According to O’Hara (1), depression is a grim illness and poor mental health condition associated with psychological, social, and physical factors in addition to chemical imbalances in the brain. This condition can occur at any mature stage of life and it is accompanied by miserable moods, wrath reactions, and lack of joy as well as frustrations. The degree of depression can either be gentle, judicious or severe. Moreover, several types of depression may affect both men and women although the latter are at greater risk (2). One of them is postpartum depression which is described as a daunting health condition that arises within six weeks or more after pregnancy loss (1). Pregnancy may be lost through normal delivery or miscarriage as a result of abortion or mother illnesses among other issues. Depressive conditions which may arise after childbirth include “baby blues, postpartum depression, and postpartum psychosis” (3). Baby blues are very common after delivery but their effects are not detrimental and they normally cease within two weeks. However, this condition may signal postpartum depression for individuals who have suffered depression previously. Postpartum psychosis is an acute form of depression after childbirth and it is very rare. Postpartum depression may arise at any time after delivery and last for a long period of time.
Research has shown that people who experience depression earlier on in life or during pregnancy are more likely to suffer from postpartum depression (1). Syntheses of previous studies carried out by Robertson and colleagues (4) in 2002 indicated that stress during pregnancy was the greatest risk factor predisposing women to postnatal disorders. This factor was highly supported by researchers like O’Hara and Beck all of whom devoted their time to studying risk factors associated with postpartum depression. In addition, individuals with a history of past mental illnesses (either associated with childbirth or other factors) are more likely to suffer from both regular and postpartum depression (4). It is believed that mental disorders expose an individual to regular depression and/or postnatal depression. Beck (5) ranked this factor as one of the greatest issues leading to postpartum depression. Furthermore, excessive anxiety during pregnancy was also found to be a great risk factor for postnatal depression (5). Anxiety is known to cause regular depression which may weaken and render an individual to depression after childbirth. As such, exaggerated fretfulness during pregnancy can serve as an indicator of an upcoming postpartum depression.
More so, individuals whose relatives suffer from any form of depression are at a greater risk of postnatal mental illnesses (5). However, the magnitude of this factor is minimal. Furthermore, relatives with psychiatric disorders may fail to disclose the condition making it difficult to effectively study its correlation with postnatal depression. Nevertheless, the completed clinical studies have revealed a great relationship between depressive family history and postpartum depression.
Besides, stressful life encounters which because ordinary depression can also lead to postpartum depression (4). Miserable life experiences may include loss of close friends, breakdown of marriages and relationships as well as loss of employment. In addition, issues like pregnancy and child delivery are stressful in nature and may lead to any major type of depression. O’Hara (1) conducted research and found a great connection between traumatic life events and the commencement of depression. This case was more common among the Americans than with the Asians. The reason behind cultural variation is not known yet. However, there is a possibility of exaggerated reporting if the retrospective method of gathering data is used. The prospective technique may serve to eliminate this error and produce reliable findings (4).
Other results indicated that depression can also result from a lack of social support (4). Previously, studies have shown that social encouragement helps an individual to cope with regular as well as postpartum depression. This support may come from various sources including friends, marital partners, and relatives among others. In addition, social support may be in the form of advice, material support, or care for the victim. Researchers have shown that potential mothers who lack this support feel isolated and they may develop a depressive condition. As such, women who suffer depression as a result of inadequate “instrumental and emotional” support before and during pregnancy are more prone to postpartum depression (1). The degree to which new mothers identify a lack of social support varies since some are more demanding than others.
More so, ordinary depression as a result of psychological risk factors may make an individual vulnerable to postpartum depression (1). Individuals who suffer from psychological depression may develop a neurotic condition as a way of dealing with such stress. This condition is depressive in nature although a person may behave and act normally. However, some people may have a certain degree of shyness and nervousness. Studies conducted by O’Hara (1) show that individuals having a neurotic condition are more prone to postpartum depression. Moreover, poor marital relationships may make a person feel unsupported and lonely thereby suffering from stress (5). When this stressful mood is augmented with increased and altered responsibilities as well as hormonal fluctuations after child delivery, postpartum depression may occur. According to Robertson (4), this trend can be reversed if married couples craft ways of the meeting changed and increases responsibilities that come with childbirth.
Additionally, socioeconomic factors like job loss, poverty, and lack of education may cause mental disorders including ‘normal’ depression and postpartum depression (5). Several studies have reported that the trend is uniform in different nations and societies. Besides, obstetric issues are known to cause both regular and postpartum depression. This may include issues like operations during child delivery or excessive pain during the labor period. O’Hara (1) reports that a correlation has been established between these factors and the onset of depression. Therefore, individuals who suffer-normal depression as a result of obstetric factors are also likely to undergo a condition of postpartum depression. These types of mental disorders may have analogous attributes and can be mistaken for one another. As such, they may lead to sleep disorders, fury, loss of hope, a sense of worthlessness, and a lack of interest in normal activities.
As the literature indicates, there is a great relationship between normal depression and postpartum depression. Individuals who suffered from depression or have relatives with depressive conditions are at a bigger risk of undergoing postpartum depression. In addition, people who undergo stressful events and lack social support are prone to depressive mental problems. Besides, the qualities of these conditions are very similar and this calls for proper identification by health caregivers to treat the correct condition.
References
O’Hara MW, Swain AM. Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 1996; 8:37–54.
Kessler RC, Berglund P, Demler O. The epidemiology of major depressive disorder. Results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003; 289 (23):3095–105.
Pitt B. Maternity blues. Br J Psychiatry. 1973; 122:431–3.
Robertson E, Grace S, Wallington T. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004; 26:289– 95.
Beck CT. Predictors of postpartum depression: An update. Nurs Res. 2001; 50:275– 85.