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Introduction

Pregnancy for a woman or with her partner can be a time of joy, excitement, and psychological well-being for many women. However, there are other women for whom the experiences of pregnancy, labor, and the transition to motherhood are overwhelming (Eva Lilyan Abel, 2008). Ongoing research shows that an upper bound of 15% of pregnant women have or currently are experiencing serious feelings of stress, anxiety or depression (O’Hara & Swaim, 1996) Mental health is the well-being of a person’s condition both psychologically and emotionally. Mental health can be categorized as an illness as an illness is an amount of time where there is a sickness that is affecting the body or mind. Mental health is dependent on emotions and mental wellbeing and therefore is classed as an illness. Mental health is a massive factor of a psychosocial dimension of the maternity experience. Therefore, women need to be aware of their mental state and emotions so that no harm comes to her and the child. There are mental health has a vast amount of complication. For example, the following is a sample but not an inclusive list: depression, anxiety, post-traumatic stress disorder and many more which we will be discussed in this essay. This essay will focus on the complications which arise from the mentality and mental illnesses that occur during childbirth and child bearing. The essay will also explore how specific challenges of mental health might impact a child bearing woman or family. This essay will also be accompanied by a cognitive map to illustrate this essay in a graph format style.

Mental Health and Illnesses

There are many women who suffer from mental illness according to the World Health Organization, where on average, about 1 in 4 women will eventually experience a type of throughout a period of their lifetime after pregnancy. This has many triggers where pregnancy can be one of them (Caroline Kinsella, 2006). A survey has been carried out which showed evidence that if you keep acive and maintain independence by carrying out a perspective in life, maintaining your physical health and coping with loss such as a family member passing away, were major factors of decreasing the chances of mental health (Mima Cattan, 2009). The people who are more susceptible to become ill with a mental illness during pregnancy are women who have previously (or currently have) had mental health problems which were severe. Not only is that a case, but even the first year of post birth there is a considerable chance that a woman might develop a mental illness. There is a multitude of mental disorders which can affect a woman or even anyone including the paternal parent. These include; bipolar disorder, psychosis, and severe depression. Severe depression is the most common. These conditions can onset at any point in life, however, severe mental illness is likely to progress rapidly post birth (NHS, 2015). A leaflet published by the NHS (2010) explains how depression and anxiety affects pregnant women through their pregnancy. It also states that the most typical type of a mental problem, pre-birth and post-birth, is depression and anxiety. Which reach a staggering rate of ten to fifteen percent of the pregnant woman population. Many pregnant women are not aware that they could have developed a mental health illness as they might be under neglect or their own mental state could not appear as significant to the individual. A woman might not have anyone to turn to speak about anything that’s on her mind about the pregnancy thinking that no one would understand her. There are treatments available for anxiety and depression. Mental health problems have been associated with missing appointments but this could be due to the patients suffering from a mental issue such as depression or anxiety, which are quite common. Maybe the woman doesn’t like to be touched by the doctor/nurse/midwife and wants to be left alone. Or maybe the patient is too scared and anxious just in case there’s a complication with the baby.

What types of Mental Disorders are there?

There are many types of mental issues a woman can experience during her pregnancy and postnatal period. These can range from PTSD to depression and anxiety. Here we will describe some of the conditions and investigate the symptoms, reasoning and outcomes.

Postpartum Post-Traumatic Stress Disorder

First, we need to understand what is PTSD, how we can prevent it and the complications in the context of pregnancy. PTSD can be split up and defined as a perticular trauma which happens at one or multiple points in life. In the Oxford English Dictionary, trauma is defined as ‘a powerful shock that may have long lasting consequences’. Trauma has an effect that can be massively overwhelming at times. Secondly, we can describe stress as ‘a state of mental or emotional strain or tension resulting from adverse or demanding circumstances’. Taking the singular definitions of trauma and stress we can piece together the meaning of Post-Traumatic Stress Disorder. This is a disorder where in a person’s life they experienced trauma which can be triggered at any time of their life many times. This causes stress which induces illnesses. To be factual, Post-Traumatic Stress Disorder often is a result of when a truly traumatic experience has happened to a person. This can range from a multitude of reasons beyond what would be called a normal human experience which causes allot of alarm and distress, for example, older men who fought in wars may have PTSD triggered when they hear a gun shot or rotary blades of a helicopter. (David Kinchin, 2005). As previously stated, there is or can be a trigger which can cause PTSD symptoms. And these symptoms have a clear onset point. This means that they don’t follow the pattern of a normal mental disorder which can be developed spontaneously. The earlier signs are developed within a series of days after the traumatic event. It is best that the people who develop PTSD seek immediate help of the emergency care services and helpers (A Pelissolo, 2016). With that knowledge, PTSD can be determined at the onset from the first few days from the trauma exposure. This means it can be controlled. Even though there are multiple treatments, there is no definitive cure for PTSD. In the case of pregnancy, this condition is known as postpartum post-traumatic stress disorder. Another mental issue linked is postpartum depression. However, the chances of developing such condition are quite low as Eva Lilyan Abel (2008) states that significant difficulties postpartum can manifest as Postpartum Depression and Postpartum Post-Traumatic Stress Disorder (PTSD), which occur in about 10% and 2% of mothers, respectively. Meaning that Postpartum Depression occurs in around ones out of ten mothers and that Post Traumatic Stress Disorder occurs at a rate of one in fifty chance. It also states that a traumatic pregnancy tends to continue anywhere from a few weeks postpartum to a year postpartum dependent if the correct professional help is acquired. There are many factors associated with negative birth experiences include previous difficult birth experiences, complications surrounding the birth, certain cognitive styles and expectations, low perceived support, first-time pregnancies, past sexual abuse, depression, high levels of medical intervention and pain during labor, low perception of control during labor, lack of involvement in childbirth education classes, and low levels of self-efficacy (Eva Lilyan Abel, 2008). Aside from the psychological aspects of PTSD, there are social negatives also. The prospect of living with someone who suffers from PTSD can potentially be an unpleasant situation. This is due to the person is easily startled, has nightmares, and who has anxiety resulting in the avoidance of social situations. Research on PTSD is producing results which shows that families do have a hard time adapting and maintaining a calm mine with someone who has PTSD they look after. (PTSD, 2015). These social impacts can be devastating and affect all family members associated with the affected person. The woman affected by postpartum posttraumatic stress disorder will develop many other related problems such as depression, anger, avoidance of social places. However, not only the person affected goes through this. The family members also affected. The family members may feel depression which is quite common in this case as family members may start thinking that their loves one will not get back to normal if the PTSD remains for a long period of time. As a result of this depression, members of the family may take up harmful activities such as drinking, smoking, drugs and not maintaining their wellbeing so they are able to cope with the family member’s symptoms. They themselves can become worried, angry or depressed.

Depression and Postpartum Depression

As previously stated, PTSD is a condition of which a person can develop a mental illness due to aa traumatic time in their lives. This can lead to depression, however, isn’t the only pathway to depression. A woman can become depressed over many aspects of pregnancy from the weight they put on, any complications with the baby or even ill health which may affect future pregnancies. Depression is a vastly complex case which affects a person’s everyday life and activities which is caused by a multitude of symptoms. There are usually signs which are shown where someone is mentally depressed. However, they can be mistaken for where people are disappointed and feel down in the sumps. This example is general human life. Depression is not simply feeling blue or disappointed or down in the dumps. This shows that depression is a much more complex matter which needs professional help (Wendy Moragne, 2011). Now that we know what depression means, we can start investigating how this condition affects the woman before and after childbirth. The cause for postnatal depression is not definite. There are multiple factors to be associated with the disorder. These can arise from mental health problems which were developed earlier in life, or a current/past relationship with a partner, experiencing the “baby blues”, however, this is not an inclusive list. During pregnancy, the body produced various hormones which can have similar symptoms to depression. For example, a woman might feel tired, even though she is well rested, but practitioners could rule it to be a part of a normal pregnancy. Not only tiredness, but poor sleep, mood swings and worry are usually assumed to be usual and common. Recognizing and treating depression during pregnancy is important, as untreated depression may confer a risk to the mother to be and the fetus. There needs to be a greater awareness so that women have access to multiple ways of learning or understanding what they could be going through and for them to seek the appropriate help. The “baby blues” is a process, part of the cycle for depression, which majority of women experience through the first week of the child birth. This means that the mother is at a point where she is experiencing depression when it should be a happy moment for her. The NHS claims that the “baby blues” is a result of the changing chemistry within the body after the birth (NHS, 2015). “Baby blues”, which is part of the depression cycle shows that not only are the changing hormones the resultant cause, but the result of stress (also known as melancholic). It is believed that about 10% of cases are melancholic. The complications of postnatal disorders are that they have the possibility of interference to the bonding of the baby to mother. (Professor Gordon Parker, Kerrie Eyers, Professor Philip Boyce, 2014).

There are options available to help mothers experiencing these symptoms such as the General Practitioner prescribing antidepressants or recommend psychological therapy. This enables the affected to manage their condition. However, there can be negatives. Such negative example is that the possibility of fetal defects and further complications to the unborn child, if certain drugs (medication) are consumed. (NHS, 2015). To this end, the condition for the development of depression in the postnatal period is canned postnatal depression or can be shown as PND. This condition isn’t an immediate type of mental health meaning it can take weeks to months within the first six months to develop. If medical help is not acquired then this can leave a parent in a position of a long lasting mental issue which may take a long period to recover from (NHS, 2015). It can be said that this type of depression, PND, is not uncommon with it being an experience where many parents experience. About 10% of women experience this condition at one point after birth. However, it is less common in fathers and partners. (NHS, 2016). This type of depression currently has no evidence for a specific technique the prevention of postnatal depression besides maintaining a healthy lifestyle. Not all mothers will develop depression. Statistics show that, as mentioned previously, only 10% of women will develop depression. However, these can be categorized into mild and severed depression. Where mild depression is the most common and only a few will develop severe depression. (NHS, 2016). There are noticeable signs to Postpartum Psychosis. Firstly the mother may be acting strangely and a “bit off”. Even though it can develop after birth, it is still a greater change of the condition occurring if there is medical history of a mental illness where severe illness increases it further. If there are signs then a medical professional should be alerted as there is help such as unit which are able to offer treatment without separating the mother from the baby (NHS, 2015).

Anxiety during Pregnancy

It is common to experience anxiety. Anxiety, which can be thought of as similar to how depression works, is both a normal emotion and a psychiatric disorder (Gerard Emilien, Cecile Durlach, Ulla Lepola, Timothy Dinan, 2002). To be more specific, we can define anxiety as the feeling of worry, nervousness or unease about something with an uncertain outcome. As exclaimed with Andrea S. Chambers, (2007) she states in her paper that out of four studies, prenatal pregnancy specific anxiety is related to premature delivery. Premature delivery can be devastating for the child as they could have organs which are not fully developed to be used outside the womb. The feeling of anxiety and vulnerability for a woman who is in the postnatal period should be questioned by a medical professional. This is an opportunity to present yourself to get the necessary help needed for a speedy recovery (NHS, 2015). Some anxiety might be little and can be triggered from little thoughts of weight gain during pregnancy or having the inability to fit into your clothes anymore and needing to go out into public with tighter and uncomfortable clothes which you worry about what people around are thinking. Help is not hard to come by for anxiety as its common. One form of help would be through Cognitive Behavioral Therapy (CBT). CBT is not the only treatment. Even though it is widely used in the recovery process for anxiety and depression, it is also a treatment for a multitude of types of mental and physical health issues. The feeling of negativity is a possible problem resulting in a cycle of a person remaining negative, even in a positive scenario. This is where CBT helps as its believed that it works on “the concept that your thoughts, feelings, physical sensations and actions are interconnected.” Essentially, it’s a process of creating positivity as a treatment so that the negativity can be overcome by looking at ways to create positivity, daily (NHS, 2016).

Conclusion

To this end I can conclude that there are mothers during childbearing that are undergoing medical illnesses and mental health problems. This can be resolved in many ways by seeking a medical professional healthcare. Depression, PTSD and anxiety is not rare but unlikely with low rates of one in ten chance. This chance would not seem to be statistically correct as many mental illnesses are not only sudden, but can be a result of a traumatic event that has happened in the mother life such as violence, previous complications with previous pregnancies or previous miscarriage. Another aspect we looked at was depression during pregnancy and how the condition can affect the mother, partner or even the whole family. However, in an event that this does occur, there is help that the woman would be entitled to including help from social services or even help from the social benefit system which can relieve the woman of stress and help her get back to normal. After birth, there may be support from friends, family, healthcare professions to help women after having a traumatic birth. There are even prescribed medications such as antidepressants which can help with certain aspects of depression, even though these are usually only prescribes when all other techniques and attempts have failed to either lower or eliminate the depression. There needs to be increased funding so that mental health can become largely investigated in depth as currently there is a decreasing amount of understanding and potential for misdiagnosis between normal aspects of pregnancy and depression. However, it is getting to a point that funding is limited as the government is pressured to fund other aspects of healthcare causing mental health to become one of the lowest funded research. Anxiety alone is a common aspect in everyone’s lives however it is different during pregnancy. It can also lead to further complications as stated in this essay.

References

A Pelissolo. (2016). Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions. Retrieved 13 March 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723637/pdf/11920_2015_Article_655.pdf Abel, E. L. 2008. Intervention to Prevent Postpartum Adjustment Difficulties. New England: Antioch University. Cattan, M. 2009. Mental Health and Well Being in Later Life. Berkshire: Open University Press. Emilien G. Durlach C. Lepola U. Dinan T. (2002). Anxiety Disorders: Pathophysiology and Pharmacological Treatment. Switzerland: Birkhauser. Kinchin, D. (2004). Post Traumatic Stress Disorder: The invisible Injury 2005 Edition. Oxfordshire: Success Unlimited.

Kinsella, C. 2006. Introducing Mental Health: A practical Guide. London: Jessica Kingsley Publishers.

Moragne W. (2011). Depression. Minneapolis: Twenty-First Century Books.

O’Hara M. & Swain A. (1996). Rates and risk of post-partum depression: A meta analysis. International Review Psychiatry. 8(1): 37-54.

Parker, G. Eyers, K. Boyce, P. (2014) Overcoming Baby Blues. Melbourne: Allen & Unwin.

National Center For PTSD. (2015). Effects on PTSD on Family. Retrieved 13 March 2017, from http://www.ptsd.va.gov/public/family/effects-ptsd-family.asp

NHS. (2010). Mental Health in Pregnancy. Retrieved 13 March 2017, from http://www.nhs.uk/ipgmedia/national/royal%20college%20of%20psychiatrists/assets/mentalhealthinpregnancy.pdf NHS. (2010). Postnatal Depression. Retrieved 13 March 2017, from http://www.nhs.uk/conditions/Postnataldepression/Pages/Introduction.aspx NHS. (2015) Feeling Depressed After Birth. Retrieved 13 March 2017, from http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/feeling-depressed-after-birth.aspx NHS. (2015). Mental Health Problems and Pregnancy. Retrieved 13 March 2017, from http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/mental-health-problems-pregnant.aspx NHS. (2016). Cognative Behavioural Therapy. Retrieved 13 March 2017, from http://www.nhs.uk/conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx

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