Diving Deep into Postpartum Depression

Pregnancy is a beautiful thing that shows how strong, resilient, and capable a woman’s body is. Not only does having a child put a physical toll on someone’s body, but it can also have a mental and psychological strain. Postpartum depression is one of the most common difficulties encountered after having a child and it affects about 13% of women after delivery. The onset is usually four weeks to three months after delivery and the symptoms are like those of depression unrelated to childbearing. Women who experience postpartum depression often experience a diminished interest in activities, dysregulation of sleep and eating, and increased agitation among other symptoms correlated with depression (Winser et al., 2002). Since postpartum depression can be detrimental to a mother’s physical and mental health, its effects can trickle down to the child as well, potentially leading to cognitive and behavioral problems.

There are two types of postpartum depression: 1) nonpsychotic and 2) psychotic. The symptoms of postpartum nonpsychotic depression include sleep and appetite disturbances, the inability to concentrate, feelings of inadequacy as a parent, and dispirited moods (Miller, 2002), and it affects about 10% to 20% of women in the United States. Women can be at greater risk for it if they had a history of major depression, psychosocial stress, and inadequate support from others around them. There are many studies that show how social support for mothers can help prevent them from having postpartum depression. With a good support system, a mother can be aided with their childcare which can significantly reduce their stress.

Unlike postpartum nonpsychotic depression episodes, postpartum psychotic depression episodes involve more emotional lability which is rapid and exaggerated changes in mood in relation to strong emotions. Also, if a mother who is suffering from this kind of postpartum depression has thoughts of hurting her child, she is more likely to act on them (Miller, 2002). The severity of this form of depression is due to a mix of manic and depressive features coupled with mood disorders such as depression or bipolar disorder. Proper treatment such as taking selective serotonin reuptake inhibitors (SSRIs) and therapy, needs to be done in order to reduce the likelihood of recurrence, even after the postpartum period. It will greatly benefit the mother and child alike.

The question of what causes postpartum depression is still ongoing, and there are many possible reasons why some women are afflicted by it and others are not. One hypothesis may be the sudden drop in hormones after birth. During pregnancy, estrogen and progesterone levels increase significantly, then drop quickly back to the levels before pregnancy 24 hours after delivery. This is only one of many possible reasons women experience this kind of depression, but there are many other external factors that can potentially perpetuate it such as environmental stressors and psychiatric history.

Unfortunately, stigmas are seen in all cultures, and they can have extremely debilitating effects on the individual. Mothers are not spared from the stigmas that society puts on mental illness. In a study done by Dennis and Chung-Lee in 2006, it was found that the fear of labeling and shame were the main factors that prevent mothers from seeking out postpartum help. The idea of “mother blaming” which is shaming the mother for unfortunate incidents that are out of her control, has been embedded in many cultures and in the minds of people, thus making it difficult for mothers to reach out for help and assistance (Pinto-Foltz & Logsdon, 2008).

Postpartum depression is a common illness that plagues millions of mothers globally. There needs to be an increase in education in order to staunch the stigma that comes along with mental illness. Moreover, mothers should also be given proper and adequate support before, during, and after delivery, no matter their socioeconomic status. Education and equal treatment are what are necessary to help mothers all over the world, and it will provide them with the support necessary to raise their child(ren) to become balanced and healthy people.

References

Miller LJ. (2002) Postpartum depression. JAMA. 287(6):762–765. doi:10.1001/jama.287.6.762 

Wisner, K. L., & Piontek, C. M. (2002). Postpartum depression. The New England Journal of Medicine, 6. DOI: 10.1056/NEJMcp011542 

Pinto-Foltz, M. D., & Logsdon, M. C. (2008). Stigma towards mental illness: A concept analysis using postpartum depression as an exemplar. Issues in Mental Health Nursing, 29(1), 21–36. https://doi.org/10.1080/01612840701748698 

Pinto-Foltz, M. D., & Logsdon, M. C. (2008). Stigma towards mental illness: A concept analysis using postpartum depression as an exemplar. Issues in Mental Health Nursing, 29(1), 21–36. https://doi.org/10.1080/01612840701748698 

Image from: https://alohabehavioral.com/2019/04/16/the-roller-coaster-ride-of-postpartum-depression/

Seasonal Depression

Although our species is considered to be incredibly advanced, we often fall victim to our own emotions. This question has been asked many times, but it has not been resolved. One of the possible answers to this issue could be found within the seasons. During the winter season, some of your friends might seem to be very down or out of their usual social behavior. This could be caused by seasonal affective disorder; which is “a mood disorder in which there is a predictable occurrence of major depressive episodes, manic episodes, or both at particular times of the year” and this pattern is correlated with major depressive episodes during the fall or the winter months (APA, 2022). For some, this means that they feel depressed during the winter months due to its gloomy feel and lack of sun all the time, while in the summer, they feel exceedingly happy and sometimes manic due to the presence of good weather, as well as increased presence of the sun in the daytime. This condition is very important to people; however, it is not talked about enough. It is also not widely understood by those around the person suffering from it. 

It is also important to note that a condition that is not widely known can lead to the failure of people around the person with it to understand them. A good example of this could be someone suffering from seasonal depression as they are going through something that gravely affects their daily lives (during specific seasons) and as such, leads the people who were friends with them to feel off-put with their current attitude and potentially not want to be friends with them anymore. This effectively isolates the person from their social environment, leading them to believe that they are the problem which, in turn, leads them to internalize their feelings in order to receive positive feedback from those who surround them. This is precisely the issue with this type of logic; as they are not the problem, but due to their surroundings they believe that they are and alter who they really are to appease those around them. If we were to provide a source of information or increase the amount of public awareness about disorders such as seasonal depression i.e. seasonal affective disorder, then this type of event would never occur and those suffering from disorders might feel more inclined to be true to themselves in social settings. In doing so, they not only free themselves from their current shackles, but they are also allowing themselves to trust in others and to trust that they will both assist them in their day-to-day life (if needed) and treat them the same way they would treat anyone else. 

As humanity continues to progress, it is important to realize that we are not perfect. Although we try our best, we can never be completely satisfied with what we have. Even though we sometimes struggle with our daily activities and moods, we can still be perfectly fine in our own way. This is why it is important that we try to understand other people's points of view and not only agree with them, but also acknowledge that there are times when a person may be suffering from a condition that is not widely known. In order for this to occur, we must enlighten the public on disorders and the social stigma that surrounds them. Currently, much of society attributes the flaws we see in others as “defects” or issues that you don’t wish to surround yourself with and our own flaws as something that occurs due to external factors such as a professor not teaching you the proper material therefore, you performed poorly on your exam and feel sad as a result. The problem with such logic is that it fails to see other points of view and it fails to accept people for who they are. Only when society changes its way of seeing and accepting others' points of view, will we see progress be made. 

References

American Psychological Association. (n.d.). Apa Dictionary of Psychology. American Psychological Association. Retrieved October 25, 2022, from https://dictionary.apa.org/seasonal-affective-disorder

Grief: An Inevitable Aspect of Life

Death is one of the few things in life that are guaranteed. At some point in time, every single one of us will lose a person or an animal who we love and care for so much. And with that loss, comes immense overwhelming feelings of sadness that are known as grief. Grief presents itself differently from person to person. Dealing with grief is a very individual experience dependent on many factors, including your personality, your coping skills, past life experiences, your faith, and how significant the loss was in your life (HelpGuide, 2022). Due to the individuality of grief, there is no set timeframe in which someone should be “healed” from it. I think it is fitting to put the word healed in quotation marks because, for many of us, the grief that comes from a loss of a loved one can last our whole lives.

Psychiatrist Elisabeth Kübler-Ross founded the concept of the “five stages of grief” in 1969 (HelpGuide, 2022). The stages are denial, anger, bargaining, depression, and acceptance. The first stage, denial, is characterized by feelings of disbelief and shock. Some common thoughts an individual can experience at this time are, “How could this happen to me?” and “It can’t be true” (Mind, 2019). Anger is the second stage, which includes blaming yourself or others for the loss and general hostile feelings and behaviors. “Why me?” or “Why them?” and “This isn’t fair” are some typical anger responses people have in this stage (Mind, 2019). Next comes the bargaining stage which is filled with guilt. Here, someone may have thoughts along the lines of, “Make this not happen, and in return, I will _____” (HelpGuide, 2022). The next stage, which is arguably the most commonly associated with grief, is depression. When one is in the depression stage, they experience feelings of hopelessness, intense sadness, and the sense that they are lost in life. “I’m too sad to do anything” is most likely a recurring thought that someone in this stage may face (HelpGuide, 2022). Finally, the last stage of grief, there is acceptance. Acceptance is about coming to terms with what happened: “Acceptance does not mean that somebody likes the situation or that it is right or fair, but rather it involves acknowledging the implications of the loss and the new circumstances, and being prepared to move forward in a new direction” (Mind, 2019).

It is important to note that not everyone experiences grief in these exact stages. Some people may go through the stages in a different order, skip some stages, or just not experience them at all. Even Kübler-Ross, who introduced this concept, acknowledges that healing from grief is not linear and that these stages are not one-size-fits-all. In her last book, about the stages of grief, she declares, “They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives” (HelpGuide, 2022). 

While grief is typically associated with the significant loss of a loved one, that is not the only instance from which grief can stem. A loss of any kind can provoke grief in someone. These losses include a divorce or a breakup, loss of a job, a miscarriage, diagnosis of an illness for you or a loved one, retirement, loss of a friendship, loss of safety after a trauma, changing careers, graduating, or even moving to a new place (HelpGuide, 2022). Regardless of the situation you are grieving from, it is immensely important to make sure you are taking care of yourself emotionally and physically during this tough time.

References

HelpGuide. (2022, October 13). Coping with Grief and Loss. Retrieved October 24, 2022, from https://www.helpguide.org/articles/grief/coping-with-grief-and-loss.htm 

Gautam, P. (n.d.). Unsplash. Retrieved from https://unsplash.com/@pgauti. 

Mind. (2019, July). Bereavement. Retrieved October 24, 2022, from https://www.mind.org.uk/information-support/guides-to-support-and-services/bereavement/experiences-of-grief/ 

Going Beyond the Baby Blues: Examining the Characteristics and Treatment of Perinatal Depression

Historically, it has been wrongfully believed that pregnancy and the puerperal period, also known as the postpartum period, serve as protective factors against mental health issues in women (Kerr, 2017). In recent years, this myth has been largely disproven as more women and mental health professionals are sharing their experiences and expertise on the matter of how pregnancy and the puerperal period are two areas of high concern where increased risk of developing mental health issues has been observed. One such critical mental health concern is perinatal, formally postpartum, depression which refers to the onset of depression or related symptoms beginning in pregnancy and/or following childbirth. The former term, postpartum depression, is limited to the period when the body is returning to its nonpregnant state, however it fails to acknowledge that depression during this time often begins during pregnancy (National Institute of Mental Health, 2022). Individuals with perinatal depression may experience extreme sadness, indifference, anxiety, and fatigue which makes it more difficult to care for oneself and the child (National Institute of Mental Health, 2022). 

Oftentimes, pregnancy and the time period following delivery can be a vulnerable and sensitive experience, as there is a multitude of changes occurring in one’s body to prepare for pregnancy and delivery. Physiological changes relating to the high and rapid variation in reproductive hormones, estrogen, and progesterone both during pregnancy and after delivery may lead to potential mood changes and emotional distress (Torres, 2020). Emotional stress may be heightened due to financial and social changes, such as the high expenses associated with keeping up with physician visits, medications, and postpartum care. Considering the range of potential triggers which may interfere with a new mother’s well-being, approximately 70% of women experience a short onset of emotional anguish following the delivery of their child (Torres, 2020). Colloquially referred to as the “baby blues”, this period of emotional stress is characterized by negative feelings of anxiety, sadness, or irritability, with the added responsibility of caring for a baby, sleep deprivation, and lifestyle changes. While “baby blues” may appear to be similar to perinatal depression, it is important to acknowledge that these are two very different conditions in their severity and duration. “Baby blues” are defined to be short-term and do not disrupt or impair an individual’s ability to carry out their daily activities. After a couple of days, patients will see an improvement in their mood without needing medication attention or treatment. However, perinatal depression is usually a longer-lasting condition paired with intense symptoms that can be emotionally and physically debilitating to an individual (Torres, 2020). 

Perinatal depression must be diagnosed by healthcare professionals, and although it is not a separate illness classification in the DSM-5 manual, patients must meet the provisions for a major depressive episode with the criteria of a peripartum-onset specifier (American Psychiatric Association, 2022). For a depressive episode to be classified as such, patients must experience at least five out of nine symptoms nearly every day for a two–week period: depressed mood, loss of interest or pleasure, change in appetite or weight, insomnia or hypersomnia, psychomotor retardation or agitation, fatigue, worthlessness or guilt, reduced concentration or indecisiveness, or suicidal ideation or attempt (American Psychiatric Association, 2022). These symptoms may increase or decrease in severity throughout the depressive episode and may result in additional shame or guilt concerning motherhood. 

Evidently, perinatal depression can have dire consequences for the pregnant individual in question by hampering their quality of life. However, these consequences can also impact the baby’s well-being and sense of attachment and bonding with the mother. This can induce sleeping and feeding issues, which can introduce a host of new concerns for the child and mother (Van Niel & Payne, 2020). With the severity of perinatal depression, treatment is usually needed to resolve the depressive episode. Treatment options include cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and the use of medications such as antidepressants. CBT and IPT are two evidence-based psychotherapy approaches that revolve around improving one’s ability to challenge negative situations (National Institute of Mental Health, 2022). CBT is a more structured therapy approach in which an individual may work to identify and tackle harmful thought patterns, behaviors, and emotional responses by substituting them with realistic and positive ways of thinking about one’s challenges and situations (Cleveland Clinic, 2022). IPT allows one to better their communication and relationship skills to develop stronger support networks and realistic expectations and outlooks on their respective situations. This allows an individual to have more resources and control over their circumstances to deal with their issue (National Institute of Mental Health, 2022). Whether an individual chooses to use therapy, medications, or both, it is no doubt that these options should be available to any individual undergoing a pregnancy. While pregnancy is commonly viewed as a time to rejoice, we, as a society, need to acknowledge the social and biological difficulties that pregnancy may introduce to the individual. 

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text rev (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

Cleveland Clinic. (2022, August 4). Cognitive behavioral therapy (CBT). https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt

Kerr, M. (2017, June 26). Perinatal depression. Healthline. https://www.healthline.com/health/depression/perinatal-depression#causes

National Institute of Mental Health. (2022). Perinatal depression. https://www.nimh.nih.gov/health/publications/perinatal-depression

Torres, F. (2020, October). What is Peripartum Depression (formerly Postpartum)? American Psychiatric Association. https://psychiatry.org/patients-families/peripartum-depression/what-is-peripartum-depression

Van Niel, M. S., & Payne, J. L. (2020). Perinatal depression: A review. Cleveland Clinic Journal of Medicine, 87(5), 273-277. https://doi.org/10.3949/ccjm.87a.19054

Do we have a healthy relationship with the news?

The accessibility of news and media has never been higher, than in today's world. Between our mobile devices and streaming platforms, we are never more than a few clicks away from the news. Much like many other facets of our life, this increase in access comes with both a handful of rewards and consequences, with the primary benefit of a higher percentage of the public able to stay up-to-date on events on a micro and macro scale. In the same breath, it can be hard to determine how much news is too much news. This thought led to a recent study that looked into the increasingly unhealthy relationship between the news and a portion of the anxious public (McLaughlin B. et al, 2022).

Led by Texas Tech University, this study aimed to look at the interconnectedness of individuals deemed to have “problematic news consumption“ and mental/physical ailments via survey. It should be noted that this study did not attempt to find a cause-and-effect relationship between the symptoms listed and problematic news consumption, rather to understand if there is a notable association between news consumption and physical, mental, and emotional symptoms. Secondly, it did not look at other mental health disorders, such as depression, or if the individuals in the study have been previously diagnosed with a mental health disorder (McLaughlin B. et al, 2022).The researchers classified problematic news consumption as: compulsively checking the news, constant state of worrying about news, and experiencing interference in everyday life stemming from being absorbed in news content. Of the 1,100 randomly chosen adults surveyed, just under half of them had moderate or severe problematic news consumption, with 16.7% of them stating that their consumption has negatively impacted other aspects of their life. The study further goes on to state how the individuals who had problematic news consumption also reported feeling increased levels of stress, anxiety, fatigue, sleep, problems, poor concentration, and gastrointestinal issues. 

Problematic news consumption is an issue that needs to be evaluated on multiple fronts. The way in which the media has disseminated information has been a topic of debate since the printing press. What is considered sensationalism and fear-mongering? The public undoubtedly has faced immense hardship over the past two years which is reflected in the 25% increase in diagnosis of anxiety and depression in people under the age of 50 (World Health Organization, 2022). One study looked to find a connection between this increase and the way COVID was covered in the media, by surveying 175 random adults and placing them into one of three groups; exposure to positive, negative, or neutral-worded news regarding COVID. What was found is that the use of negative language/frightening language resulted in higher percentage of participants noting negative emotions and decreased feelings of emotional resilience (Giri, 2021). Not only does high media access come with potential detriments to one’s mental health, an increase in Internet usage has also shown to have a correlation with increased feelings of anxiety (Caplan et al, 2010). 

The world is certainly an unpredictable place and with an increasing amount of people feeling as though the world is falling apart around them, only feeds into an overwhelming feeling of anxiousness. Part of this can be attributed to the never-ending pipeline of information we have, but a balance needs to be struck so that individuals are properly informed of recent events impacting society and preserving their mental health in the process. 

Other than the use of pharmacological methods to treat anxiety and depression, one effective way to reduce screen time and in turn reduce stress and anxiety is to practice mindful meditation. This practice of training to focus your attention on achieving “calm concentration and positive emotions” has been used in conjunction with cognitive behavioral therapy to help treat depression and anxiety (APA, 2019).  

Problematic news consumption is most likely a concept that will only become more and more prevalent in the general public. It is imperative that news outlets make a more conscious effort to report the facts as they are presented, without the need to consistently push a theme of despair with it. As for what can be done on the individual level, it is not as simple as “stop worrying about things outside of your control“. This is a situation that needs to be monitored closely with more research hopefully leading to more targeted cognitive therapies for problematic news consumption.

References

Caplan, S. E. (2010). Theory and measurement of generalized problematic Internet use: A two-step approach. Computers in Human Behavior, 26(5), 1089–1097. https://doi.org/10.1016/j.chb.2010.03.012 

McLaughlin B., Gotlieb M R. & Mills D J. (2022, August 23). Caught in a Dangerous World: Problematic News Consumption and Its Relationship to Mental and Physical Ill-Being. Health Communication. https://www.tandfonline.com/doi/full/10.1080/10410236.2022.2106086 

Giri, S. P., & Maurya, A. K. (2021). A neglected reality of mass media during COVID-19: Effect of pandemic news on individual’s positive and negative emotion and psychological resilience. Personality and Individual Differences, 180(110962), 110962. doi:10.1016/j.paid.2021.110962

World Health Organization. (2022, March 2). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. Who.int; World Health Organization: WHO. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide 

(N.d.). Retrieved October 25, 2022, from Apa.org website: https://www.apa.org/topics/mindfulness/meditation

Impact of Sex and Gender on Mental Health

The prevalence of mental health disorders greatly varies between men and women. Mental health disorders are known to impact an individual's quality of life in terms of their emotions, behaviors, mood, and thought processes (Otten et al., 2021). Although mental illness can impact anyone, studies have shown that there are higher rates of specific disorders found in one sex compared to the other. In addition, it has been challenging for scientists to determine the true causes of the vast differences in prevalence rates between sexes.

The disorders that are more commonly identified in women are often related to the internalization of emotion while men are diagnosed with disorders that externalize emotions (Eaton et al., 2012). The National Comorbidity Survey has identified that women are approximately twice as likely to be diagnosed with anxiety disorder, social phobia, major depression, and panic disorder in comparison to men (Eaton et al., 2012). The survey has also indicated that men have higher prevalence rates for alcohol and drug dependence, as well as antisocial personality disorder when compared to women (Eaton et al., 2012). Moreover, dementia as well as mood and neurotic disorders are found more in women (Suanrueang et al., 2022). Intellectual disability, schizophrenia, along with mental and behavioral disorders are better detected in men (Suanrueang et al., 2022). In addition, each sex experiences different severities of the diagnoses. For instance, adverse symptoms related to schizophrenia are more commonly reported in men while there are worse anxiety symptoms present in women (Otten et al., 2021). Men have also reported having experienced more traumatic incidents in their lives, yet women are more likely to develop post-traumatic stress disorder after traumatic events (Otten et al., 2021). Additionally, suicide performed by men occurs more frequently while women have higher numbers of suicide attempts (Otten et al., 2021).

Although the origins of the prevalence rate differences between the two sexes have not been made clear, many factors that impact the rates have been determined (Otten et al., 2021). Seeing as sex refers to the biological construct of an individual at birth, factors including hormone production of sex-specific hormones may explain differences in relation to psychiatric and stress disorders (Otten et al., 2021). Gender refers to the self-identity of an individual and relates to the behavior associated norms and power distribution that society has assigned to men and women (Otten et al., 2021). Gender-related factors include; self-esteem, gender-related violence, and family-related factors (Otten et al., 2021). Socioeconomic positions and social interactions vastly differ among men and women depending on their culture, and where they live. Furthermore, disparities in education, family, and lifestyle-related factors are being studied as characteristics that impact differing mental health diagnoses in men and women (Otten et al., 2021).

All individuals regardless of sex and gender should be provided with fair mental health treatment options. The various differences in prevalence rates can change the future of mental health assistance. For instance, improved prevention options can be discussed with the respective sex (Suanrueang et al., 2022). Enhanced mental health evaluations can be performed and risk factors are more likely to be identified (Suanrueang et al., 2022). In addition, new medications can be formulated and more tailored treatment options can be provided. Ultimately, these unique prevalence rates can aid in the implementation of better mental health resources for men and women.

References

Eaton, N. R., Keyes, K. M., Krueger, R. F., Balsis, S., Skodol, A. E., Markon, K. E., Grant, B. F., & Hasin, D. S. (2012, February). An invariant dimensional liability model of gender differences in mental disorder prevalence: Evidence from a national sample. Journal of abnormal psychology. Retrieved October 4, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402021/

Otten, D., Tibubos, A. N., Schomerus, G., Brähler, E., Binder, H., Kruse, J., Ladwig, K.-H., Wild, P. S., Grabe, H. J., & Beutel, M. E. (2021, February 5). Similarities and differences of mental health in women and men: A systematic review of findings in three large German cohorts. Frontiers in public health. Retrieved October 4, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892592/

Suanrueang, P., Peltzer, K., Suen, M.-W., Lin, H.-F., & Er, T.-K. (2022). Trends and gender differences in mental disorders in hospitalized patients in Thailand. Inquiry: a journal of medical care organization, provision and financing. Retrieved October 4, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019317/          

Photo: Nhân, D (n.d). People Wearing Sneakers. Pexels. https://www.pexels.com/photo/people-wearing-sneakers-1021145/