ppd for the website 1-2

Postpartum DepressionYounglee KIM, RN, BSNKYL0229@hotmail.com : 

Postpartum DepressionYounglee KIM, RN, BSNKYL0229@hotmail.com

Introduction : 

Introduction Over the centuries, normal thought is that the moment when a pregnant woman delivers her child that it will be a special and precious moment for her, but studies show that is not always so. Unfortunately, all of women have not felt joy and feeling of pleasure normally associated with bring a new life into this world.

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Many of women have reported namely depressed mood, fatigue, and feeling of worthless or excessive. Family members easily ignore mothers’ feelings of unhappiness and sandiness during postpartum period Medical attention has tended to ignore the seriousness of PPD, too.

The broad meaning of depression : 

The broad meaning of depression Depression is probably the most common psychiatric complaint, and it was called melancholia. The course of the disorder is extremely variable from persons to persons. It may be mild or severe, acute or chronic. In psycho logy, it is about feelings of low self – worth or guilt and a reduced ability to enjoy life.

The categories of depressions : 

The categories of depressions Dysthymia Bipolar disorder PPD Premenstrual dysphonic disorder Recurrent brief depressive disorder

The NIMH (1994) the overall symptoms of clinical depression : 

The NIMH (1994) the overall symptoms of clinical depression Sandiness, anxiety, or “empty” mood Hopelessness and pessimism Feelings of guilt, worthlessness and helplessness Loss of interest or pleasure in hobbies and activities including sex Decreased energy, fatigue, and being “slowed down” Difficult concentrating, remembering, and making decisions Insomnia, or oversleeping Appetites and weight loss or overeating Thought of death or suicide Restlessness and irritability

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Hormonal change decrease the levels of progesterone and estrogen after placental delivery cause a change in the neurotransmitter levels in leading to symptoms of depression (Cohen & Nonacs, 2005) Three terms of depression during the postpartum period; postpartum blues (the baby blues), postpartum depression (PPD), and postpartum psychosis.

Postpartum blues (the baby blues) : 

Postpartum blues (the baby blues) Incidence 50% -80% Onset Days 2-5 Duration Few days Symptoms Changed mood Episodic tearfulness Irritability, Anxiety Overwhelming Lost appetite Sleeping problem

Postpartum depression (PPD) : 

Postpartum depression (PPD) Incidence 5-15% Onset the first 2 weeks-3 months Duration Up to 1 year Symptoms Depressed mood, Sleep changes Anxiety Fatigue Feeling worthless Inability to concentrate Suicide plan or attempt

Postpartum psychosis : 

Postpartum psychosis Incidence 0.1% Onset the first 2 weeks-6 weeks Duration Weeks to months Symptoms Irritability Confusion Psychotic symptoms Delusion Hallucination

The symptoms of PPD : 

The symptoms of PPD Depressed mood. Loss of interest or pleasure in activities of life. Sleep changes. Agitation or retardation in movements. Fatigue or loss of energy. Feeling worthless or excessive inappropriate guilt. Inability to concentrate or think; being indecisive every day. Thought of death, suicidal ideation without a plan or a suicide plan or attempt. Somatic symptoms, including headache, constipation, diarrhea and severe anxiety. Shame and low self-esteem. the American Psychiatric Association (APA)

8 critical attributes : 

8 critical attributes Anxiety. Fatigue. Inability to concentrate. Sleep change. Somatic symptoms. Suicide plan or attempt. Unconcern. Unhappiness.

The significant predicators of PPD : 

The significant predicators of PPD History of prenatal anxiety Occurrence of postpartum blues Low self-esteem A stressful life resulting in excessive demands Lack of social support from family and friends A strained material relationship The nature of the infant’s temperament Childcare stress (Lintner & Gray, 2006)

The seriousness of PPD : 

The seriousness of PPD Although many researches have studied and examined aspects of PPD and circumstances, the seriousness of PPD is still low. Health care providers are often confused or unknowledgeable about postpartum depression, because of poor recognition and intervention. postpartum women and their families are not being exposed to appropriate treatment (Ugarriza, 2006).

Recognition PPD : 

Recognition PPD To understand PPD is; To emphasize the logical and valuable approach to depressed postpartum women, To develop more knowledge of PPD To find precise recourse to detect PPD To perform therapeutic and professional care

Screening tools : 

Screening tools Center of Epidemiological Studies-Depression Scale (CES-D) Edinburgh Postnatal Depression Scale (EPDS) Postpartum Depression Screening Scale (PDSS) Beck Depression Inventory Second Edition (BDI-II)

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The CES-D ---The scale consists 20 items, with four responses ranging from “rarely” to “most of the time”, and measure depressive symptoms occurring during the past week The PDSS --- It consists 35 items and assesses for dimensions of depression related to sleeping/ eating disturbances, anxiety/ insecurity, emotional liability, loss of self, guilty/ shame, cognitive impairment, contemplating harming oneself and thoughts of suicide. The BDI-II--- It includes a 21 –items, multiple-choice screening tool that assesses for the presence of depression, as well as the severity of depression, and corresponds well with DSM-IV-TR.

The EPDS : 

The EPDS A commonly recommended screening tool of PPD. The question based on mother’s feelings over the past 7 days 10 items to detect prenatal and postnatal depression. The English and Spanish versions The total score is ranged from 0 to 30. The bigger score means a more severely depressed Possible Depression: 10 or greater Severe condition: 13 or greater Always look at item 10 (suicidal thoughts)

The practice : 

The practice

Solutions : 

Solutions

Tips : 

Tips Rest as much as you can/ Sleep when the baby is sleeping. Don’t try to do too much or try to be perfect. Ask your partner, family, or friends for help. Make time to go out, visit friends, or spend time with your partner. Discuss your feelings with your partner, family, and friends. Talk with other mothers so you can learn from their experiences. Join a support group. Contact health care members about groups in your area. Don’t make any major life changes right after giving birth. Major changes can cause more stress. (The Federal Government Source for Women’s Health Information)

Support group & Medication therapy : 

Support group & Medication therapy

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The lack of awareness of PPD and appropriate services of PPD can result in delayed PPD treatment Support group and medicine treatment ultimately are an efficient and effective route to decrease the symptoms of PPD (Elkin et al., 1989; Scott, et al., 1995; Oei & Shuttlewood, 1996; Highet & Drummond, 2004; Milgrom, et al, 2005). The combination of both treatments is the ideal treatment for PPD (Lane, et al., 2001; Highet & Drummond, 2004; Boath et al., 2004; Ross et al., 2006).

Untreated postpartum depression : 

Untreated postpartum depression Untreated postpartum depression can affect mother's ability to take are of the children. Untreated postpartum depression can hurt mother and her baby, too. Therefore, mother may feel guilty and lose confidence in herself as a mother

Depressed mother can affect her baby! : 

Depressed mother can affect her baby! Delays in language development Problems with mother-child bonding Behavior problems Increased crying (The Federal Government Source for Women’s Health Information)

Strategies for PPD : 

Strategies for PPD To detect PPD is the first action To assess the condition of depressed mothers (screening tools) To find appropriate treatments /resources of PPD (family or friend) To combine support group and medication To maintain therapeutic relationship

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PPD is treatable and recoverable. All postpartum women must have a rational and collaborative support from health care givers and families in order to resolve the mental problems and enjoy special and valuable experience with their babies during the postpartum.

Resources : 

Resources http://www.4women.gov/ U.S. Department of Health & Human Services http://www.womenshealth.gov/faq/depression-pregnancy.cfm More resources & information sites http://postpartum.net/ Postpartum support international http://www.depressionafterdelivery.com/ Postpartum nutrition & medication

PPD Video : 

PPD Video http://postpartumprogress.typepad.com/weblog/2008/03/postpartum-depr.html PPD resources http://www.youtube.com/watch?v=fA8vfvYvq7A

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Thank you!

Extra data : 

Extra data U.S. Department of Health & Human Services http://www.womenshealth.gov/faq/depression-pregnancy.cfm http://www.4women.gov Postpartum support international http://postpartum.net Postpartum nutrition & medication http://www.depressionafterdelivery.com/