The Struggle to Survive: Living Through the Rising Cost

Postpartum depression (PPD) presents a significant public health concern, affecting not only the physical and mental well-being of mothers but also that of their infants. Research suggests that approximately 13 million women worldwide are diagnosed with PPD annually (Xu et al., 2023). Mild depressive symptoms are experienced by around 50% to 75% of mothers, with 10% to 15% developing postpartum depression within the first week after childbirth (Xu et al., 2023).

Understanding preventive measures to reduce its prevalence is very crucial.

 1. Exercise intervention has proven effective in preventing PPD disorders. In a 12-week exercise intervention study, aerobic exercise was found to relieve postpartum depression symptoms in PPD patients. Engaging in suitable aerobic exercise during pregnancy has been reported to promote pelvic mobility and improve birth canal space to relieve maternal labor pain. However, it also aids in preventing pregnancy complications. Studies suggest that PPD symptoms may manifest during pregnancy, with a similar 12% occurrence rate of depression reported, which indicates that preventive measures during pregnancy may have a significant impact on reducing PPD (Xu et al., 2023).

Moreover, research indicates that the antidepressant effects of exercise can persist beyond the cessation of physical activity. Therefore, research suggested that incorporating aerobic exercise into prenatal care may substantially prevent PPD more than exercise as a postpartum treatment strategy.

Engaging in moderate exercise during pregnancy can reduce the likelihood of developing postpartum depression (PPD) among expectant mothers. Partaking in at least 150 minutes of moderate-intensity aerobic exercise per week significantly enhances the efficacy of physical activity in preventing and treating PPD (Xu et al., 2023). Moderate aerobic exercise prompts the release of endorphins, which uplift mood and alleviate symptoms of anxiety and depression. Additionally, it helps regulate hormone levels, improve sleep quality, and enhance self-awareness and self-esteem, thereby positively influencing the mitigation of postpartum depression (Xu et al., 2023).

Also, social support plays a vital role in maintaining the mental well-being of pregnant and postpartum women, with supervised exercise and team-based exercise serving as effective avenues for providing such support. For instance,

• Team exercise fosters a positive environment for maternal emotional communication, and sharing maternal emotions enhances mothers’ childbirth knowledge and skills, reduces fear of labor pains, alleviates negative emotions, improves interpersonal communication, and enhances self-efficacy (Xu et al., 2023).

• Supervised exercise, which involves physical activities piloted and supervised by healthcare professionals or fitness trainers, ensuring that exercises are safe and suitable for individual pregnant and postpartum women. Participating in supervised exercise classes or programs also offers opportunities for social interaction, which is critical for mental well-being and can lighten feelings of isolation by connecting with other new mothers and professionals in a supportive setting (Xu et al., 2023).

2. Music therapy, when used as an adjunct to conventional psychotherapies, has been shown to improve physiological symptoms and effectively reduce negative emotions without any adverse side effects. It can positively impact and alleviate symptoms of PPD, offering a safe and affordable substitute to standard treatments. Music therapy is considered to reduce the need for pharmacological interventions during PPD treatment. Research has indicated that music therapy interventions such as music listening, improvisation, songwriting, singing, relaxation and meditation, and lyric analysis effectively reduce the risk of prolonged PPD and it can encourage strengths, empower individuals, and foster connections with themselves and others (Patch & Short, 2022).

References

Xu, H., Liu, R., Wang, X., & Yang, J. (2023). Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis. PLOS ONE, 18(11), e0287650–e0287650. https://doi.org/10.1371/journal.pone.0287650

Patch, M. C., & Short, A. E. (2022). Addressing the “Baby Blues”: Developing a Music Therapy Model for Prevention and Treatment of Postpartum Depression. Australian Journal of Music Therapy, 33(2), 82–90. https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=10&sid=e5bc3ad9-8160-4ed8-bb4f-752141ecd9c5%40redis

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Uterine fibroids (UFs) are the most common benign tumors found in women of reproductive age, with a disproportionate impact on women of color. These disparities are believed to be combined with environmental, genetic, and socio-economic factors.

 Some of the lifestyle changes that can help prevent or reduce the development of uterine fibroids are;

1. Decreasing Alcohol consumption: It’s advised that women decrease their alcohol consumption to reduce the risk of developing uterine fibroids (UFs). Studies have reported an association between alcohol intake and an increased likelihood of UFs. Studies believe that alcohol may alter hormone levels and disrupt hormonal balance, contributing to the formation of UFs. It is advisable to consult with a healthcare professional for personalized advice based on unique health occurrences. By being mindful of alcohol consumption and adhering to recommended limits, proactive steps can be taken to lower the risk of UFs.
2. Engage in at least four hours of vigorous physical activity per week: Research has found a significant association between an increased BMI and the risk of UFs. Obesity is believed to be a contributing factor to UF. Studies believe that women who engage in at least four hours of vigorous physical activity per week are more likely to encounter a decrease in the risk factors of UFs.
3. Consuming more fruits, Vegetables, and dietary fibers:  High intake of processed and refined foods, unhealthy fats, and sugary drinks, and low consumption of fruits, vegetables, and fiber-rich foods may contribute to hormonal imbalances, inflammation and oxidative stress, thereby encouraging the growth of UFs as indicated in the research. Additionally, a lack of fruits, vegetables, and fiber-rich foods has been reported to be associated with an elevated risk of UFs. Fruits, vegetables, and fiber-rich food are excellent sources of antioxidants, vitamins, and minerals that help combat oxidative stress and inflammation. Specifically, Dietary fiber has been indicated to have protective impacts against UFs by supporting hormonal balance and improving regular bowel movements. Hence, adopting a healthy and balanced diet with whole grains, fruits, vegetables, lean proteins, and healthy fats is essential.
4. Managing stress:  Studies have found that chronic psychological stress could increase the risk of uterine fibroids and indicated a significant link between chronic psychological stress and an elevated risk of UFs, predominantly among non-Hispanic Black women. Eating healthy, exercising regularly, getting enough sleep, relaxing, connecting with friends and family, and practicing mindfulness are some ways to manage stress.

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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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.

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.

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.