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Thursday, 28 June 2012 14:07

Postpartum Depression (Part 2): Why We Must Support Mothers Struggling With PPD in More Constructive Ways Featured

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If you haven’t read my

first article on Postpartum Depression

(PPD) yet, I highly suggest you read it before reading this one; it will give you some context and background to better understand this article as a whole, as well as my perspectives on PPD through my experiences with PPD as a mother, and through my academic research.  


As part of my Master’s Degree in Mental Health Counseling, I recently completed a class on human development.  The goal of this class was to help student counselors understand the different theories of development and how life events may impact development, for better or worse.  Ideally, this deeper understanding of how one’s experience can affect a person in many ways facilitates a greater respect for an individual’s circumstances, and how this person may have come to be sitting in a counselor’s office. 

The Birthing Site was gracious enough to help me with my personal research by posting an online survey I created to supplement my research.  I received an incredible amount of responses that helped me gain a better understanding of women’s experiences of PPD.  One of the questions I asked was if women thought that understanding the process of child development was helpful.  All of the women who had knowledge of child development said that they felt it helped, and nearly all of the women who didn’t have knowledge of child development said they think it might help.  After writing the previous article on PPD, (and showing the admins of TBS the academic research project,) they asked me to write a supplementary article explaining the potential impact of PPD on child development.  This article will explain what I learned in through this project; the basics of human development, research on PPD and child development, and how PPD may impact child development.

If you are suffering from PPD, please read this carefully.  This project was intended for an academic audience, not necessarily for women with PPD who don’t have an education and background mental health.  The goal of this project was not to find a way to make women feel even guiltier about what they were going through.  In fact, my goal was to strengthen my basis for developing a private practice that focuses on women navigating all things with regard to motherhood from pre-conception and beyond.  I never realized how much mothers do without even a simple thank you (which we all know would go a long way) until I became a stay at home mother after the birth of my second son.  A secondary goal of this project was to help fellow counselors understand the struggles of a woman with PPD and how appropriate counseling will not only benefit her, but also her children.  If we try to support mothers in a more constructive way throughout all of the experiences of motherhood, the benefits to the mother and child are potentially endless.  

 

I wrote this article based on my project because I have a passion for mothers and I am driven to advocate for a better support system for mothers beginning with pregnancy and extending throughout motherhood.  I too suffered from PPD.  My guilt and shame were compounded by my knowledge of child development that I already had from my undergrad degree.  When I realized I may have PPD, I forced myself to seek help because I knew it was best for both me AND my kids.  I sat suffering in silence, feeling like I was drowning in sadness, looking at my sweet little boy and wishing I could do something to make things better.  When I was able to get help, I was incredibly relieved to have someone to talk to who didn’t invalidate what I was feeling, who listened to me unload my stress, and who helped me find ways to take care of myself so I was in a better place to take care of my baby.

 

What is the big deal about psychological theories of human development?

 

Theories of human development attempt to explain how people may come to be who they are based on their life experiences.  These theories identify basic needs at different life stages and illustrate how if those needs are not met, (or are met in an unhealthy way) a person may be more likely to experience some type of distress or impairment with regards to mental health.  

 

There is no one theory of development that is regarded as being the absolute truth, and all of the respected and utilized theories allow room for the fact that some people are more resilient than others.  So many factors may contribute to the development of psychological challenges (the nature vs. nurture debate) that it is impossible to identify every single event that contributes to the resiliency of one person or the struggles of another.  One thing is common among all of the theories; healthy human development occurs when basic needs are met.  If basic needs are not met, development does not occur in an ideal way and a person may be at greater risk of mental, physical, social, and emotional challenges during the rest of his or her life.  Some people are more resilient than others, and sometimes it’s difficult to determine why.

 

During my research for this and many other projects, there is a common thread; mental illness (MI) has the potential to affect both the person with the MI, as well as those around her.  People with major MI such as schizophrenia, PTSD, or a personality disorder experience a great deal of social impairment and often lack the ability to maintain healthy relationships, even with their parents, siblings, or lifelong friends.  Even people with depression may suffer in ways that affect those around her, such as her husband and children.  If you’ve ever lived with someone who has major depression, you know how difficult it can be to watch your loved one struggle on a daily basis.  For someone who has major depression, tasks that seem mundane and “everyday” such as showering and eating are sometimes too much to do.  

 

So what does any of this have to do with Postpartum Depression?  For my final project, I was asked to identify a population who may benefit from mental health services and create a presentation about how this population’s state of being may have been affected by something in their development, or how this population’s challenge may impact development (for the self or others.)  Between my passion for mothers and children, my own experiences of PPD after both of my births, and my interest in child development, I had developed the thesis for my project before the ink dried on the syllabus: What potential impact does PPD have on child development, and how can counselors help mothers with PPD?   

 

Theories of Child Development

 

I utilized four theories of development to help illustrate how PPD has the potential to impact child development, (I will discuss how the theories connect to PPD after I explain the theories.)  The first theory is Maslow’s Hierarchy of Needs.  Essentially Maslow created a psychological pyramid that constitutes different needs that must be met in order for a person to progress up the pyramid of healthy development.  A figure of the pyramid can be seen here. The first four needs (beginning at the bottom) are basic needs: Food, Security, Love and Belonging, and Esteem.  If one of these needs is not met appropriately, it may be difficult for someone to progress to building stable friendships, intimate relationships and realizing their full potential and sense of self.  

 

The second theory I utilized is Eric Erickson’s Psychosocial Stages of development.  Each stage is described as a challenge between two opposing forces.  The first stage is Trust vs. Mistrust.  A newborn who cries and his needs such as being fed, diapered, and comforted learns the basic idea of trust and will likely be easier to calm and comfort than a child whose needs are not consistently met.  This latter child may develop a sense of mistrust: “even when I cry, I don’t know if I’ll be fed.”  This child may begin to cry excessively in an attempt to get his needs met and may learn that there is not someone he can depend on to care for him.

 

The third theory I discussed was Bowlby’s Attachment Theory.  A baby’s attachment style is mostly based on that baby’s opportunities to bond with a caregiver, the characteristics of that caregiver, the characteristics of the baby, and general family environment.  If a baby bonds with a warm and attentive caregiver in a generally warm environment, that baby will likely develop a healthy attachment known as secure attachment.  This child may be distressed if separated from her mother, but will be comforted upon her mother’s return and resume previous activities.  If a child does not have opportunities for healthy attachment, she may develop a less healthy attachment and have more difficulties adjusting to changing situations in both the short and long term because either she does not know that the mother’s return will bring comfort, or she is unsure if the mother will actually return.

 

The fourth theory I utilized is Bandura’s Social Learning Theory.  This theory says that personality is the result of complex interactions between the environment, behavior, and psychological processes. (Behavior causes the environment and environment causes behavior.)  Children learn from watching others, attempting to replicate what they see, and their motivation to do it again is based on reinforcement.  

 

What all of these theories have in common is that healthy development requires positive interactions with caregivers.  Of course, there is no guarantee that healthy development will guarantee a person free of all MI and unhealthy behaviors.  Conversely, there is no guarantee that unhealthy development will guarantee that someone is destined to live a life of MI and unhealthy behaviors.  Generally speaking however, nearly all of the research illustrates that healthy development increases the likelihood of sustained mental health and generally healthy behaviors (or at least the tools to navigate the process of mistakes) throughout life.  Research also indicates that unhealthy development may put children at a disadvantage (cognitively, intellectually, and socially) and at higher risk for MI and behavior problems.

 

Connecting PPD and Child Development

 

Now that we have a little background on both PPD and Child Development, let’s tie it together.  In some extreme cases of PPD, a mother is completely unable to care for her newborn.  Many women who suffer this form of PPD are suffering so much that they can’t physically get out of bed to care for their child.  If a newborn is not being fed on demand, changed regularly, and held and interacted with often, his development is at an increased risk of being jeopardized, (physically, mentally, emotionally, cognitively ect.)  

 

Babies are social creatures; they need us to interact with because it is the most salient way they learn about the world in their early life.  Even mothers who may not be suffering from PPD in such an extreme way, but who are distant, isolated, and suffering feelings of shame and guilt may be communicating this negative atmosphere to their baby.  Perhaps their baby is being physically cared for, but he may be learning that his mom is not a source of comfort (maybe she doesn’t hold him often) or that being fussy is the only way to get her attention.  If this occurs, he may grow into a toddler who is demanding, has tantrums, or acts out because it is the only way he knows how to get the attention he so desperately needs.

 

There is limited research on PPD and child development, mostly because research would need to be long term which requires both the researchers and the participants (mothers and children) to stay in communication for a number of years.  The research that does exist indicates that children whose moms suffered from PPD may be at a higher risk for cognitive, intellectual, and social challenges, especially if the mother does not receive any treatment and the depression does not go away, (or goes away and comes back frequently.)  When mothers who did not suffer from PPD and their children were compared to mothers who did suffer from PPD and their children, the interactions between mother and child, as well as the child’s behavior in middle and late childhood were often drastically different.  Children of mothers who had PPD had increased behavior problems in school, increased challenges with social interactions, and lower academic performance.  Mother-child interactions were often lacking in warmth and attunement, and when mothers did appear warm to their children, the children often mirrored the mother’s behavior while in her presence (appearing sad or fussy/anxious).

 

So where does this leave us?

 

American society tells mothers that they should be happy they have a baby, regardless of their experience of pregnancy, birth, and the postpartum period.  This is not only ignorant, but a slap in the face to mothers everywhere.  We willingly sacrifice so much to bring these precious babies into the world, and we are expected to come through it as if nothing drastic happened.  The truth is, any life changing even has the potential to impact and change you, no matter who you are.  We must revive a society that supports mothers, allows mothers to connect, and informs mothers of their options, choices, and freedoms so that they are empowered to seek help (and not be criticized for it) if need be.  When we help mothers, ultimately we help children too.  Perhaps the ways in which this help manifests will not be obvious, but shouldn’t we try?  Shouldn’t we support mothers so that we are helping them give their children the best chance at success?  PPD isn’t about being weak, it’s about how some women need some extra help to get through such a significant event in their lives, and it shouldn’t matter how they got there (being a mom, or having PPD.)  All that matters is that PPD can take a toll on both the mother and her baby, and it is our responsibility to help, in any way we can.  

 

References

 

 

 

 

 

 

 

 

 

 

 

 

 

  • Banti, S., Mauri, M., Oppo, A., Borri, C., Rambelli, C., Ramacciotti, D., Montagnani, M.S. … Cassano, G.B., (2011). From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Comprehensive Psychiatry, 52(4), 343-351. doi: 10.1016/j.comppsych.2010.08.003
  • Dennis, C., & Chung-Lee, L. (2006). Postpartum Depression Help-Seeking Barriers and Maternal Treatment Preferences: A Qualitative Systematic Review.  Birth: Issues in Perinatal Care, 33(4), 323-331. doi: 10.1111/j.1523-536X.2006.00130.x
  • Field, T., Sandberg, D., Garcia, R., Vega-Lahr, N., Goldstein, S., & Guy, L. (1985). Pregnancy problems, post partum depression, and early mother-infant interactions.  Developmental Psychology, 21(6) 1152-1156.
  • Goodman, J.H., & Santangelo, G. (2011). Group treatment for postpartum depression: A systematic review. Archives of Women's Mental Health, 14(4), 277-293. doi: 10.1007/s00737-011-0225-3
  • Halonen, J.S., & Passman, R.H.  (1985). Relaxation training and expectation in the treatment of postpartum distress. Journal of Consulting and Clinical Psychology, 53(6) 839-845.
  • Hay, D.F., Pawlby, S., Angold, A., Harold, G.T., & Sharp, D. (2003). Pathways to violence in the children of mothers who were depressed postpartum.   Developmental Psychology, 39(6), 1083-1094.
  • Hopkins, J., Campbell, S.B., & Marcus, M. (1987). Role of infant related stressors in postpartum depression. Journal of Abnormal Psychology, 96(3), 237-241.  
  • Leadbetter, B.J., & Bishop, S.J., Raver, C.C. (1996).  Quality of mother-toddler interactions, maternal depressive symptoms, and behavior problems in preschoolers of adolescent mothers. Developmental Psychology 32(2) 280-288.
  • Leahy-Warren, P., McCarthy, G., & Corcoran, P. (2011). Postnatal depression in first-time mothers: Prevalence and relationships between functional and structural social support at 6 and 12 weeks postpartum. Archives of Psychiatric Nursing, 25(3), 174-184. doi: 10.1016/j.apnu.2010.08.005
  • Juntunen, C.L., & Atkinson, D.R. (2002) Counseling across the lifespan. Thousand Oaks, CA: Sage Publications, Inc.
  • Mauthner, N. S. (1999).  Feeling low and feeling really bad about feeling low: Women’s experiences of motherhood and postpartum depression. Canadian Psychology, 40(2), 143-161. doi: 10.1037/h0086833
  • Poobalan, A. S.,  Aucott, L. S., Ross, L., Smith, W.C. S., Helms, P. J., & Williams, J. H. G.  (2001). Effects of treating postnatal depression on mother-infant interaction and child development: Systematic review. The British Journal of Psychiatry, 191(5), 378-386.
  • Tronick, E., & Beeghly, M. (2011). Infants’ meaning-making and the development of mental health problems. American Psychologist 66(2), 107-119.

 

Read 953 times Last modified on Thursday, 28 June 2012 14:14
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