Postnatal Depression - Essay Example

? Qualitative lab report: Postnatal depression Insert (s) Postnatal depression is a serious common health problem that is usually characterized by persistent mood swings and emotional distress following the birth of a baby. Some of the common symptoms include feeling of very low or despondent thinking, tiredness, laziness, shying away from the world, a sense of inadequacy. Although the theories about postnatal depression vary, a number of some psychologists concur that PND vary from other depression just in so far that it occurs after birth. Others argue that some woman experience depression in the last episode of pregnancy and what is known as PND could be a prenatal depression caused by hormonal changes and psychological responses due to pregnancy. Qualitative lab report: Postnatal Depression Introduction Postnatal depression also called postpartum depression (PPD) is a clinical depression which normally affects women especially after childbirth. Many women often undergo a period of low mood after having a baby. Although there are a number of differences between postnatal depression and the normal ordinary depression, there are also a significant number of similarities. Generally the first episodes of postnatal clinical depression normally develop in the first few months after childbirth and the condition may also develop out of severe cases of child blues. Some of the symptoms of PND that are similar to those of the ordinary depression include mood swings and persistent feelings of miserable and tearful without any apparent reason (Beck, 2002, p.454). The condition is primarily common in mothers with a history of depression among their family members, those who have experienced stressful events during their pregnancy as well as mothers who have suffered previous episodes of depression. Postnatal depression is mainly as a result of the experiences of pregnancy, childbirth and the responsibilities that come with parenting an infant. Biological, psychological and behavioral symptoms of depression are a normal part of this period where lots of women are unable to perform what they did before either because of pregnancy, consequences of child-birth or because of the demands of caring for an infant. Symptoms of this condition include sadness, fatigue, a change in eating and sleeping patterns, reduced libido, nervousness and irritability (Murray, 2002, p.102). The etiology of postnatal depression is however not clearly understood therefore it is sometimes assumed that the depression is caused by a number of factors including lack of vitamins. Although the theories about postnatal depression vary, a number of some psychologists concur that PND vary from other depression just in so far that it occurs after birth. Others argue that some woman experience depression in the last episode of pregnancy and what is known as PND could be a prenatal depression caused by hormonal changes and psychological responses by being pregnant. The majority however believes that PND has a complex of causes and the origins are social circumstances and life history of each woman (Nicolson, 2001). The present qualitative study primarily involved the use of interviews to investigate individual’s behavior and attitudes during post-natal depression young women. One of the participants was a middle aged woman known as Sonya (name changed) who had previously experienced postnatal depression after having her first childbirth at the age of 37. The interviewee was provided with a number of questions regarding her background, experiences with postnatal depression as well as how she managed to cope with the disorder. It is hoped that face to face interviews using a combination of structured and unstructured questions will provide richness and depth to the collected information as compared to the other methods. Experimental Method Design Semi-structured interview was used to collect data towards experience of depression. A thematic analytical approach (Braun & Clarke, 2006) was used in this study to analyze transcribed materials as it offers a good way to pick out relevant and precise information from rich data. Participants Participant was a 37 years old mother Sonya, who was a one example of a large scale qualitative study interviewing women about their experience of depression. Sonya had worked for fifteen years before she decided to have a child at the age of 37. Although her experience was not particularly traumatic, she underwent a complicated childbirth which eventually resulted in an emergency caesarean. Materials Transcribed interview was handed in during the class with all the information needed to analyze the data. Another materials needed in the study were colored pens and paper. Procedure Prior to the recruitment of the participant, ethical approval was sought and granted by the appropriate authorities. Generally, the participant was interviewed for a total of six hours and the interview sessions were spread over two meetings, one week apart. Results and Discussion Analytical procedure The procedure employed in this research involved the use of thematic qualitative analytic to identify the major themes and their codes in the transcribed interview. The recorded interview was transcribed into word and analyzed in order to help successfully identify the main themes. Lastly, the identified themes were re-checked in order to determine the validity of the themes selected for analysis. Figure 1: Codes and themes identified through a thematic analysis. Themes Relationships Lifestyle change Negative feelings Codes Friends, New challenging responsibilities Mood swings Partner/husband Shock of becoming a mother Depression Workplace Long hours of work Anxiety Relationships Changed relationships are another important theme that was identified during thematic analysis of the transcribed interview. Becoming a mother usually come with new roles and this may sometimes alter the relationship between the new mother and her partner, family members and workmates as both sides have to adjust (Miller, 2002). For example, Sonya no longer feels her husband gives her the support she needs. “Well Johnie doesn’t ask me what I do during the day therefore it’s no surprise that I don‘t value it,” “After having Suzie I think my lifestyle changed a lot more than his. I think that was one of the main things, that I was accepting a complete obliteration of what I was doing before, you know, to care for Suzie” On the other hand, another important code under relationships is friends. Sonya particularly feels that having a baby has affected her relationship and interaction with friends. S. “I’m on a treadmill of constantly trying to please everybody for them to think “I’m a jolly good person” S. “I suppose if you look back to my mother I was thinking that, you know, once I have a baby then I’m no longer the business woman I’m you know the person who should always be there with the hugs and does the ironing.” Lastly, Sonya also feels that her child birth has also significantly impacted on her workplace and the onset of postnatal depression has hindered her from accomplishing some of her responsibilities and work related tasks. “Some times I think if I hadn’t been ill, would I have gone to work quicker possibly and maybe felt happier? Because it’s more my natural personality to have part work, part Suzie but I kept thinking” According to Hall (2006, p.256), this is particularly attributed to the fact that becoming a new mother comes with a lot of responsibilities that may eventually put pressure on the new mother to temporarily give up her job as well as make a number of other work related adjustments. Change in lifestyle One of the main themes evident throughout the interview was the change in lifestyle and the shock of becoming a mother as one of the predisposing factor for the disease. From her clinical history particularly with regard to her previous lifestyle, it is most likely that Sonya was very much unprepared for the impact of child birth and the new responsibilities that come with being a mother (Beckford-Ball, 2000, p.126). For example, for all the twelve years she to Johnnie, Sonya had got used to working hard and for long hours. For years, the couple shared a similar lifestyle that was dominated by long hours of work. In this regard, Sonya suddenly begins to experience new responsibilities and has to learn how to deal with a helpless creature whose only mode of communication is crying. As a result the postnatal depression may have resulted from the fact that Sonya is overwhelmed by the new challenging responsibilities that come with being a new mother. Additionally Sonya may have also experienced shock because the baby did not conform to some of her expectations (Nelson, 2003, p. 471). For example, although the baby’s behaviour was typical for her age, Sonya blamed her daughter for behaving badly because she did not conform to her expectations of her. Here is an excerpt from the interview that seems to justify this argument: I: Perhaps you would like to begin by telling me a bit about what motherhood has been like for you? S: “I felt paralysed, and locked into a lonely and isolated world. Depression was like being imprisoned in my own prison. I have to put on a mask and play the role of the coping mother”. I can appear okay to the rest of the world even though I feel terrible inside. I could feel panic rising up in my stomach if she wouldn’t put her coat on to go out, if she cried a bit. It was all these exaggerated feelings of not being in control and panic as soon as she did anything that was not what I expected. I expected her to be like a robot, you know, I’d dress her, she’d put her arms up and I mean that’s not reality. If she wants to run around a bit before she puts her nappy back on then that’s normal. But to me, I was thinking “She shouldn’t be doing this, she should have her nappy on now” and it was almost like when a housewife is obsessionally tidy. It was like an obsession about “She will always look clean, she will always eat her dinner without a spot going on the you know.” It was almost that sort of, I’m imposing standards on her that are much too high and I was trying to fulfil them and making myself feel ill. It’s like if someone comes for a cup of coffee when you’re ill you think. One of the theories that best explain Sonya’s shock of becoming a new mother is the social cognitive theory. This theory was put forward by Beck, Rush, Shaw and Emery in 1979, and has been adopted to take into account the situations around pregnancy, birth and parenting the infant. Cognitive theory generally suggests that our feelings and our actions are strongly influenced by our way of thinking and particularly by the importance we give to events and experiences (Boyce and Hickey, 2005, p.607). When applied to the peri-natal period, these cognitions and beliefs may include negative ideas about changes in the body shape, changes in role (especially in marital relationship, family or workplace), or being the best mother. According to Nicolson (2001, p.78), this is particularly because motherhood usually involves a number of losses not only with regard to the freedom but also the loss of independence, sense of individuality and sometimes even the loss of one’s income. Negative feelings Another important theme noticed in the analysis of the transcribed interview was negative feelings. Although Sonya did not experience her childbirth as particularly traumatic, the birth process was complicated and she had to undergo an emergency caesarean. The experience of trauma caused by undergoing unplanned caesarian section may have resulted in negative feelings such as mood swings, depression and anxiety (Sword, 2002, p.128). I: Have you been able to discuss how you were feeling with anyone? S: My psychotherapist says, “What would it hurt if you were yourself, if you slumped in the corner and said ‘Look, I’m ill, this is how I am, take me or leave me.” I can’t do that. Would that be so terrible? “I’d think – well none of those people will want to know me when I’m well because they’ve seen me so bad, you see? But I find it painful to say, “I’ve been through it, it wasn’t a nice experience, but it’s made me stronger.” I know all those things logically, but in my heart of hearts, in a way, I wanna say, “No, that wasn’t me. This is me, “which is not positive for recovery, is it? The presence of negative feelings in new mothers is supported by biological theory. The theory is based on the idea that the huge transformation which takes place in a woman’s body during pregnancy, labor and following birth, leads to postnatal depression (Ross, 2001, p.563) Nonetheless the theory is not backed-up by scientific research, into explaining the hormonal levels and rates of reported depression only in minority of women, neither does it explain the fact that all women go through the process of giving birth but only a section of them experience postnatal depression. The biological theory is also not supported by facts for treating postnatal depression with the suggested use of hormone prescriptions, just reducing signs of depression in a consistent manner and again, antidepressants that reduce signs of depression in the general population also reduce signs of postnatal depression (Paulson, J.2010, p.74). Conclusion Postnatal depression usually occurs regardless of the family circumstances and whether or not the baby is a first born or second. Although there is no known cause of postnatal depression, there are a number of possibilities that have been put forward in trying to explain the genesis of this depression in new mothers. The first one is the shock of becoming a mother .changed relationship, finding it hard to adjust the new status, lack of support, other stresses to coupe up with, difficult labor, changes to your body, hormonal imbalance, childhood experiences. The affected mothers are usually unable to enjoy themselves and this is particularly common in new mothers who may feel that they do not enjoy the presence of the new baby according to their expectations. On the other hand, mothers often feel that the new babies are overwhelming and may also occasionally experience panic attack episodes lasting a couple of minutes. The other common symptoms include fatigue, sadness, loss of appetite, changes in sleep, anxiety, crying period, and reduced libido. Reflexivity I particularly chose the topic of post natal depression for my research dissertation because of my previous encounters with the victims of the disorder. I once had a sister who suffered silently from post natal depression until she decided to seek the services of a local psychotherapist where she was eventually diagnosed with post natal depression. Watching my sister suffer silently from the effects of postnatal depression, I developed some of my previous conceptions regarding the condition based my observations of the experiences of my friend. I used to wrongly think that postnatal depression is purely a figment of the affected patient’s imagination and can therefore have no medical justification. I also believed the common media myths about post natal depression that depicted mothers with the condition as out of control individuals who are often seriously ill or non-functioning and can therefore not be trusted with their own children. Having a close relative suffering from the condition however taught me that post natal depression is just but a normal pregnancy related mood disorder that can effectively be corrected through early diagnosis and interventions. Based on my previous experiences, observations and my current beliefs, I have taken great care during my thematic analysis to avoid any biasness due to my personal feelings. References Alder, E. , Truman, J.K. 2002. Counselling for postnatal depression in the voluntary sector. Psychology and Psychotherapy: Theory, Research and Practice, 75, 207-220 Beck, C.T. 2002. Postpartum Depression: a Metasynthesis. Qualitative Health Research, 12, 4, 453-457. Beckford-Ball, J. 2000. The Stages of Post-natal Depression. British Journal of Midwifery, 8, 2, 126-128 Boyce, P. & Hickey, A. 2005. Psychosocial risk factors to major depression after childbirth. Social Psychiatry and Psychiatric Epidemiology, 40, (8), pp. 605-612. Hall, P. (2006). Mothers’ Experiences of Postnatal Depression: an interpretative phenomenological analysis. Community Practitioner, 79, 8, 256-260. Harris, B. 1994. Biological and hormonal aspects of postpartum depressed mood. British Journal of Psychiatry, 164, 288-292. Kirkley, D.L. (2000). Is Motherhood Good for Women: A feminist exploration. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 29, 459-464. Miller, L.J. 2002. Postpartum Depression. The Journal of the American Medical Association, 287, 6, 762-766. Murray, L. 2002. The impact of postnatal depression on infant development. J Child Psychol Psychiatry33, 543-61. Nelson, A. 2003. Transition to Motherhood. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32, 465-477. Nicolson, P. 2001. Postnatal Depression: Facing the Paradox of Loss, Happiness and Motherhood. John Wiley & Sons Ltd.: England. Paulson, J.2010. Focusing on depression in expectant and new fathers: prenatal and postpartum depression not limited to mothers. Psychiatry Times 27 (2), pp.72-88. Ross, M.K. (2001). Promoting the Transition to First-time Parenthood. British Journal of Midwifery, 9, 562-566. Sword, W. (2002). Review: Mothers with postpartum depression had to readjust expectations, cope with loss, and find ways to meet needs. Evidence-Based Mental Health, 5, 128. Read More