By: Briana Miranda And Hanako Reyes Hanako Reyes Period 2

ETIOLOGY TERMS OF BIOLOGICAL, COGNITIVE AND SOCIOCULTURAL FACTORS Sociocultural Rules of their culture Family structure and dynamics Social organization Socially-sanctioned defence mechanisms Rituals Social Stressors Biological Genetic predisposition Genetic predisposition History of premenstrual dysphoric disorder History of depression during pregnancy Decrease in reproductive hormones Changes in blood volume, blood pressure, immune system and metabolism Cognitive Low Self-esteemed Low Self-esteemed

SYMPTOMS Loss of appetite Insomnia Intense irritability and anger Overwhelming fatigue Loss of interest in sex Lack of joy in life Feelings of shame, guilt or inadequacy Severe mood swings Difficulty bonding with your baby Withdrawal from family and friends Thoughts of harming yourself or your baby

PREVALENCE An estimated 9-16 percent of postpartum women will experience PPD. Among women who have already experienced PPD following a previous pregnancy, some prevalence estimates increase to 41 percent.

DIAGNOSIS The Diagnostic and Statistical Manual of Mental Disorders (DSM) considers postpartum depression a subtype of major depression. symptoms of major depression must develop within four weeks of giving birth Depressed mood most of the day, nearly every day Reduced interest and pleasure in activities you used to enjoy Significant change in your appetite or unintended change in your weight Inability to sleep (insomnia) or excessive sleepiness (hypersomnia) Restlessness or notable slowed movements Fatigue or loss of energy Feelings of worthlessness Diminished ability to think, concentrate or make decisions Recurrent thoughts of death or suicide

CULTURAL FACTORS Not all cultures recognize this as a problem needing medical attention Religious belief systems Urban vs. rural upbringing Women of African descent in America Distinctive language related to depression The transmission of information among people about depression Beliefs about healthcare and the healthcare system

GENDER VARIATIONS Occurs in both males and females can get it. Occurs in approximately 10% to 15% of new mothers, with a 25% to 50% risk of recurrence. Gender differences in postpartum depression: a longitudinal cohort study by Vicenta Escribà-Agüir and Lucía Artazcoz. Found that at three and 12 months postpartum, 9.3% and 4.4% of mothers and 3.4% and 4.0% of fathers, respectively, were newly diagnosed as having depression. Low marital satisfaction, partner's depression and depression during pregnancy increased the probability of depression during the first 12 months after birth in mothers and fathers.

TREATMENT APPROACHES Counseling. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional. Through counseling, you can find better ways to cope with your feelings, solve problems and set realistic goals. Sometimes family or relationship therapy also helps. Antidepressants. Antidepressants are a proven treatment for postpartum depression. If you're breast- feeding, it's important to know that any medication you take will enter your breast milk. However, some antidepressants can be used during breast-feeding with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants. Hormone therapy. Estrogen replacement may help counteract the rapid drop in estrogen that accompanies childbirth, which may ease the signs and symptoms of postpartum depression in some women. Research on the effectiveness of hormone therapy for postpartum depression is limited, however. As with antidepressants, weigh the potential risks and benefits of hormone therapy with your doctor. With appropriate treatment, postpartum depression usually goes away within a few months. In some cases, postpartum depression lasts much longer. It's important to continue treatment after you begin to feel better. Stopping treatment too early may lead to a relapse.

THE RELATIONSHIP BETWEEN ETIOLOGY AND THERAPEUTIC APPROACH Etiology and therapeutic approach relationship: -Hormonal imbalance during/after pregnancy is sometimes treated with estrogen therapy. -If patient previously had depression/ depression is common in family, it is usually treated with antidepressant medications. -Feelings of low self esteem and low satisfaction are sometimes treated with cognitive behavioral therapy and interpersonal therapy. -Depressive symptoms are sometimes treated with psychotherapy and infant-mother relationship therapy.

WALKER-TESSNER MODEL Psychological Outcome: Postpartum Depression Having a child Biological: Hormonal Imbalances Ahokas A, Kaukoranta J, Wahlbeck K, Aito M 2001 Pre-Disposition for Depression Ahokas A, Kaukoranta J, Wahlbeck K, Aito M 2001 Cognitive Factors: Intrusive thoughts Illogical thinking Thoughts of harm to the child Self-Esteem is low Michael W. O'Hara, Scott Stuart, Laura L. Gorman, Amy Wenzel, 2005 Stressors Child Crying Feeding child No sleep Cutrona and Troutman 1986