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.
   Four Major Diseases linked to smoking

   According to the Centers for Disease Control and Prevention (2021), Cigarette smoking damages almost every organ in the body, leading to numerous diseases and overall health decline. In the United States, smoking is responsible for over 480,000 deaths each year, nearly one in five deaths. For women, smoking can make it more difficult to conceive and can adversely affect a baby’s health before and after birth. In men, smoking can reduce sperm quality, decreasing fertility and increasing the risk of congenital disabilities and miscarriage. Smoking also harms oral health, potentially leading to tooth loss. Moreover, it increases the risk of cataracts, which cloud the eye’s lens and impair vision. It can cause age-related macular degeneration (AMD), damaging a small spot near the retina’s center needed for central vision. Additionally, smoking is a risk factor for type 2 diabetes mellitus and can complicate its management, with active smokers having a 30-40% higher risk of developing diabetes compared to nonsmokers.

   The four major diseases linked to smoking are

   • Cardiovascular Diseases
     • Increased mortality rates due to smoking.
     • Elevated risk of ischemic heart diseases.
   • Respiratory Conditions
     • Smoking is a primary cause of chronic respiratory deaths.
     • Increased risk of respiratory diseases and tuberculosis.
   • Stroke
     • A Study reports a Positive correlation between smoking prevalence and stroke-related deaths.
   • Lung Cancer
     • Study reports there is a higher likelihood of lung cancer with increased daily cigarette consumption.

   Risk Factors for Uterine Fibroids Among Black Women

   Uterine fibroids (UFs) represent the most prevalent non-cancerous tumors among women of reproductive age. Symptomatic fibroids can lead to significant health issues and are the primary reason for hysterectomies in the United States and globally, contributing to substantial socioeconomic impacts and affecting over 70% of women of reproductive age (Langton et al., 2024). African American women tend to develop fibroids approximately 10 years earlier than White women in the US and bear a disproportionate health burden from these tumors

   Black women experience UFs at higher rates, with an earlier onset, more severe symptoms, and faster disease progression compared to other groups.

   According to Sithembinkosi Ndebele (2024), 85% of participants were non-Hispanic Blacks. Black participants had a higher likelihood of a UF diagnosis, and the following risk factors were reported contributing to the high prevalence of UFs in Black individuals:

   1. Socioeconomic Status: Lower socioeconomic status is reported to increase the rates of UFs.
   2. Adverse Environmental Exposures: Increased exposure to environmental pollutants is associated with a higher prevalence of UFs.
   3. Chronic Stress: Experiences that increase chronic stress are significant contributors.

   Lifestyle and socioeconomic factors, closely tied to neighborhood characteristics, further influence UF prevalence. These factors include:

   1. Body Mass Index (BMI): A higher BMI correlates with a higher risk of UFs.
   2. Alcohol Use: Regular alcohol consumption is positively correlated with UF diagnosis.
   3. Income and Occupation: These factors influence access to healthy food and healthcare.

   How to Survive During Rising Costs and Government Shutdown

   With the government shutdown, many aspects of daily life have been severely impacted. The rate of food insecurity is increasing, and challenges related to housing, transportation, and other social determinants of health are becoming more pressing. SNAP benefits have been frozen, leaving many families struggling to put food on the table. As a result, more individuals and families are turning to food pantries and community resources for support.

   At the same time, the cost of food and necessities continues to rise, deepening the struggles faced by countless households. These are difficult times, but I want to encourage everyone affected to stay strong, remain hopeful, and trust that better days are ahead.

   Here are some practical ways to cope and survive during the rising costs and government shutdown:

   Prioritize Your Needs

   • You must focus on needs such as housing, food, transportation, utilities, and medication.
   • Decrease or pause non-essential spending, such as new purchases, entertainment, or dining out.

     Manage Your Money Wisely

   • Avoid any unnecessary debt.
   • Prioritize rent/mortgage and food.
   • Discuss with your utility company, landlord, or bank to explore any available payment plans or deferments during the shutdown.

   Explore any available community resources

   • Assess community and faith-based resources (Local food banks, churches, non-profits) for support with food and bills.
   • Check your city’s website to find out what supports are available to access.

      Protect Your Mental and Emotional Health during the difficult time

   • Financial insecurity can be draining. Stay connected with family, friends, and coworkers for emotional support.
   • Get good exercise, rest, and be consistent with your routines
   • Have faith and be hopeful that the challenges are temporary and will surely pass
   • Focus on what’s within your control.

   Maintain Perspective

   • Use this period to build your financial discipline and strength
   • Celebrate each time you pay a bill and make meals; a win is worth celebrating
   • Reflect on value by focusing on more relationships, essentials, and faith than on any material things

   Contributing factors to the High Obesity Rates Among African American Women

   Research reports that American women are disproportionately affected, with the highest obesity rates among all groups in the U.S. About 80% are classified as overweight or obese.

   Disparities in weight loss

   Research indicates that African American (AA) women tend to lose less weight compared to their Caucasian counterparts.

   Contributing Factors

   The contributing factors to the disparities are;

   • Limited access to nutritious food
   • Inadequate health insurance
   • Lack of safe spaces for physical activity

   Barriers to Weight Management

   Challenges that hinder weight management efforts include:

   • Personal beliefs
   • Limited time
   • Family dynamics
   • Lack of motivation
   • Financial constraints

   Cultural Influence on Body Image

   Cultural norms within the AA community, which often embrace larger body sizes and promote a positive body image, can also influence health behaviors. While fostering a positive body image has psychological benefits, it may reduce motivation to maintain a healthy weight. In Black culture, obesity and being overweight are often considered acceptable and carry little to no stigma. Cultural perspective may partially explain why general health promotion efforts are less effective in this community. The study reports that many Black female students aim to embody the culturally valued “thick and curvy” figure, consuming specific foods to shape their bodies while avoiding activities that might result in weight loss.

   Why it may be difficult to seek care

   A deep-rooted distrust of the healthcare system makes it difficult for many AA women to seek medical advice or treatment.

   Physical inactivity as a health risk factor

   Underestimating body weight can reduce engagement in healthy behaviors, such as regular physical activity. Physical inactivity is a major contributor to non-communicable diseases and mortality, emphasizing the need to address these issues within the AA community.

   Prevalent Barriers to obesity within the African American population.

   As we know, obesity stands as a significant health concern affecting the lives of African Americans. It is imperative to grasp the barriers that contribute to the rising rates of obesity within this population.

   Obesity is characterized by excessive body fat accumulation influenced by environmental and genetic factors and poses various health risks, including specific cancers, type 2 diabetes, hypertension, osteoarthritis, hyperlipidemia, and cardiovascular disease. Omondi & Freysteinson (2023) estimated annual medical expenses related to obesity issues in the United States to be around $147 billion. Research reveals that obesity prevalence is notably high among African Americans, with rates around 49.6%, surpassing non-Hispanic Whites at 42.2%. Mainly, obesity rates are higher among African American women, reaching 56.9%, compared to 41.1% among African American men (Lofton et al., 2023).

   Access to nutritious foods is limited for African Americans, who often consume less nutritious diets with high levels of added sugars and fried foods. Multiple obstacles hinder healthy eating habits, including limited knowledge, the cost of nutritious foods, time constraints for meal preparation, reliance on transportation to access stores, and communication barriers with healthcare providers regarding dietary habits.

   Similarly, opportunities for physical activity are restricted, exacerbating the obesity issue. Reduced physical activity levels and increased sedentary behaviors like gaming or screen time have been associated with higher body mass index (BMI). African Americans facing obesity encounter various challenges in engaging in physical activity, including a lack of awareness regarding effective exercise methods, limited access to affordable exercise programs, inadequate facilities, transportation limitations, and health concerns.

   References

   Omondi, H., & Freysteinson, W. M. (2023). Understanding Obesity in African American Women Using Leininger’s Theory. Nursing Science Quarterly, 37(1), 71–75. https://doi.org/10.1177/08943184231207383

   Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023). Obesity among African American people in the United States: A review. Obesity, 31(2), 306–315. https://doi.org/10.1002/oby.23640

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   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

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