Depression of the First Postnatal Year - Essay Example

Qualitative lab report: Postnatal depression Insert (s) Postnatal depression isusually referred to a depression of first postnatal year and it affect approximately affect every tenth woman but it also affects men. Postnatal depression is characterized by a 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 by being pregnant. 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). Additionally, the affected patients 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. Sometimes anxiety may also be experienced in postnatal depression. For example, 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. 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. Among men, with emphasis to new fathers, the incidence of postpartum depression has been approximated to be between 1% and 25%. Symptoms of this condition include sadness, fatigue, a change in eating and sleeping patterns, reduced libido, nervousness and irritability. 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 determine and investigate experiences of postnatal depression among 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 analysis of the recorded 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. The shock of being a mother One of the main themes evident throughout the interview was 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. 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. 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. 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 Alder and Truman, 2002).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. Difficult labor Another important theme noticed in the analysis of the transcribed interview was the impact of having a difficult labor on Sonya’s condition. Although Sonya did not experience her childbirth as particularly traumatic, the birth process was complicated and this eventually led to an emergency caesarean. Difficult labors are usually characterized by long and extremely painful delivery as well as emergency treatments or unplanned caesarean section delivery. The potential impact of difficult labor is often underestimated and just like Sonya, many people often overlook the experience of trauma caused by difficult labor, such experiences may eventually impair the relationship between the mother and the child as well as between the mother rand her partner. 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? And in my mind, yes. 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? Difficulty in labor 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. 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. 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. In analyzing ‘postnatal’ and ‘depression’ differently, one might believe that ‘depression’ is as a result of being in the ‘postnatal’ period, which then raises the question, is ‘postnatal depression’ different from ‘depression’ at any other time? To answer this question we need to look at theories and confirmation which determine postnatal depression, how signs of depression transform over time and the effect different treatment have. There are three main theories concerning postnatal depression; biological, cognitive and socio-cultural. The socio-cultural theories share some similarities with the cognitive ones that are, people’s beliefs affect their mood, but the difference is that many of these beliefs are supported and reinforced by social structures that are for instance, the popular culture, the media and the law. This theory is supported by an analysis if socio-cultural influences in the countries which in summary tend to value being young, thin, beautiful and rich, but the theory are also supported by cross-cultural comparisons. In many non Western countries postnatal depression is not an acknowledged phenomenal to the extent that there is no corresponding term or phase in many other languages. The socio-cultural theory is given more emphasis by the differences in cultural practices around pregnancy, childbirth and child-rearing, which provide potential mechanism for monitoring differences in reports of postnatal depression. The disadvantage of this theory is in trying to explain why is it that not all women who give birth show depression. However a small modification to the theory would be different women are exposed to different messages about themselves as women and as mothers and again some women are more influenced than others by such messages. Another challenge with this theory is the designing an intervention to reduce or prevent postnatal depression may be hard, given that near impossibility of controlling messages at a societal level. References Alder, E. , Truman, J. (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. 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. Read More