Class 8: Postpartum Depression Flashcards
psychosocial complications in the PP period have implications for the… (3)
- mother
- newborn
- entire family
what implications might psychosocial complications have on the mother, newborn, and family?
- may interfere w attachment to newborn and family integration
- may threaten safety and well-being of mother, newborn, and other children
define: perinatal mood disorders
- includes anxiety or major and minor depressive episodes that occur during pregnancy or in the 1st 12 months after delivery
perinatal mood disorders (PMD) encompass: (5)
- depression
- anxiety
- OCD
- bipolar disorder
- psychosis
baby blues are considered…. they could be categorized as??
- a normal variant of PMD
- could be categorized as a “mild depression”
describe the occurrence of baby blues
- common, up to 80% of birthers
PMD can eventually…
- incapacitate birthers to point of being unable to care for themselves and their babies
define: baby blues
- a “normal”, mild, transient condition affecting up to 80% of birthers, all ethnicities
when do baby blues occur?
- begin 3-4 days after childbirth
- peaks on days 4-5
- resolves within 2 weeks
= time limited, if beyond = something else
what are signs of baby blues (10)
- emotional lability
- crying
- feeling down
- depressed
- restless
- fatigue
- insomnia
- headaches
- anxiety
- sadness and anger
those w severe symptoms of baby blues may be at greater risk of…
- PPD
baby blues are mild, it does not??
- impair function, resolves on its own
what is included in nursing care for baby blues
- encouraged to rest
- take care of self
- discuss feelings
- it is self limiting
what is included in perinatal mood disorders ? (3)
- perinatal anxiety disorders
- perinatal depression/postpartum depression
- postpartum psychosis
perinatal mood disorders occur when?
- during pregnancy or within the 12 months after birth
define: paternal mood disorders
- partner w depression/anxiety in the PP
what are risk factors for perinatal mood disorders? (7)
- depression or anxiety during pregnancy
- recent stress
- traumatic birth experience
- preterm birth/infant admitted to NICU
- low social support
- personal history of depression
- breastfeeding problems
what are major risk factors for perinatal depression (8)
- adolescent birthers
- low education lvl
- recent immigration
- depression or anxiety during pregnancy
- family hx of depression
- personal hx of depression
- lack of social support
- recent stress
what are other risk factors for perinatal depression (4)
- low self-esteem
- relationship difficulties
- lower socioeconomic status
- obstetric or pregnancy complications
PP depression without psychotic features is characterized by: (5)
- low mood
- lack of interest in activities
- can be mild to severe
- functioning impaired
- SI or HI can be present
what is included in treatment for PP depression without psychotic features (5)
- antidepressant/antianxiety meds
- electroconvulsive therapy (if not responding to meds)
- supportive care
- psychotherapy
- monitoring for suicidal or homicidal thoughts
PP anxiety disorders includes: (7)
- GAD
- OCD
- panic disorder
- panic attacks
- phobias
- social anxiety disorder
- PTSD
PP anxiety disorders are characterized by.. (6)
- irrational fear & worry r/t newborn
- trembling
- NV
- dizziness
- dyspnea
- insomnia
- OCD in PP w obsession & compulsions toward the infant (checking, washing), thoughts of harm to infant (v. distressing to person)
what is included in treatment for PP anxiety disorders (4)
- CBT
- SSRIs
- education
- psychotherapy
what is included in dc teaching for PP anxiety disorders
- teach that anxiety can worsen during PP –> may help w coping
describe the occurrence of PP psychosis
- rare (0.2%) but recurrence is high (30-50%)
what causes an increased risk of PP psychosis
- if pre-existing bipolar disorder
PP psychosis is characterized by? (5)
- depression
- hallucinations
- delusions
- thoughts of harming infant or self
- symptoms of depression may already have been present
describe symptoms onset of PP psychosis
- onset sudden , over 24-72h timeframe, within the 1st month PP
PP psychosis is a …
- psychiatric emergency
PP psychosis often requires
- psychiatric hospitalization
what is included in treatment of PP psychosis (2)
- antipsychotics
- mood stabilizers (ex. lithium)
what is included in mngmt of PP psychosis
- cannot be left alone or alone w infant/children
what is included in prevention for PP psychosis
- screening for perinatal mood disorder
when should screening for perinatal mood disorders occur? (3)
- during pregnancy
- PP unit
- in community
what is included in nursing care on the PP unit (5)
- review prenatal record
- look for warning signs
- assess for supports
- offer referral to SW and other resources
- notify provider if concerns
what is included in nursing care for PP psychosis in the home & community? (2)
- PHN’s play lrg role in assessing for PP mood disorders
- may need to refer to resources or contact crisis services if warranted
what is key w PP psychosis?
- safety is key –> need to ask about SI and HI
what are warning signs of PP psychosis on PP unit (6)
- refers to self as ugly and useless
- markedly depressed
- lacks social support
- refuses to interact w or care for baby –> ex. not responding to criers
- has difficulty sleeping
- experiences loss of appetite
why is it imp to screen for perinatal mood disorders?
- screening helps to identify & treat earlier
what is 1 tool used for screening for perinatal mood disorders? what score indicates requirement for closer monitoring?
- edinburgh postnatal depression scale
> =13 = close monitoring
what is included in nursing assessment/role on the PP unit (6)
- observe infant-mother bonding
- discuss perinatal mood disorders w all families, and advise of resources if these concerns arise
- give mom & family the resources in a handout
- advise about normal baby blues vs abnormal
- encourage woman to practice self-care daily
- encourage her to reach out to community supports
what is included in nursing assessment/role on the PP unit (6)
- observe infant-mother bonding
- discuss perinatal mood disorders w all families, and advise of resources if these concerns arise
- give mom & family the resources in a handout
- advise about normal baby blues vs abnormal
- encourage woman to practice self-care daily
- encourage her to reach out to community supports
perinatal mood disorders can occur …?
- anytime during pregnancy or up to 12 months PP
who should receive info on PP baby blues and what to expect?
- all individuals
encourage individuals and their partners to… (2)
- monitor carefully for signs of a mood disorder
- seek care as soon as possible
if there are concerns for self-harm or harming the infant PP, or symptoms of psychosis, what is always required? (2)
- emergent care
- individual and infant are not to be left alone
