Postpartum Depression Research Paper

During the terms of pregnancy, women truly experience life-changing moments. From the moment the baby’s first kick is felt to the time of the baby’s departure after a nestled nine months in the womb, changes are occurring everywhere physically and emotionally in and with a woman's body. While bringing in a new life is an exciting and eventful time, new mothers go through a whole different experience and some may even face a prolonging case of postpartum depression. Unlike a sense of the “baby blues,” a short-lived period of feeling sorrow and separation following their new delivery, postpartum depression is a mental health illness that lasts for a longer period of time affecting the mother’s mind and actions. According to the Centers for

Disease Control, eleven to twenty percent, or approximately 600,000 women will develop postpartum depression in the United States, meaning as high as one in five women will experience postpartum depression in their lives. This mental health illness does not discriminate women from any age, race, ethnicity, or socioeconomic status, which only increases the concern of postpartum depression in the United States and why this issue should be openly discussed throughout the society.
With similar symptoms as depression, such as a loss of interest in everyday hobbies and activities, feelings of hopelessness, and a lasting “empty” mood, postpartum depression is differentiated through symptoms that revolve around the baby, such as feeling numb, disconnected, or doubting the ability to care for the child. The depression must be felt consistently for an extended period of two weeks where the mother will endure the symptoms and show a change from recent functions. In a 2014 Tejas Ear, Nose, and Throat (ENT) study, researchers found that “women who were depressed had a decreased sense of smell,” meaning if more women were aware of postpartum depression, the tendency of the issue would highly decrease because more women would alleviate their problems and get their depression treated. The first step to eradicating the lack of knowledge of mental health issues such as postpartum depression is to raise awareness. In correlation to the ENT study, noses do more than just help humans smell, noses can detect a change in behavioral patterns. Considering the works of Scents and Sensibility: A Molecular Logic of Olfactory Perception, Richard Axel, University professor in the Department of Neuroscience at Columbia University and investigator at the Howard Hughes Medical Institute discusses the utter importance of the human nose through linking how the nose functions and to its moderations in the human perception. The connection between the numerous and wondrous functions of the human nose and the human chemical signals prompts the question: Can sense of smell be used as an indicator of depression in postpartum women?
The human nose is responsible for more than what humans give credit for because not only is it used for the smell but the nose is responsible for sending information to the brain based on the human perception of the different tastes and emotions that are encountered in everyday life.

As previously mentioned, Richard Axel’s work of Scents and Sensibility discovered that there are more than 1,000 olfactory genes with each its own unique encoding olfactory receptor. As odorant molecules are detected, these molecules can go through either two of these passages referenced as the orthonasal olfaction or the retronasal olfaction. Scientists at the Monell Center, the “world’s only independent, non-profit scientific institution,” have connected an increase in diseases and aging can affect the maintenance of a normal sense of smell. According to the collective studies of Andreas Keller, medical expert in smell perception at the Rockefeller University, and Dolores Malaspina, professor of psychiatry at the NYU School of Medicine, uncovered the concern and relevance of making olfactory dysfunctions a concerning issue because it disrupts the quality of life. The detection of a decrease in sense of smell with mothers who suffer from postpartum depression would allow the mothers to detect the depression before it got to the point where treatment is required. Women from lower socioeconomic backgrounds would benefit from this circumstances because money that would have to be spent on

treatments for the depression, can be saved for other expenses, like for the baby.
Despite the fact that postpartum depression does not single out women based on age, race, ethnicity, or socioeconomic status, treatment for postpartum depression is selective of the group of women who can get treated.

Typically, women of higher socioeconomic status have a leverage on the access for treatments because of their capabilities but the truth is, fewer than half of the women who experience postpartum depression will seek treatment. On the other hand, women from of lesser socioeconomic status suffer the most because access to the treatments is not within their reach.Treatments for postpartum depression include psychotherapy, antidepressant medications, and electroconvulsive therapy. Dr. Andrea Macari, a nationally known clinically psychologist and media personality, is one of the most renowned in the profession of psychotherapy. Through psychotherapy, she uses this as an opportunity to use communication to help her patients. For women who may not have the money for the treatment, an option for them is once the hindrance of scent is detected, this could raise a realization and halt the

depression.
When the mother is affected by postpartum depression, the whole family is affected. Nicole Letourneau, expert professor and advisor in the Faculties of Nursing and Medicine at the University of Calgary, states that the whole family will feel the effects of the mother’s depression. While mothers tend to be the popularized topic on this mental health issue, fathers go through just as much. Compared to the ten to twenty-five percent of mothers that face postpartum depression, ten to fourteen percent of fathers will develop the depression. On a marital stance, both the mother and father can be screened in order to identify and diagnose their current level of the postpartum depression. Developed in Scotland to assist primary care health professionals in determining the severity of the depression, the Edinburgh Postnatal Depression Scale, or EPDS, is a “brief ten-question self-report” that reflects the moods over a course of seven days. For example, a question from the EPDS can go from “I have been able to laugh and see the funny side of things” as severe to “[t]he thought of harming myself has occurred to me”. Because the EPDS has been translated into many different languages and is used worldwide, thus, proves that the issues of postpartum disorder affect more than just one area in the world. While the EPDS provides a screening test for all women of all ethnicities, the test is culturally limited because there is a lower precision to the translated EPDS compared to the original English version. According to Sumitra Devi Shrestha, doctor in affiliation with the Ministry of Health and Population and Lifeline organization in Nepal, it is the only screening tool that can determine this mental health issue but with a cultural and societal block in the way, it prevents a problem in determining postpartum depression. Results found that out of the 1281 records, most of the non-English speaking and low-and-middle income countries did not meet the criteria for formal validation for using the screening test. On the other hand, more developed countries such as Holland, Australia, Sweden, Italy, Spain, United Arab Emirates, France, and India are validated to effectively use the EPDS.
As a culture, there is a lack of appreciation in the five senses: sight, smell, hear, taste, and touch, till it is lost. In his collection of mind-twisting three-dimensional art pieces, Joe Hill, England’s professional three-dimensional artist, invites the reader to break down and interpret the images using their eyes perception of the work. The use of smell is just as important as the eyes, as proven in a 2010 to 2011 South Korean study. Led by Joo Yh, affiliated to the College of Medicine in Seoul Korea, discovered upon the study that an olfactory dysfunction was associated with an increased risk for depressed mood and suicidal intentions because the dysfunction got in the way of daily life. Thus, with South Korea’s findings, only proves that mental health issues are not highly addressed which is why the distinction between short-lived baby blues and long-lived postpartum depression is unclear within society.
Even within the world of psychology, postpartum depression has not made a clear mark, which is understandable as to why society has not caught up. Recently, as of 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM), written by the American Psychiatric Association, progressed as it has recognized the depression during pregnancy as well as in the four weeks following delivery as “peripartum onset” as a step forward. The DSM also referred to as the “bible of diagnostic criteria”, had categorized postpartum depression into the Mixed Depression and Anxiety Disorder and Obsessive Compulsive Disorder categories because the APA had generalized postpartum women to be present with mixed depression and anxiety anyways. It makes sense as to why many cases of women who suffer from postpartum depression go untreated because professionals themselves do not recognize the severity of the illness.
In order to lessen the amount of women who face the effects of postpartum depression, the initial step of awareness must be taken. If more women would take their symptoms into consideration and reach out to their family and friends, there would be a predicted decrease in the rate and percentage of women diagnosed with postpartum depression. Another method that could be developed in the near future is a “scratch n’ sniff” procedure that would have the ability to detect the different scents that trigger depression by the human noses. Unlike the EPDS, a simple “scratch n’ sniff” does not require any analysis or interpretation of any questions. The creation of a sniff test for detecting postpartum depression was inspired by researchers at Columbia University who created the University of Pennsylvania Smell Identification Test (UPSIT) used to identify the loss of odors in patients with Alzheimer's. If a sniff test can be used to detect Alzheimer’s, there can be a way to detect the depression firsthand. While this idea of a “scratch n’ sniff” test is fairly new, it would revolutionize the way health professionals could observe diseases and illnesses as its most obvious implications. Because the sniff test is a developing idea, even for Alzheimer’s disease, it would come with many limitations. These limitations include discovering specific scents that may link or trigger the brain into perceiving the depression and how it relates to the progression of the depression itself. With this in mind, the world of mental health illness will forever change with the progression and awareness of postpartum depression. Overall, there is no certain solution to curing postpartum depression, but with the elevated perception and awareness of the mental health issue, each change forward is a step in progression.