Depression in New Mothers : Causes, Consequences and Treatment Alternatives PDF
Preview Depression in New Mothers : Causes, Consequences and Treatment Alternatives
Depression in New Mothers Maternal depression is the number one cause of disability in developed countries and results in adverse health outcomes for both mother and child. It is vital, therefore, that health professionals are ready and able to help those women that suffer from perinatal and postpartum depression (PPD). Now in its third edition, Depression in New Mothers provides a comprehensive approach to treating PPD in an easy-to-use format. It reviews the research and brings together the evidence base for understanding the causes and for assessing the different treatment options, including those that are safe for use with breastfeeding mothers. It incorporates a new psychoneuroimmunology framework for understanding postpartum depression and includes chapters on: • negative birth experiences • infant characteristics • psychosocial factors • antidepressant medication • therapies such as cognitive-behavioral therapy • herbal medicine and alternative therapies • suicide and infanticide. This new edition incorporates new research findings on risk factors, the use of antidepres- sants, and complementary and alternative medicines, as well as updated, international perspectives and research into ethnic minority differences. Rich with case illustrations and invaluable in treating mothers in need of help, this practical, evidence-based guide dispels the myths that hinder effective treatment and presents up-to-date information on the impact of maternal depression on the mother and their infants alike. Kathleen A. Kendall-Tackett is a health psychologist and International Board Certified Lactation Consultant, and the Owner and Editor-in-Chief of Praeclarus Press, a small press specializing in women’s health. Dr. Kendall-Tackett is Editor-in-Chief of two peer-reviewed journals: Clinical Lactation and Psychological Trauma. She is a Fellow of the American Psychological Association in Health and Trauma Psychology, Past President of the APA Division of Trauma Psychology, and a member of the Board for the Advancement of Psychology in the Public Interest. Dr. Kendall-Tackett is Clinical Professor of Nursing at the University of Hawaii at Manoa and Clinical Associate Professor of Pediatrics at the Texas Tech University School of Medicine, USA. This page intentionally left blank Depression in New Mothers Causes, consequences and treatment alternatives Third edition Kathleen A. Kendall-Tackett Third edition published 2017 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2017 Kathleen.A. Kendall-Tackett The right of Kathleen A. Kendall-Tackett to be identified as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. First edition published 2005 Second edition published 2009 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloguing in Publication Data Names: Kendall-Tackett, Kathleen A., author. Title: Depression in new mothers : causes, consequences and treatment alternatives / Kathleen A. Kendall-Tackett. Description: Third edition. | Abingdon, Oxon ; New York, NY : Routledge, 2016. | Includes bibliographical references and index. Identifiers: LCCN 2016010204 | ISBN 9781138120754 (hardback) | ISBN 9781138120778 (pbk.) | ISBN 9781315651521 (ebook) Subjects: | MESH: Depression, Postpartum–etiology | Depression, Postpartum–diagnosis | Depression, Postpartum–therapy | Maternal Welfare–psychology | Risk Factors | Socioeconomic Factors Classification: LCC RG852 | NLM WQ 500 | DDC 618.7/6–dc23 LC record available at http://lccn.loc.gov/2016010204 ISBN: 978-1-138-12075-4 (hbk) ISBN: 978-1-138-12077-8 (pbk) ISBN: 978-1-315-65152-1 (ebk) Typeset in Times New Roman by Out of House Publishing Contents Foreword by Penny Simkin x Preface xiii Part I Symptoms, incidence, and consequences 1 1 Depression in new mothers: myth vs. reality 3 Myths about postpartum depression 3 Symptoms of depression 4 Incidence and prevalence of depression in new mothers 7 Summary 13 2 Conditions comorbid with postpartum depression 15 Postpartum anxiety disorders 15 Posttraumatic stress disorder 20 Eating disorders 22 Substance abuse 22 Postpartum psychosis 22 Summary 24 3 Why depression is harmful for mothers 25 Depression is not benign 25 Summary 31 4 Why maternal depression harms babies and children 33 The impact of untreated depression on fetal development 33 Effects of maternal depression on infants 39 Effects of maternal depression on toddlers and preschoolers 41 Contents Effects on school-age children 43 Effects on young adults 44 The interaction styles of depressed mothers 45 Infanticide 47 Conclusion 48 5 Assessment of postpartum depression 51 Challenges to assessing postpartum depression 51 Screening for depression 53 Screening and assessment scales 56 Additional factors to assess 63 Conclusion 64 Part II Risk factors 67 6 Physiology of postpartum depression I: inflammation and psychoneuroimmunology 69 How humans respond to a perceived threat 69 Why inflammation is particularly relevant to depression in new mothers 72 Physical and psychological stressors that increase inflammation and risk of depression 73 Hormonal influences 75 Conclusions 79 7 Physiology of postpartum depression II: breastfeeding and mother–infant sleep 81 Breastfeeding confers survival advantage by protecting mothers’ mental health 81 Depression and breastfeeding cessation 84 Sleep, feeding method, and maternal mental health 89 Conclusions 102 8 Traumatic birth experiences 105 Incidence and prevalence of traumatic birth experiences 105 Diagnostic criteria for PTSD 107 Characteristics of traumatic birth experiences 121 vi Contents Human rights in childbirth 122 Possible interventions for traumatic birth experiences 122 Conclusion 124 9 Infant temperament 127 Infant crying and colic 128 Summary 132 10 Prematurity, infant health problems, and disability 133 Prematurity 133 Infant disability or chronic illness 143 Summary 145 11 Psychological risk factors I: attributional style, self-esteem, and psychiatric history 147 Attributional style 147 Self-esteem, self-efficacy, and personality traits 148 Psychiatric history 150 Disaster and postpartum mental health 151 Loss 153 Summary 154 12 Psychological risk factors II: violence against women 155 Adverse childhood experiences 155 Intimate partner violence 158 Abuse and the inflammatory response 159 Abuse history and parenting difficulties 160 Summary 161 13 Social risk factors 163 Immigration 163 Maternal age 165 Socioeconomic status 166 Maternity leave and employment 168 Social support 168 Summary 175 vii Contents Part III Treatment options 177 14 Complementary and integrative treatments I: omega-3s, SAMe, and exercise 179 Omega-3 fatty acids 179 S-Adenosyl-L-methionine (SAMe) 186 Exercise 187 Summary 191 15 Complementary and integrative therapies II: bright light therapy, vitamin D, St. John’s wort, and emerging therapies 193 Bright light therapy 193 Vitamin D 197 St. John’s wort 198 Emerging therapies 202 Conclusion 204 16 Community interventions 205 Peer support 205 Healthcare provider support 206 Home visiting 206 Education 207 Summary 208 17 Psychotherapy 209 Cognitive-behavioral therapy 209 Interpersonal psychotherapy 212 Anti-inflammatory effects of psychotherapy 215 Summary 216 Trauma-focused treatment 216 Conclusions 221 18 Antidepressants in pregnant and breastfeeding women 223 Helping mothers weigh their options 223 Types of antidepressants 225 Breastfeeding and medications 232 viii Contents The anti-inflammatory effects of antidepressants 234 Phases of depression management with medications 235 Conclusions 237 Epilogue: some final thoughts 239 Listen to mothers 239 Let mothers know about factors that might be influencing their emotional state 239 Offer specific suggestions that can help 239 Help her mobilize her own support system, including offering referrals to people or organizations that can offer long-term support 240 Conclusions 240 References 241 Index 284 ix
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