1. a) Depression is a state of mind which is experienced by some people when they feel melancholy for long periods of time or for a relatively short time span (Rabadi et al., 2017). Depression can cause serious physical and mental health problems. A huge number of people suffer from depression regularly in Australia. A different type of traumatic life events, family and abuse by any drugs or alcohol are the cause of depression that one suffers from. Depression occurs most frequently among the young females than the males. Depression has become the main cause many diseases among young females and males.
Suicide is the act of ending one’s life intentionally (Douglas, 2015). A high amount of suicide cases have been observed in Australia for the past few years. The rate is higher among the age groups ranging from 15-44 and is approximately higher among males. About 1.9 percent of death incidents are occurring from suicide. Alcohol consumption and unemployment are the two among many causes of suicide. Suicide is highly responsible for the maternal and the late maternal death in Australia and occurs most frequently. It is the outcome of the depression and the anxiety suffered by the mother during her pregnancy period.
1. b) Depression is most common among young people particularly female in Australia and is the topic of discussion in this part. It is the primary cause of all the deaths among the young people. Some of the main causes of depression are the negative environment of the family, lack of self-confidence, interpersonal problems, stressful daily life and being tormented by others (Furnham, Ritchie & Lay, 2016). Depressed young people are found to have a higher rate of anxiety as compared to the normal healthy person. The young people, who belong to this age group, are often isolated from their family and suffer from depression. The negative impact of the society is also responsible for depression.
The maternal and post maternal suicide is common and is studied here. These suicidal incidents are mainly the outcome of the perinatal anxiety and depression (Michael, 2016). The main cause of the suicidal incidents after the end of the pregnancy is the psychosocial distress. The violence starts during pregnancy and that she needs extra support from her partner. Maternal suicide may happen when their pregnancy is terminated untimely due to miscarriage or the termination of the pregnancy. The pre-existing mental problem is also responsible of the suicidal incidents among the pregnant women.
2. Scenario B has been discussed and analyzed in this section. The pregnant woman named Elizabeth is undergoing depression since her child’s birth. She was on a leave prior to her child’s birth from her job. Craig, who is her husband, has started working as a truck driver and recently he is away home for few days every week. They both had enjoyed social life before she got pregnant. These have made her isolated. Her husband could not give her enough time and she has to spend the time alone. She is feeling isolated as she is lacking any kind of social connection during the entire period of her pregnancy. Her husband should spend more time with her when she needed him as she is feeling isolated and depressed as a result of this.
The feeling of isolation and the anxiety that she was suffering from the seventh month of her pregnancy has made her to feel low and lack of energy. The hopelessness feeling due to the lack of ability to breast feed her baby and giving proper care to her made her more hopeless and depressed (Barrera, Kelman & Muñoz, 2014). Elizabeth is feeling that her baby is not well attached with her after her birth and refuses her attempt to breast feed.
Elizabeth knew that her mother was also suffering from depression during her pregnancy (Woolhouse et al., 2014). This made her more anxious. Moreover, she was successfully breast feeding her baby when she was at the hospital. She is facing a problem in doing so after her return. She feels anxious of the fact that she is not able to make a bond with her child after her birth. She is feeling helpless after returning home as she could not breast feed her child which she was yearning for long. This hopelessness feeling arouse every time she is about to breast feed her. This has made her bottle feed her baby (Murray, Fearon & Cooper, 2015). Elizabeth feed her baby at night but her husband help het to feed their baby during day. This makes her getting more into the depression and her urge to commit suicide. Elizabeth has a feeling that she is not able to take proper care of her baby. Finally, she wanted to leave her baby to others who would be able to take proper care of her baby and to whom her baby would be safe and sound.
These reasons contributed to her mental illness.
3. The action adopted for the benefit of public to prevent the harms that tends to be harmful to the life of others is termed as the beneficence (Mangual Figueroa, 2016). An example of beneficence is the resuscitation of the man who is drowning or the public vaccination programs that is carried out to reduce the risk of any disease. The attending nurse of Elizabeth must take care of her and make her feel comfortable. She should assure her that the child will gradually cooperate with her initiative of breast feeding. She would accompany her so that she would not feel isolated and get depressed (Barrera, Kelman & Muñoz, 2014). She must have a talk with her husband and ask him to provide her company. He should be aware that Elizabeth is not able to attend her job as she is in a maternal leave and that she needs proper care to get rid of her depression. She would try to increase her supports around her which will help her to reduce her loneliness and hence her depression.
The act of causing no harm to a person seeking medical help is termed as the non-maleficence. The usage of a particular drug can be stopped as it proves to be harmful rather than beneficial in case of a particular person (Bradley, 2017). The depression from which Elizabeth is suffering from must be studied and analysed. Elizabeth’s mental illness should be treated adopting methods that would cause no harm in her. She should be given antidepressants that would not have any negative impact on her body as she has just ended her pregnancy. Elizabeth should undergo a screening procedure followed by a psychotherapy trial. The psychotherapy treatment would help her recover from her mental anxiety and depression without any serious damage. Elizabeth would avoid maleficence and would stop any herbal treatment.
According to the aspects of the mental health, a patient has the right to specify their treatment procedures (Galderisi, 2017). Every person should have an easy access to the healthcare and the affordable and good quality of treatment. Elizabeth should be sent to the local health care and discuss about her mental illness. Elizabeth should be made aware of one of the Mental Healthcare Law regarding suicide. These may help to prevent her from such thoughts. She would be allowed to choose the way of treatment that she wants. The psychological treatments and the emotional support would make Elizabeth overcome her mental sickness.
4. Postpartum depression has some risk factors that affect the health of a woman (Kendall-Tackett, 2016). It is a psychiatric disorder which starts due to the biopsychosocial changes. A decrease in the gonadal steroids is the characteristics of the onset of the postpartum depression. Elizabeth would suffer from depression to a great extent. The intense hopelessness and the self guilt of not being a successful mother has made her even more depressed. These feelings have forced her to take the decision of committing suicide. There remains a risk on her part of suicidal attempt.
It is the duty of the nurse to study and identify Elizabeth’s mental problem and give her support both emotionally and physically. She needs a company whenever she wants in order to lessen her depression (Park et al., 2014). The nurse should talk with her husband and ask him to give her the comfort so that she would be able to overcome her guilt. Elizabeth is also suffering from withdrawal and low mood as she is not able to meet her child’s needs.
The low social status that Elizabeth is experiencing since her pregnancy is the major risk factor associated with her postpartum depression. Her husband should be made aware of this fact by the nurse and that he would support her. She may also suggest psychotherapy in order to cure her postpartum depression.
The major outcome of the postpartum depression is the lack of interaction of the mother with her child. This gap of communication is also suffered by Elizabeth with her new born. In spite of her great effort, Elizabeth could not breast feed her baby. This communication gap would have a serious effect on her child’s development as all the crucial developments occur during the first year after the birth of the baby (Murray, Fearon & Cooper, 2015). According to some studies, the mood of the mother is directly related to her baby’s development. The more the mother is depressed the lesser the baby would develop.
The only way that Elizabeth could reduce her depression is through counseling. Elizabeth needs to share her fear and anxiety that she is suffering from, with others (Park et al., 2014). These socializations which she is lacking since her pregnancy would play an important role in her recovery from the mental illness. Elizabeth’s mood can be recovered by exercise and by good nutrition and she must avoiding taking things that may trigger mood swings and anxiety.
5. Scenario B outlines the mental health problems experienced by Elizabeth. After giving birth, she is feeling low in mood and a prevailing hopelessness as she failed to breast feed her baby. She is also having a feeling that her baby is not so attached with her. These symptoms show that may be Elizabeth is suffering from postpartum depression that may happen sometimes after delivery (Bell et al., 2016). This mental illness may be the outcome of the sharp hormonal change that a mother experience after giving birth. This hopelessness and the thought of committing suicide is simply the outcome the postpartum depression. Elizabeth can take anti-anxiety medications after consulting with her doctor to cure her mental illness without affecting her baby.
A supportive interaction should be made with Elizabeth and it is the duty of the nurse to carry on an assessment of the mental needs required by Elizabeth. Accurate information should be gathered in order to educate the new mothers with the symptoms of the postpartum depression period. Elizabeth should get proper emotional support and education regarding her mental illness.
Elizabeth can take other options of treatment other than only emotional support. She can take antidepressant medications after consulting with her doctor and go through the psychotherapy sessions. Interpersonal psychotherapy or IPT has been one of the most effective treatments used to cure patients with postpartum depression (Miniati et al., 2014). Interpersonal psychotherapy mainly focuses on the interpersonal changes and the various challenges faced by the depressed women during their postpartum period.
Pharmacological treatment bring about metabolic changes within the mother, moreover, the baby also gets exposed to such medication through breast milk that may affect the baby in future (O’hara & McCabe, 2013). The use of the Fluoxetin, an antidepressant has lesser side effects and has a greater effect in the reduction of the depression. These medications with little or no side effects would help Elizabeth to overcome her depression. It helps to reduce the different symptoms that are associated with this type of depression.
The psychotherapy along with the pharmacological treatment is seemed to have the positive impact on the patients with postpartum depression (Dennis & Dowswell, 2013). A depressed woman like Elizabeth who suffers from postpartum depression and includes the suicidal thought that requires both the psychotherapy and the pharmacological treatment. They are often asked to get hospitalized also in order to cure her illness. The psychotherapeutic treatment may not be effective in some cases when treated without any pharmacological support.
References
Barrera, A. Z., Kelman, A. R., & Muñoz, R. F. (2014). Keywords to recruit Spanish-and English-speaking participants: evidence from an online postpartum depression randomized controlled trial. Journal of medical Internet research, 16(1).
Bell, A. F., Carter, C. S., Davis, J. M., Golding, J., Adejumo, O., Pyra, M., … & Rubin, L. H. (2016). Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study. Archives of women’s mental health, 19(2), 219-227.
Bradley, L. (2017). Non-maleficence: perspective of a medical student. Br J Gen Pract, 67(659), 252-252.
Dennis, C. L., & Dowswell, T. (2013). Psychosocial and psychological interventions for preventing postpartum depression. The Cochrane Library.
Douglas, J. D. (2015). Social meanings of suicide. Princeton University Press.
Furnham, A., Ritchie, W., & Lay, A. (2016). Beliefs about the causes and cures of depression. International Journal of Social Psychiatry, 62(5), 415-424.
Galderisi, S. (2017). Conceptual aspects of mental health in its intersection with human rights and development. European Psychiatry, 41, S8.
Kendall-Tackett, K. A. (2016). Depression in new mothers: Causes, consequences and treatment alternatives. Taylor & Francis.
Mangual Figueroa, A. (2016). Citizenship, beneficence, and informed consent: the ethics of working in mixed-status families. International Journal of Qualitative Studies in Education, 29(1), 66-85.
Michael, D. (2016). Maternal mortality trends in Australia.
Miniati, M., Callari, A., Calugi, S., Rucci, P., Savino, M., Mauri, M., & Dell’Osso, L. (2014). Interpersonal psychotherapy for postpartum depression: a systematic review. Archives of women’s mental health, 17(4), 257-268.
Murray, L., Fearon, P., & Cooper, P. (2015). Postnatal depression, mother–infant interactions, and child development. Identifying Perinatal Depression and Anxiety: Evidence-Based Practice in Screening, Psychosocial Assessment, and Management, 139-164.
O’hara, M. W., & McCabe, J. E. (2013). Postpartum depression: current status and future directions. Annual review of clinical psychology, 9, 379-407.
Park, M., Cuijpers, P., van Straten, A., & Reynolds, C. F. (2014). The effects of psychotherapy for adult depression on social support: a meta-analysis. Cognitive therapy and research, 38(6), 600-611.
Rabadi, L., Nazer, M. D. K., Ajlouni, M., Haddad, K., Masannat, S., Batarseh, G., & Al Hmoud, S. (2017). Diabetes and depression. A study.
Woolhouse, H., Gartland, D., Perlen, S., Donath, S., & Brown, S. J. (2014). Physical health after childbirth and maternal depression in the first 12 months post partum: results of an Australian nulliparous pregnancy cohort study. Midwifery, 30(3), 378-384.
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