Postpartum depression (PD) is an excellent example of one of the psychological disorders that are usually undetected and undertreated. Ten to fifteen percent patients after delivery experience this mood disorder. In the US, seven to twenty percent of new mothers are affected by this affliction, reducing the quality of life in the afflicted women and their offspring’s. Scholars attribute this condition to several psychosocial stressors. Recent studies have discovered a link between a patient’s history of major depression as well as the manifestation of depressive symptoms before pregnancy to the condition under scrutiny.
Nonetheless, other factors such as traumatic experiences during pregnancy, obstetric complications, and low socioeconomic statuses also contribute to the development of the disease ( Anokye et al., 2018 ). PD jeopardizes the quality of mother-infant relationship which adversely affects the infant. If left untreated, the disorder heightens the risk for chronic, recurrent, and intractable depression. The increase in the number of women suffering from chronic depression indicates flaws in the current diagnostic procedures. Effective screening procedures in obstetrical and primary care should be developed and implemented to the health of women in the global society.
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Etiology
The etiology of the condition is unclear. Several studies suggest that PPD is caused by vitamin deficiency. The precise root of the ailment is yet to be established. Nonetheless, several studies indicate that the most probable cause is the change of hormones during gestation. Notably, the levels of hormones such as estrogen, progesterone, and cortisol decline dramatically, forty-eight hours after birth. According to Vliegen, Casalin, and Luyten (2014), s ome women tend to be overly sensitive to the fluctuations in hormonal concentrations, especially after delivery. Nonetheless, the claims are yet to be ascertained, and other studies report no significant link between a drop in the levels of cortisol and the manifestation of depressive symptoms during and after pregnancy. Conversely, several other studies prove that there is a correlation between these hormones and the disease ( Vliegen, Casalin, & Luyten, 2014). Undeniably, all women experience hormonal fluctuations after they deliver. Nonetheless, only ten to fifteen percent of these mothers suffer from the affliction. Despite the relevance of the previous statement, it does not suggest that hormones do not contribute to PPD.
Risk Factors
Child delivery is one of the most distressing experiences in every woman’s life. While some are lucky and endure a few hours of labor, others succumb to prolonged hours or even days of intense pain. Generally, this is a period of immense physiological and psychological change for women. Vulnerable women may manifest depressive symptoms as a result. Multiple studies link PPD with the previous history of depression ( Anokye et al., 2018 ). Women who have once suffered from the disorder are fifty to sixty percent more likely to develop PPD. Other risk factors such as early child conception, substance abuse, domestic violence, the lack of social support during pregnancy, bipolar disorder, and unplanned pregnancy, among others, can contribute to PPD.
Signs and Symptoms
The symptoms of postpartum depression may be different from those manifested by patients suffering from non-postpartum depression. Generally, in PPD, women experience adverse changes in sleep, eating, and activity patterns. Notably, many of these patients have no significant history of any psychological disorders. Hence, most of them are reluctant to visit the doctor. Myers and Johns (2018) suggest that PPD patients experience obsessive thoughts and suicidal ideation. Sixty percent of women exhibit the former and are aggressive towards the neonate. Notably, they impose no harm on the infants but avoid them to suppress their thoughts. In addition, these patients, experience mood swings, sleep deprivation, changes in appetite, sadness, self-doubt, difficulty concentrating and remembering, paranoia, hallucinations, delusions, and persistent thoughts of death. Nine out of every ten patients have a combination of these symptoms.
Screening for PPD
Myers and Johns (2018) stress the vitality of early and accurate detection and treatment of PPD. Screening usually takes place during the fourth to sixth-week postpartum visit. The Edinburgh Postnatal Depression Scale (EPDS) is the most common screening tool for PPD. According to Myers and Johns (2018), t he scale comprises of ten question items and with each having scored from zero to three. In the case of patients without any history of depression, any score that goes beyond twelve has a sensitivity of eighty-six percent and specificity of seventy-eight percent for PPD. Aside from this, doctors also use the PHQ-9 scale ( Myers & Johns, 2018). The patient health questionnaire enables physicians to evaluate related symptoms and functional defects to make a tentative diagnosis. The completion of the PHQ-9 questionnaire leads to scoring by the caring clinician or any other relevant medical practitioner. The score ranges from one to twenty-seven and enables the physician to gauge whether depression is mild or severe.
Nonetheless, these methods are flawed and ineffective. Disturbed patients or even those with attention issues can answer the questions in a manner suggesting that they have the symptoms, even when they do not. Furthermore, most of the indicators revealed through the scales are similar to those manifested by patients with other psychological sicknesses such as schizophrenia and bipolar disease, among others. It is therefore difficult to gauge whether a patient is suffering from PPD or another psychological illness.
Conclusion
PPD is one of the most prevalent psychological afflictions in women after postpartum. The condition usually remains undetected and untreated, due to the lack of an effective PPD diagnostic procedure. The use of questionnaires is ineffective in accurately diagnosing the disorder. It is critical for more effective screening methods to be developed and employed, to prevent the development of chronic depression. Approaches that rule out the significant symptoms are required to promote an accurate PPD diagnosis. The step would promote the psychological health of women after delivery.
References
Anokye, R., Acheampong, E., Budu-Ainooson, A., Obeng, E. I., & Akwasi, A. G. (2018). Prevalence of postpartum depression and interventions utilized for
It's management. Annals of general psychiatry , 17 (1), 18.
Myers, S., & Johns, S. E. (2018). Postnatal depression is associated with detrimental
Life-Long and multi-generational impacts on relationship quality. PeerJ , 6 , e4305.
Vliegen, N., Casalin, S., & Luyten, P. (2014). The course of postpartum depression: a review
of longitudinal studies. Harvard review of psychiatry , 22 (1), 1-22.
