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.
   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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   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.

   Should we throw away our medicines after the ‘Best Before’ or Expiry date?

   Introduction

   One of man’s best inventions is drugs, especially disease-specific ones. Drugs are substances other than food, which can prevent, relieve the symptoms, or cure an abnormality or disease. Globally, the cost of drugs has soared over the years, resulting in a situation whereby low-income earners are unable to buy branded medications. In underdeveloped and developing countries where food and drug agencies have poor capacity to perform their regulatory functions optimally, we tend to see the proliferation of substandard or fake drugs. So many times, this ugly trend is energized by not just greed but by the market demands for affordable medications.

   Why Medication exceeds expiry date

    To mitigate the challenge of not being able to buy drugs, when necessary, people from resource-limited settings stack up some essential medications in their homes, which eventually exceed the best before or expiry dates on them. Sometimes, doctors could change a patient’s prescription because of reactions, allergies, or inability to purchase the drug, which could result in leftover drugs that eventually exceed the expiration date. Also, big pharmacies and patent-drug stores cannot sell all their stock, leading to the expiration of some drugs. This situation has raised many questions about the safety of these drugs after their expiration or beyond the “best before” date. Because of the importance of drugs and the health risks involved when taken wrongly, people have always consciously discarded unused drugs when it’s past the expiration date, even one day.

   How Safe is a drug after the expiry date?

   The debate about drugs being safe after their expiration date has persisted over the years, as many people still hold the opinion that pharmaceutical companies deliberately label their drugs with short shelf lives to guarantee steady patronage. Eventually, most of these unused drugs are discarded. The context that drugs can still be safe for a long time after expiration has gained several affirmations. In a recent study by Benjamin Davido and others titled ‘Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages’ published in MDPI Journal “Antibiotics”, it was reported that when appropriately stored in line with the expected conditions, no expired antibiotics tested failed to be potent after one year of expiration. In another study by Sushil Sharma and others, titled ‘A study to investigate the chemical potency, physical stability, and efficacy of analgesic agents over a period of two years post their expiry date’ published in the “Medical Journal Armed Forces India”, it was seen that drugs such as Diclofenac, Piroxicam, and Ibuprofen retained their stability, analgesic efficacy, chemical active ingredients and by implication their potency up to a duration of two years after expiration.

   Important factors to consider

   However, the issues of proper storage and handling can play a big role, especially in the tropical climate of West Africa and other geographical regions. Hence, people in the tropics may have to rely on their capacity to store their drugs in the required condition in deciding whether to use a drug past the expiration date or not.

   Conclusion

   This article doesn’t advocate for the use of expired medication but to reduce anxiety about accidental use. It is essential to understand factors that impact drug stability.

   (Written by Ebenezer Dic-Ijiewere PhD.)

   NB: Always consult your healthcare professionals regarding expired medications to ensure medication safety and effectiveness.

   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

   Unlocking the Benefits of Consistent Physical Activity

   Inadequate exercise or physical activity can contribute to the prevalence of non-communicable diseases. Given that non-communicable diseases account for over 80% of deaths in some nations, they are regarded as “the number one killer” globally. Physical exercise is any movement that requires energy, like housework, manual labor, walking, or manual labor. Exercise, on the other hand, is a regimen of physical activity that is organized and planned to enhance physical fitness.

   Evidenced-based benefits.

   1. Physical Health: Research reported that 150 min of moderate-intensity or 75 min of vigorous-intensity physical activity led to a 14% risk reduction in all-cause mortality in patients with cardiovascular disease. In healthy adults, the risk decreased by 7%. Regular exercise has been shown in numerous studies to be beneficial in lowering the risk of cardiovascular disease as well as improving the health of patients with a variety of other conditions, such as certain cancers. stroke, type 2 diabetes, age-related sarcopenia, obesity, and multiple sclerosis.
   2. Mental Health: Research findings indicate that youth with mild to moderate mental health issues can benefit from organized sports and exercise programs. In one study, participants highlighted the significance of intensity choice for their enjoyment and commitment to the program, and it was shown that a self-selected intensity sport and exercise intervention was beneficial for depression. Research findings indicate that youth with mild to moderate mental health issues can benefit from organized sports and exercise programs. In one study, participants highlighted the significance of intensity choice for their enjoyment and commitment to the program, and it was shown that a self-selected intensity sport and exercise intervention was beneficial for depression. Also, engaging in physical exercise for 14 weeks can considerably improve mental symptoms, reduce anxiety and somatization, lessen obsessive-compulsive symptoms, and lift depressed moods.
   3. Quality Sleep: Study indicated that quality of sleep was positively impacted by exercise. Additionally, insomnia was somewhat alleviated following the exercise intervention. For instance, studies reveal that first-year students who exercise more get better sleep than those who exercise less during the night.

   Evidenced-based research recommended the following:

   1. Adults should aim for more than 300 minutes of moderate-intensity aerobic physical activity, 150 minutes of vigorous-intensity aerobic physical activity spread out over the week, or an equivalent mix of moderate-intensity and vigorous-intensity aerobic physical activity.
   2. Engage in moderate-to-intense muscle-strengthening activities that target all major muscle groups two or more days a week.
   3. Adults 65 and older engage in multicomponent physical activity that involves functional balance and strength training at a moderate or higher intensity for at least three days a week in addition to aerobic exercises.

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