Successful interventions for managing or reducing effects of Postpartum depression (PPD)

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.

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.

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.

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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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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.

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.