Presentation on theme: "P OSTNATAL D EPRESSION. References * Mental Health Foundation (2002) Postnatal Depression Mental Health Information New Zealand (MHINZ) *Boath,E. & Henshaw,"— Presentation transcript:
P OSTNATAL D EPRESSION
References * Mental Health Foundation (2002) Postnatal Depression Mental Health Information New Zealand (MHINZ) *Boath,E. & Henshaw, C. (2001) The treatment depression: a comprehensive literature review, Journal of Reproductive and Infant Psychology, Vol. 19, No. 3, p The Royal College of Psychiatrists. Postnatal depression. Postnatal depression Postnatal depression
Post natal Depression The term postnatal depression refers to a number of emotional changes which may occur after childbirth. These include -the “baby blues”, -postnatal depression -postnatal psychosis content/uploads/2011/04/postnatal-depression1.jpg
Postnatal or maternity (baby) blues -very common – up to 80% of women experience -typically peaks 3-5 days after birth -brief period of mother feeling down and tearful and a feeling of not coping. -feeling passes after a few days -regarded as a normal reaction resulting from hormonal changes after birth.
M ANAGEMENT OF “ BABY BLUES ” - reassurance - practical help - rest, - healthy nutritious food - - education - -
Postnatal depression (PND) -more serious than baby blues -10–20% of women experience PND -may occur any time during the first year after childbirth and may continue for as long as 1-2 years. Can affect anyone. -combination of physical, emotional and environmental factors can trigger PND.
Associated risks of PND -the question as to the impact PND has on the mother-baby relationship is unproven. Some suggest it may affect infant cognitive and emotional development. However it is unlikely where there are other people around the baby and child. -adverse effects on family as a whole.
Risk factors – before pregnancy and birth -past history of depression or mental illness. -relationship difficulties. -little social support. -onset of depression during pregnancy. -stresses – financial/housing problems.
Risk factors related to birth -birth complications resulting in caesarean delivery. -birth experience not living up to expectations. -birth of a baby with a congenital abnormality or a baby who is ill following birth.
Risk factors after birth -persisting postnatal blues. …prolonged or continuing….. -not wanting to hold her baby, or feeling detached or negative about her baby. -sleep problems (mother). -fussy baby, problems with feeding, colic. -lack of support. -ongoing social problems.
Physical symptoms of PND -change in sleeping patterns -change in appetite -decreased energy, tiredness and fatigue -physical slowing or agitation
cognitive symptoms of PND -thoughts of worthlessness and inadequacy -thoughts of hopelessness and death -difficulty thinking clearly -anxiety symptoms – very common -thoughts of loneliness.
Symptoms – mood symptoms of PND -persistent low, sad or depressed mood -loss of interest and pleasure in usual activities -irritable mood 2.jpg
Outlook for PND -without treatment may last 6 months or more -with treatment, 70 – 80% of women will recover much sooner. -majority of women will have a complete recovery. -20 – 30% will improve but still have some symptoms persisting for months later. -for a minority, 5 – 10%, no improvement and will remain unwell for two or more years.
Help and support -General practitioner -Plunket nurse / family centres / plunket line -Family-Counsellor/psychologist -Parent Help -Maternal mental health services at local hospital -Iwi health services -Other mothers
Treatment -Counselling – supportive listening, practical problem solving and information giving. -Medication: antidepressants -Combination of both. Key : mother acknowledging that she needs help and sensitive, non judgmental help being available. Often mothers with PND find the greatest support from mothers who have had PND.
Postnatal psychosis -rare – one or two per 1000 births. -usually within 1 – 3 weeks of delivery. -prompt diagnosis and expert treatment is critical. -risk factors similar to those of depression. -history of mood disorders. -no previous history
Signs and Symptoms Mood disturbance – depression or mania or both, with symptoms of psychosis at the same time. Symptoms of psychosis -delusions (unusual or altered belief) -thought disturbances -hallucinations (occur when someone hears, feels, sees, or smells something which is not there)
Treatment-Hospitalisation. -Crisis intervention. -Medications: anti-psychotic medication or mood stabilizer. -ongoing support …….
In an attempt to try and identify women with PND early there are various questionnaires available. One that has been commonly used is the Edinburgh postnatal depression scale.