Postpartum Depression - Essay Example

?Introduction Postpartum depression is one of major psychological disorders that hamper the health of new mothers. According to DSM-IV of mental disorders, the major depression with postpartum onset is defined as “episodes of depression beginning within 4 weeks of giving birth” (Miller, 2002, p.762). A meta-analysis of 28 studies by Gavin et al. (2005) found that around 15% new mothers suffer from postpartum depression (PPD) (Letourneau et al., 2011, p.345). Researchers have revealed that problems like marital stress, divorce, child abuse and neglect, suicide and infanticide result from the PPD in women (Cuijper, Bra?nnmark & Van Straten, 2008, p.104). This shows that PPD is not a short term psychological problem limited to the period around child birth, but is a long term problem that can cause severe harm to the psychological, emotional and social aspect of mother and infant. Hence, it is necessary to understand how it can be treated so that it does not affect the mother and her child negatively. This paper aims at understanding what kind of treatment is most effective in treatment of PPD. More specifically, this paper aims to find out if the psychological treatments are effective in treating PPD, and if they are sufficient enough to treat the disorder completely. The Findings To attain the purpose of the paper, the review of research studies was conducted. This was done by reviewing the articles which adopted different methods of researches to gain insight into effective treatment of PPD. Three articles were selected for the study. The findings of the three articles are discussed below. Article 1 In their article “Psychological Treatment of Postpartum Depression: A Meta-Analysis,” the authors Cuijper, Bra?nnmark and Van Straten have discussed their research study regarding the effects of psychological treatment in case of PPD. Their research was based on the meta-analysis of 22 primary studies, 766 articles and 17 study reports (2008, p.105). These studies were based on different methods like cognitive-behavioral therapy, social support interventions and interpersonal psychotherapy (Cuijper, Bra?nnmark & Van Straten, 2008, p.105). The study revealed that there was consistent and substantial decrease in depressive symptoms as a result of psychological intervention (Cuijper, Bra?nnmark & Van Straten, 2008, p.105). However, the meta-analysis also found that the effects of psychological treatments on depression in women with PPD are moderate (Cuijper, Bra?nnmark & Van Straten, 2008, p.113). Studies by Churchill et al. (2001) and Cuijpers & Dekker (2005) found that even though the effects are significant, they were lower compared to the effects of psychological treatments in patients with other psychological problems (Cuijper, Bra?nnmark & Van Straten, 2008, p.113). In fact, it was found that the effects of biological treatments such as pharmacological treatment and electroconvulsive therapy are higher than the psychological treatment in women with PPD (Cuijper, Bra?nnmark & Van Straten, 2008, p.113). The authors concluded that as the biological causes are more prominent in the PPD, the biological treatments are more effective (Cuijper, Bra?nnmark & Van Straten, 2008, p.113). The comparative studies in the meta-analysis also confirmed that psychological treatments are less effective compared to other treatments for PPD (Cuijper, Bra?nnmark & Van Straten, 2008, p.113). Article 2 In their article “Effect of home-based peer support on maternal–infant interactions among women with postpartum depression: A randomized, controlled trial,” the authors Letornet et al., have discussed the trial study they conducted to understand if peer support can help in increasing the quality of mother-infant interaction. Murray et al. (2003) found that PPD increases stress in infants as it decreases the quality of maternal-infant interaction (Letourneau et al., 2011, p.346). A systematic review by Beck (1998) found that children’s cognitive and social-emotional development is affected negatively by the PPD (Letourneau et al., 2011, p.346). However, study by Strass (2002) revealed that due to infant health concerns, fear of addiction and belief that depression will resolve on its own, up to 50% of mothers refuse to take medications for their PPD symptoms (Letourneau et al., 2011, p.346). The authors found that the treatment for PPD does not affect the maternal-infant interaction (Letourneau et al., 2011, p.346). Hence, they conducted a randomized controlled trial to evaluate how the mothers and infants affected by PPD are influenced by home-based peer support that included the maternal-infant interaction teachings (Letourneau et al., 2011, p.347). The treatment of home-based peer support is an aspect of social support and hence, falls under the psychological intervention method. The study revealed that mothers with PPD do not receive the maternal-infant interaction teachings by peers that well (Letourneau et al., 2011, p.345). The authors concluded that the professional nurses might be able to deliver the teachings more optimally (Letourneau et al., 2011, p.345). During the study, it was observed that the effect size was small for one of the two measures of maternal-infant interaction (Letourneau et al., 2011, p.351). It was also found that for measures of symptoms of PPD and perceived social support, the effect size was medium (Letourneau et al., 2011, p.352). However, for the main outcome of the trial, i.e. the maternal-infant interactions, the effect size was smaller than anticipated (Letourneau et al., 2011, p.352). The study revealed that the social support intervention failed to improve maternal-infant interaction (Letourneau et al., 2011, p.352). It was understood that the mother’s ability to interact with her infant sensitively and responsively was impaired due to significantly higher depressive symptoms (Letourneau et al., 2011, p.352). This nullified the effects of psychological or social support treatment that was provided to the mothers (Letourneau et al., 2011, p.352). Hence, the results of this study confirms the results of the previous study discussed, which says that psychological interventions or social support interventions are not as effective as biological interventions in treatment of PPD. Article 3 In the article “Postpartum depression,” author Laura Miller has discussed the literature review on PPD. It has been found that the psychological therapies like cognitive behavioral and interpersonal psychotherapy have demonstrated efficacy in treating PPD in women (Miller, 2002, p.764). However, these therapies work only in cases where the depression is mild. However, women with severe depression, suicidal tendencies or psychosis are referred to psychiatric care as it is well known that psychological therapies prove quite insufficient in treatment of these severe symptoms and disorders (Miller, 2002, p.764). In such cases, the treatments that are found to be appropriate and effective are crisis management, pharmacotherapy, psychotherapy, strengthening social support network and electroconvulsive therapy, as they represent comprehensive and multifaceted approach to treatment (Miller, 2002, p.764). Moreover, the vulnerability to depression is understood to be contributed by the rapid hormonal changes that take place after the delivery of child (Miller, 2002, p.762). This shows that apart from the psychological factors like history of major depression, psychosocial stress and inadequate social support (Miller, 2002, p.762), the biological factors also play a major role in development of PPD in women after giving birth. Hence, it is not surprising to know that for PPD, antidepressant medication is considered as a chief method of treatment (Miller, 2002, p.764). The findings of the literature review in this article are consistent with the findings in other two articles. Conclusion From the discussion of the review of the articles, it is clear that psychological therapies are not sufficient enough to treat the PPD in new mothers. The articles reviewed show that the reason is the cause of the PPD. All the three articles agree that as the root of the PPD lies in the biological conditions like hormonal changes, PPD can be treated only by treating the biological conditions. The biological conditions can be treated only through medication and electroconvulsive therapy. The findings reveal that even though the psychological therapies are effective in treating PPD, they are not as effective as psychiatric treatment, antidepressant medications and electroconvulsive therapy. References Cuijpers, P., Bra? nnmark, J.G. & Van Straten, A. (2008). Psychological Treatment of Postpartum Depression: A Meta-Analysis. Journal of clinical psychology, 64 (1), 103-118. Letourneau, N., Stewart, M., Dennis, C., Hegadoren, K., Duffett-Leger, L. & Watson, B. (2011). Effect of home-based peer support on maternal–infant interactions among women with postpartum depression: A randomized, controlled trial. International Journal of Mental Health Nursing, 20, 345-357. Miller, L.J. (2002). Postpartum Depression. The Journal of the American Medical Association, 287 (6), 762-765. Read More