P O R T A N C E A N D C O N C E R N O F P P D • Discussing PPD is important because it is able to reduce the stigma associated with mental health, which can allow mothers to feel more comfortable to seek care for postpartum depression, which should be seen as a health crisis that has been significantly growing throughout the recent years (Xayyabouapha et. al., 2022) • Pregnant women are vulnerable to “social isolation and helplessness,” which they are often lacking during pregnancy. Social support is essential for them (Low et. al., 2023). • If maternal mental health problems are not addressed during pregnancy and postpartum, pregnant mothers are at a higher risk of developing PPD (Xayyabouapha et. al., 2022). • The addressing of mental health in maternal health is currently underdeveloped, especially for those in lower to middle income social statuses (Xayyabouapha et. al., 2022)..

INTERVENTI ON.

C U R R E N T I N T E R V E N T I O N S • There are a variety of existing interventions available for treating PPD: individual and group psychotherapies psychotropic medication (such as antidepressants) hormone therapies These methods can be successful protective factors against PPD, and are most effective when medication is combined with various therapies, or when cognitive-behavioral techniques are combined with group therapies. • “Specifically in PPD, feeling cared for during therapy may be particularly important because women may perceive that their needs have been overlooked in relation to their infants’ needs” (Hadfield & Wittkowski, 2017, p. 734). • “The US-based Support and Training to Enhance Primary Care for Postpartum Depression (STEP-PPD) is a program that provides training and resources to health care providers on best practices in the management of PPD” (Hadfield & Wittkowski, 2017, p. 734)..

B A R R I E R S • "Adherence to medication is generally poor in women with PPD” (Hadfield & Wittkowski, 2017, p. 723). • Mothers may struggle to access and participate in treating their post-partum depression symptoms for many reasons, including the following barriers: • traveling/transportation • being occupied with child-care responsibilities • feeling ashamed or judged • lack of insurance or means to cover the costs of therapy or medication • fear of children being taken away.

I N T E R V E N T I O N S U G G E S T I O N S • An important aspect of intervention is the increase of psychoeducation surrounding PPD in treatment services for new or expecting mothers, “in order to facilitate recognition and challenge beliefs that encourage shame and stigma and pose a barrier to service use” (Hadfield & Wittkowski, 2017, p. 735). • The US Preventive Services Task Force has suggested that universally screening new mothers for depression may lead them to be more open about expressing their feelings of symptoms earlier on, making the implementation of prevention strategies easier. • Training for PPD care, such as STEP-PPD, should emphasize the skills of active listening, validation, and empathy as channels for engaging and compassionate care (Hadfield & Wittkowski, 2017, p. 734-735). • Social workers can be of great contribution to PPD treatment through this channels: • Intake and assessment • Empowerment by providing support and guidance • Collaborating on goal-setting • Making referrals • Connecting family to resources.

THEOR Y.

T H E O R Y O F P P D • Cheryl Tatano Beck identified a four-stage process of postpartum depression Encountering Terror Dying of Self Struggling to Survive Regaining Control.

T H E O R Y O F P P D • Encountering Terror may occur within a few weeks to six months post-delivery. During this stage, women unexpectedly feel as though they are trapped with no means of escape. Horrifying anxiety attacks may occur that are described as losing one's mind, and at times feel worse than the actual depression. In conjunction with anxiety attacks, relentless obsessive thinking often occurs (Marsh, 2013). • Throughout Dying of Self, women begin to no longer feel normal and sense as though their former identity is absent (Marsh, 2013)..

T H E O R Y O F P P D • Amid stage 3, women struggle to survive and often times find it difficult to participate in the daily requirements of life. While in the midst of Struggling to Survive, women desire steps to resolution from conditions formed in the previous stage; however, many feel as though they are battling the system (Marsh, 2013). • The final stage experienced in PPD is that of Regaining Control. One does not regain control instantly, it is a slow process as unpredictable transitioning occurs. Women experience good days but still bad days will be encountered as well (Marsh, 2013)..

C O N C L U S I O N • PPD is a public health issue that has not been addressed enough. Mental health, especially for women, is especially stigmatized. New mothers are vulnerable population, and they require adequate support that can decrease the growing rates of PPD for the well-being of themselves, their children, families, and society. • PPD is a multifaceted condition affecting countless women globally. The diagnosis of this disorder involves a complex interplay of emotional, psychological, and physical symptoms, often manifesting as feelings of sadness, anxiety, and a sense of overwhelming fatigue. Recognizing these symptoms early is vital for preventative treatment. Various approaches like therapy, medication, and psychoeducation can offer hope to those battling PPD. Insights into the condition emphasize the importance of a strong support system, regular medical check- ups, and open communication with healthcare providers. • Moreover, theories surrounding postpartum depression suggest that a combination of hormonal, genetic, and environmental factors may contribute to its onset. This highlights the need for ongoing research and understanding to develop more effective prevention and treatment strategies. • Why We All Need to Talk About Postpartum Depression TedTalk.

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