Prevalence of Postpartum Depression and AssociatedFactors among Postnatal Women Attending At HiwotFana Specialized University Hospital, Harar, East Ethiopia,2015/2016 by Sisay Shewasinad in OAJRSD in Lupine Publishers.
Postpartum depression also known as postnatal depression is
a non psychotic depressive disorder of variable severity and it can
begin as early as two weeks after delivery and can persist indefinitely
if untreated. Most of the time, it occurs within the first three month
after delivery. The illness can cause distress and impair a mother’s
ability to carry out her normal tasks, care for herself and care of her
baby. It is a clinical depression with symptoms that can include a
feeling of fatigue, social withdrawal, sadness, changes in sleeping
and eating patterns, and guilt (including related to ability to care
for the infant), crying, loneliness and low self esteem lasting longer
than two weeks or beginning two weeks or more after delivery
[1,2]. The term “Post¬partum Depression” encompasses several
mood disorders that follow childbirth. Important developments in
the study of PPD include its association with symptoms of anxiety
and bipolar disorders in addition to those of depression [2].
Becoming a mother can be difficult this is due to a major
psychological shift from viewing oneself as a woman who is pregnant
to viewing oneself as a new mother. This major emotional shift
may create problems. Following childbirth, seesawing emotions
and heightened emotional responses may occur [3]. The biological
mechanism of PPD is believed to coincide with that of major
depressive disorder. Depression in general is a disease of neuronal
circuit integrity, which has been shown in studies by a reduction
in brain volume of individuals diagnosed with major depressive
disorder. Interestingly, the amount of volume loss correlates
directly with the number of years of ill¬ness. Stress and depression
act to reduce numerous brain pro¬teins that promote neuronal
growth and synapse formation, and antidepressant medications
have been shown to increase these and other protective proteins,
thereby reversing the mechanism of depression.
These underlying neurobiological changes result from
developmental interactions between genetic susceptibility and
environmental factors (i.e., the psychosocial stresses ac¬companying
motherhood) rather than a simple “chemical im¬balance,” as
previously believed. Specifically, the neurobiolog¬ical effects of
rapid postpartum hormone withdrawal predispose women with
established risk factors to PPD. An interesting distinction that makes
PPD unique from other depressive disorders is that it is marked
by a prominent anxi-ety component. This may be why so many
cases of PPD are missed, as many clinicians use the Patient Health
Question¬naire which covers depressed mood and dysphoria, but
not anxiety-as their primary screening technique. The stress of
caring for a newborn or even the circumstances surrounding labor
and delivery may precipitate the first symp¬toms of PPD.
Multiple risk factors for postpartum depression have been
suggested as no single cause has been identified. Personal
vulnerability, personal traits and social factors such as unplanned
pregnancy occupational instability, single parenthood and marital
discord have been cited. The effects of postnatal depression on
the mother, her marital relationship, and her children make it an
important condition to diagnose, treat and prevent. The mother
unable to provide care to her infant as manifested by decreased
adherence to regular check up well baby visits and increased
frequency health care provider’s visits due to infant problems.
Lastly depressed mothers have lower rates of gratification and
enjoyment in their mothering role compared with non-depressed
mothers. The patterns of symptoms in women with postpartum
depression are similar to those in women who have depression
unrelated to childbirth apart from the fact that the content may focus on the delivery or baby. Evidence from epidemiological
and clinical studies suggests that mood disturbances following
childbirth are not significantly different from affective illnesses that
occur in women at other times.
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