The four-stage process to regain control of Postpartum Depression

Postpartum depression (PPD) is characterized by a major depressive episode that begins within four to six weeks following delivery, as per international diagnostic criteria. Recurrence rates for PPD are high, with 40% of affected women experiencing depression again in their lifetime and nearly 50% facing another episode in subsequent pregnancies. Symptoms of PPD encompass fatigue, irritability, anxiety, lack of pleasure, feelings of helplessness, sleep and appetite disturbances, indifference towards life events, low self-esteem, and feelings of incompetence as a parent, among others. PPD is considered a multifactorial condition influenced by both environmental and genetic risk factors for depression.

Risk factors for PPD  include:

• Previous depression.
• Adverse life events.
• Lack of social support.
• Socioeconomic position.
• Personal and family psychiatry history.
• Stressful experiences (such as trauma).
• Specific pregnancy-related factors.
• Intimate partner violence (IPV) occurring close to or during pregnancy also elevates the risk of postpartum depression.

The impacts of PPD are significant and extend beyond the affected individual. They include poor attachment between the mother and newborn, potential stunted growth and low weight in the child, disrupted breastfeeding, and adverse effects on the infant’s cognitive, emotional, and social development. There is also an increased risk for psychiatric disorders in the child during infancy, childhood, adolescence, and adulthood. Women of color and those with lower incomes are more likely to suffer from postpartum depression and may face barriers to accessing treatment (Gopalan et al., 202).

The four-stage process to regain control of Postpartum Depression

Women experiencing PPD often undergo a four-stage process in an attempt to regain control:

1. In the initial stage, mothers grapple with intense worries, persistent obsessive thoughts, and difficulties focusing.
2. In the second stage, women feel a sense of loss of their “regular selves,” describing a robotic feeling while caring for their infants. Withdrawal may occur, and thoughts of self-harm or suicide may surface.
3. The third stage involves women planning strategies to overcome PPD, such as seeking help from healthcare providers, engaging in prayer, or finding comfort in support groups.
4. In the final stage, women regain control of their thoughts and feelings as despair lifts.
   The Struggle to Survive: Living Through the Rising Cost

   The rising cost of living has become a significant public health concern, particularly for low-income individuals who are struggling daily to survive. Addressing the social determinants of health among this population remains an urgent issue, as many face ongoing challenges accessing essential needs such as food, housing, transportation, and healthcare. During my assessment of some of the low-income individuals, I found that several individuals eat only once a day to save money for rent. Many reported choosing to go hungry rather than risk homelessness. Some have been living in their cars for nearly a year, while others rely on the homes of friends to shower and change clothes. It is heartbreaking to witness the difficult situations people endure every day to stay alive.

   The rising cost of living has multiple impacts on health and well-being. According to Grewal et al. (2024), increasing housing costs—one of the key components of living expenses—can have both direct and indirect health consequences. Their study indicates that:

   • Financial strain from high housing and living expenses contributes to increased stress, anxiety, and depression, particularly among renters and low-income individuals.
   • Food insecurity often results when households must prioritize rent or transportation over nutrition, leading to poor dietary intake and higher risks of chronic diseases.
   • Limited access to healthcare arises when individuals cannot afford medical visits, medications, or preventive care due to competing financial demands.
   • Housing instability or homelessness can expose individuals to unsafe environments, lack of sanitation, and interrupted social support networks, which worsen both physical and mental health outcomes.

   Overall, Grewal et al. (2024) emphasize that the effects of rising housing and living costs are unequally distributed, disproportionately affecting low-income individuals who already face multiple barriers to health. This highlights the need for comprehensive policy approaches that integrate housing affordability, income support, and healthcare access as essential strategies to promote health equity.

   Source: https://doi.org/10.1186/s12889-024-18360-w

   Strategies for Improving Sleep Quality

   Sleep is essential for the health and well-being of children, adolescents, and adults. Quality sleep supports emotional well-being, metabolic health, cognitive function, mental health, and cardiovascular and cerebrovascular health. Additionally, getting sufficient, high-quality sleep helps reduce the risk of fatigue-related accidents and injuries, such as motor vehicle accidents and workplace incidents.

   Recommended Sleep Duration

   The American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS) recommend that adults aim for at least 7 hours of sleep each night to promote optimal health. Similarly, the National Sleep Foundation (NSF) advises adults to get 7 to 9 hours of sleep per night, with older adults requiring 7 to 8 hours.

   Prevalence of Sleep Disorders and Mental Health Impacts

   About one-third of the population experiences insomnia symptoms, such as difficulty falling or staying asleep. Additionally, 4% to 26% of individuals report excessive sleepiness, and 2% to 4% have obstructive sleep apnea. Insomnia is associated with a significantly increased likelihood of mental health issues; individuals with insomnia are 10 times more likely to experience clinically significant depression and 17 times more likely to experience anxiety compared to those without insomnia. Poor sleep is also linked to post-traumatic stress, eating disorders, and psychosis spectrum experiences, such as delusions and hallucinations.

   Improving sleep Quality

   Improving sleep quality benefits mental health, and research reports that sleep plays a causal role in mental health challenges. Better sleep positively affects future mental health, even those without clinical symptoms.

   Strategies for Improving Sleep Quality

   • Creating a relaxing sleep environment
   • Limiting daytime naps
   • Managing stress and worries
   • Being mindful of food and drink choices
   • Sticking to a consistent sleep schedule
   • Incorporating physical activity into daily routines.

   Six Healthy Lifestyle Practices to Alleviate Depression Symptoms

   Causes of Depression

   Depression can arise from a multitude of factors, such as genetic, environmental, psychological, and biochemical ones.

   Risk factors for depression

   A person is more likely to experience depression if they have trauma, significant life changes, stress, a family history of depression, physical illnesses (like diabetes, cancer, or Parkinson’s disease), or as a side effect of certain medications.

   Diagnosis of major depression disorder

   A minimum of two weeks must pass with some of these symptoms and signs being presented almost daily to be diagnosed with Major Depressive Disorder:

   Common symptoms of depression
   The common symptoms of depression include.

   • Persistent sadness,
   • Hopelessness,
   • Pessimism,
   • Emptiness,
   • Lack of energy,
   • Feeling guilty or unworthy. The lack of interest or pleasure in pastimes,
   • Alterations in appetite that result in either weight gain or loss,
   • Slower speech, movement, or thought.
   • Increased fidgeting
   • Difficulty focusing, thinking coherently, or making decisions
   • Suicidal thoughts, suicidal attempts, thoughts of death, or self-harming behavior

   Lifestyle Practices to Alleviate Depression Symptoms

   1. Self-care. Practice stress-reduction techniques like tai chi or meditation. Get enough sleep, exercise, and eat a balanced diet. For the most part, adults require 7 to 9 hours of sleep. Refrain from using recreational drugs and alcohol, as these can exacerbate symptoms and complicate the treatment of depression.
   2. Educating family and friends about depression: They can assist you in identifying early indicators that your depression might be relapsing.
   3. Maintain your treatment regimen. Continue taking your medication and attending therapy sessions even after you feel better. Sudden medication discontinuation may result in withdrawal symptoms and a relapse of depression. If necessary, work with your physician to modify your medication or dosage to adhere to your treatment plan.
   4. Make modest, achievable goals: realistic goals to increase motivation and self-assurance. During the first stages of care, you might want to walk, have lunch with a friend, or make a bed. Gradually increase your goals as you get better.
   5. Identify the warning signs: Determine what triggers your depression, and if you notice any unusual changes in your feelings, thoughts, or behavior, speak with your doctor or a mental health professional. Keep a journal of your daily emotions, feelings, and reactions to identify trends and identify the things that lead to depression.
   6. Seek support. Maintaining relationships with people is crucial, especially during difficult times or periods, regardless of whether you receive support from family or a support group.

   Male Health and Prostate Diseases

   The prostate is a small, walnut-sized, shaped organ below the bladder and in front of the rectum. The main functions are to create fluids for semen and force semen through the urethra during ejaculation. It is usual for the prostate to get larger as one age.  Because of the location just below the bladder and in front of the rectum, also wrapping around the upper part of the urethra, the tube that carries urine from the bladder out of the body, it means abnormal prostate conditions can affect urination and sexual function. The prostate is prone to three main conditions, which are Prostatitis, an infection or inflammation of the prostate gland; Benign prostatic hyperplasia (BPH), an aging-related enlargement of the prostate gland; Prostate cancer, the growth of cancerous cells inside the prostate, which may break out of the gland and affect other parts of the body.

   Prostatitis

   This is the inflammation (swelling) of the prostate gland, and common causes include infection (usually bacteria), injury, or an immune system disorder. The symptoms may include the inability to urinate, Painful or difficult urination, and painful ejaculation, accompanied by fever, Blood in the urine (hematuria), and Severe discomfort or pain in the pelvic area or genitals.

   The Risk factors for prostatitis include:

   Previous prostatitis, Infection of the urinary or reproductive system, HIV infection or AIDS, Use of a tube inserted into the urethra to drain the bladder (urinary catheter), and Diagnostic sampling of prostate tissue (biopsy).

   Laboratory tests for Prostatitis include Urinalysis, urine microscopy/culture/sensitivity, HIV, measurement of Prostatic specific antigen levels in the blood, Scan, etc.

   Benign prostatic hyperplasia (BPH)

   The prostate will almost certainly get larger increasing age. A small amount of prostate enlargement is present in many men over age 40 years of age.  More than 90% of men over age 80 have the condition. It’s not clear why it happens, but it may be linked to the decline in the male sex hormone testosterone with aging. This enlargement is a condition called benign prostatic hyperplasia (BPH).  The key word is benign.  BPH has nothing to do with cancer and doesn’t increase the risk of prostate cancer. It can make urination and ejaculation difficult because as the prostate grows, it presses on the urethra. That interferes with the flow of urine and the release of ejaculate during orgasm. In less than half of all men with BPH, symptoms may include dribbling at the end of urinating, Inability to urinate (urinary retention), Incomplete emptying of the bladder, Incontinence, needing to urinate two or more times per night, Pain with urination or bloody urine (these may indicate infection). Slowed or delayed the start of the urinary stream, straining to urinate, Strong and sudden urge to urinate, and Weak urine stream.

   The Link between BPH and Sexual Problems

   Scientists aren’t sure why, but they agree that the worse the BPH symptoms are, the more likely an individual is to have sexual issues such as reduced sex drive, trouble keeping an erection, and less sexual satisfaction. It may have something to do with genetics or age. It’s also possible that the sleeplessness or anxiety that can come from an enlarged prostate makes sexual problems worse.

   Laboratory Test for BPH.

   A digital rectal exam is usually done to feel the prostate gland. Urine flow rate is monitored, Urinalysis to check for blood or infection, Urine culture to check for infection, Prostate-specific antigen (PSA) blood test to screen for prostate cancer, Cystoscopy, Blood urea nitrogen (BUN) and creatinine tests to check for reduced kidney function.

   Risk Factors for BPH include;

   • Age – symptoms start manifesting by age 50 to 60 in 60% of men.
   • Unhealthy diet- daily consumption of a diet high in red or processed meat, saturated fats, and dairy products can increase your risk for prostate problems. Sodium (salt), Alcoholic and caffeinated beverages like coffee, tea, and soda can also increase your risk due to being diuretics that increase urine production.
   • Type 2 diabetes, poorly managed Hypertension, and other heart diseases, Smoking, obesity, and a Sedentary lifestyle are common risk factors.
   • Prostatitis
   • Family history/genetics
   • Frequent Urinary Tract infection (UTI)

   Prostate Cancer

   Cancer is a disease in which abnormal cells divide uncontrollably and destroy body tissue, in the case of prostate, abnormal prostate cells continue to grow until it has destroyed normal body tissues around and beyond the prostate.  Prostate cancer usually develops slowly, so there may be no signs for many years. Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra). When this happens, one may notice things like increased need to pee, straining while peeing, a feeling that the bladder has not fully emptied. Causes of prostate cancer are largely unknown. However, certain things can increase the risk of developing the condition.

   Risk factors for Prostate cancer include;

   • Age: The chances of developing prostate cancer increase as one gets older. Most cases develop in men aged 50 or older. Prostate cancer risk begins to rise sharply after age 55 years and peaks at age 70–74, after which it starts to decline. For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
   • Men whose fathers or brothers were affected by prostate cancer are at slightly increased risk themselves.
   •  Other risk factors include Obesity, Smoking (increases steroid hormone production such as DHT, and estrogen), High levels of pesticides, excessive consumption of dairy products (milk, yogurt, cheese, lactose-free milk, and fortified soy milk and yogurt), excessive red meat consumption, Saturated fat, and Sedentary lifestyle.

   Beneficial Foods to Eat

   A diet rich in fruits, vegetables, and healthy fats, such as the Mediterranean diet, may benefit health. Salmon, rich in healthy fats that contain omega-3 fatty acids, helps prevent and reduce inflammation within the body, and other cold-water fish, such as sardines and trout, are also rich in these fats.

   Tomatoes: Tomatoes are packed with lycopene, an antioxidant that may benefit prostate gland cells. Cooking tomatoes, such as in tomato sauce or soup, helps to release the lycopene and make it more readily available to the body. Berries: Strawberries, blueberries, raspberries, and blackberries are excellent sources of antioxidants, which help to remove free radicals from the body. Free radicals are the byproducts of reactions that occur within the body and can cause damage and disease such as concern over time.

   Broccoli: Broccoli and other cruciferous vegetables, including bok choy, cauliflower, Brussels sprouts, and cabbage, contain a chemical known as sulforaphane. This is thought to target cancer cells and promote a healthy prostate.

   Nuts: Nuts are rich in zinc, a trace mineral. Zinc is found in high concentrations in the prostate and is thought to help balance testosterone and DHT. Besides nuts, shellfish and legumes are also high in zinc.

   Citrus: Oranges, lemons, limes, and grapefruits are all high in vitamin C, which may help to protect the prostate gland.

   All these are vital in addition to exercises to strengthen the pelvic floor muscles, such as brisk walking, Kegel exercise, and moderate strength training.

   (Written by Ebenezer Dic-Ijiewere PhD.)

   The Health Effects of Stress

   Overview of Stress: Stress significantly affects health, contributing to disease development and burdening healthcare systems considerably. It is a significant factor in various ongoing health issues, particularly cardiovascular diseases, which are often impaired by everyday psychosocial pressures, such as work-related stress.

   The following are the roles of stress in disease development.

   Gender Differences in Stress Responses: Gender plays a vital role in how individuals experience and manage stress. Research reports that women are more likely to develop mood disorders and autoimmune. At the same time, men tend to have higher rates of early substance abuse, infectious disease, mortality, and antisocial behavior. Unsuccessful stress management can lead to severe physical and mental health consequences for both individuals and communities.

   Physiological Responses to Stress: The study reports that stressful events can trigger emotional responses such as anxiety and worry, impacting the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) system, which may lead to unhealthy lifestyle choices, comprising poor sleep, alcohol consumption, decreased physical activity and increased smoking thereby increase the risk of diseases.

   Chronic Stress in Specific Environments: Chronic stress in educational settings and workplaces impacts mental and physical health noticeably. Also, it indicates that occupational stress significantly affects mental well-being.

   Traumatic Events as a Stress Source: Traumatic events are a prevalent source of stress that affects a large portion of the population. The study reports that In North America, about 60% to 75% of individuals will experience a traumatic event in their lifetime, including serious accidents, exposure to war, sexual assault, chronic childhood abuse, or neglect.

   Key Strategies to Cope with Stress

   Stress has a significant impact on overall health, playing a crucial role in the development of various diseases and placing a substantial strain on the healthcare system (Shchaslyvyi et al., 2024). It is closely linked to numerous long-term health problems, especially cardiovascular conditions, which are often worsened by daily psychosocial pressures like job-related stress (Shchaslyvyi et al.,2024) It is essential to understand the healthy ways to cope with or manage stress.

   Various strategies recommended according to the CDC (2025)

   1. Take Care of Your Mind

   Limit news and social media exposure: Excessive exposure to harmful or distressing news can exacerbate stress.

   Make time to unwind: Incorporate relaxation practices such as deep breathing, stretching, or meditation.

   Keep a journal: Writing can help you process emotions, reflect on your thoughts, and release tension.

   Spend time outdoors: Whether you are being active (walking, hiking) or just relaxing outside, nature can be a calming presence.

   Practice gratitude: Regularly noting things you are grateful for helps improve emotional well-being.

   Connect with others: Talking to trusted friends, family, or community/faith-based groups provides support.

   2. Take Care of Your Body

   Get enough sleep: The CDC recommends 7 hours or more per night for adults and suggests maintaining a consistent sleep schedule.

   Move more: Physical activity is one of the most effective ways to reduce stress; even small amounts can help.

   Eat well: A balanced diet (fruits, vegetables, lean proteins, whole grains, low-fat dairy) supports both physical and mental health.

   Limit alcohol and avoid substance misuse: Moderating alcohol intake, avoiding illegal drugs, and not misusing prescription medication are essential.

   Avoid tobacco: Smoking, vaping, and the use of other tobacco products can worsen stress or its effects.

   Stay up to date with healthcare: Regular check-ups, screenings, and vaccinations help you maintain your physical health — which can help buffer stress.

   3. Integrate Physical and Mental Health

   The CDC emphasizes that mental well-being and physical health are closely linked. Regular physical activity is not only good for the body but also supports emotional resilience.

   It encourages finding a “right combination” of coping techniques that work for you — not everyone copes the same way.

   4. Know When to Seek Extra Support

   The CDC notes that while stress is everyday, chronic stress (long-term) can lead to serious health problems.

   If you’re struggling to cope or stress is affecting your daily life, it’s okay to reach out for help. They list resources, including crisis lines.

   Sources

   CDC. (2025)

    International Journal of Environmental Research and Public Health, 21(8), 1077–1077. https://doi.org/10.3390/ijerph21081077

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