Postpartum depression: a clinical study

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Mental Health - Nursing
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BIO-PSYCHOSOCIAL ANALYSIS OF CASE STUDY – 1
INTRODUCTION
Postpartum depression or PPD is classified as one of the major episodes of depression, which
starts tentatively a few weeks after delivery. Although childbirth is one of the significant and
joyful events in the life of a woman, almost 15-85% suffer from PPD due to various biological,
psychological and social factors (Sylven, 2012). While there are several causes for the
development of postpartum depression, some factors, such as those seen in the case of Dorothy,
seems to enhance the effect. Her economic conditions, estrangement from her immediate family
and friends as well as the strained relationship with her husband, all seem to contribute to her
postpartum depression.
Since postpartum depression is not uncommon among the mothers (and not just the first timers),
several theories have been put forth to assess the impacts of various factors that might be
responsible. Whatever the reasons for the condition early recognition by the physicians or nurses
can ensure quicker treatment to reduce the distress of the patients like Dorothy (Abdollahi, Lye
& Zarghami, 2016).
This essay is an analysis of the bio-psychosocial causes of the condition experienced in Dorothy,
where she is not able to respond to her child, and is all the more depressed with her
circumstances. Also, since nursing care or medical intervention is sought, this essay will also
look into possible ways one can help Dorothy to overcome her depression under clinical
conditions.
ANALYSIS: DISCUSSION OF BIOPSYCHOSOCIAL FACTORS

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There are innumerable factors that can contribute to after-childbirth distress, and they can be
categorized as biological, psychological and social conditions. One or all of them, in
combination, can result in postpartum depression in new mothers. Let us look at these factors
separately.
Biological Factors of Postpartum Depression
It is not only Dorothy here, who might not feel elated to hold her baby or nourish her. There are
many who might not feel the ability to care for the young one, or share their enthusiasm so
openly, due to a simple reason that they have undergone a physically and emotionally exhausting
labour, as here in Dorothy (Caplan, 2013).
Researchers attribute this to the hormonal changes related to pregnancy and childbirth. There is
an enormous change that takes place in the endocrine system, which involves both the hormones
and neurotransmitters (Skalkidou, Hellgren & Masco, n.d.). These changes are in lieu of the
pregnancy and preparation for childbirth and nursing. It is also believed that the steroidal release
(and enhanced release when compared to normal levels at other times) can cause negative
reactions to set in.
Although, our body systems also learn to cope with the sudden rise and then the fall of secretion
of essential hormones, that is why, innumerable new mothers also enjoy their motherhood from
day one. There are, however, cases where this balancing phenomenon might not be corrected
automatically, and combined with other psychological and social factors, enhance the effects of
depression. Others believe that the hypothalamic-pituitary-adrenal system or the HPA may
perform differently in women who are more susceptible to depression, as is the case with
Dorothy (Abdollahi et al., 2016). Hence, to sum up the biological factors, it can be concluded

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that certain internal reaction to the extreme hormonal changes happening in the body of a
pregnant woman can lead to depression.
Psychosocial Factors of Postpartum Depression
Psychosocial factors that usually are seen as significant factors for postpartum depression include
the mother's age, unwanted or unplanned pregnancy, high expectations as a mother, family
history of depression, bipolar disorders in the patient and so on.
The social causes, such as lower income, no proper relationship between the husband and wife,
estrangement in the family, no proper support, abusive husband, alcohol or drug abuse, are some
of the contributing factors to depression after childbirth.
Unfortunately, here, in case of Dorothy, there are several of the above mentioned social and
psychological factors as well as family history of depression that is contributing to her anxiety
and distress.
Dorothy, does not have the support of her family, and her economic status does not seem to be
very good. Also, with a husband, who is both alcoholic and abusive, and an unplanned (surprise)
pregnancy, as well as an authoritative mother-in-law, she does not feel herself worthy of caring
for the baby. With a family history of depression, it is not surprising that Dorothy feels the signs
of distress very strongly, to the extent that she has visions of damaging her daughter.
Anxiety, meeting up to the standards of the society as a new mother, and also dealing up with
sleeplessness, and no proper nutrition, all toll on the mother's health, and in turn, increase the
depression, as in the case of Dorothy. Without proper medical intervention, she might not be able
to overcome this, to look after Amy.