Child Development

(Frankie) #1
The least severe and most common type of postpartum depression is known as the ‘‘baby blues,’’ a mild
syndrome occurring in up to 80 percent of new mothers that usually starts within the first few days
following childbirth and may last from a few hours to several days. (Karen Huntt Mason/Corbis)

been associated with problems for infants such as in-
creased levels of distress/irritability, protest, with-
drawal, and avoidance of social interaction. Maternal
postpartum depression has been related to insecure
parent-infant attachment in some studies but not oth-
ers. Researchers need to provide a better understand-
ing of how the timing, chronicity, and intensity of the
mother’s depression are related to the infant’s devel-
opment. In general, even though maternal depres-
sion in the postpartum period has been found to be
problematic for mothers and infants, it is important
to keep in mind that depressed mothers ‘‘don’t always
look as bad as they feel’’ (according to researchers
Karen Frankel and Robert Harmon) and that they
likely have the ability in most cases to provide ‘‘good
enough’’ parenting to their young children.


Are Interventions Effective in Treating


Postpartum Depression?


There have been two main approaches for treat-
ing postpartum depression, neither of which has had
much empirical testing. The first strategy is to focus
directly on the individual woman, with the main goal
of reducing her depressive symptoms. As discussed
above, postpartum depression is by definition a major
depression that occurs during the postpartum period.
There is ample evidence to suggest that major de-
pression can effectively be treated with psychophar-
macological intervention (i.e., antidepressant
medication). Mothers (and physicians) are generally


reluctant, however, to use medication during the
postpartum period given potential complications as-
sociated with breast-feeding. Alternatively, individual
psychotherapy has been used to help improve the
moods of depressed women. For example, Michael
O’Hara and his colleagues reported in 2000 that in-
terpersonal psychotherapy (IPT) was an effective
treatment for reducing depressive symptoms, and im-
proving social adjustment, in women with postpartum
depression. Initially, IPT involves identifying depres-
sion as a medical disorder that occurs within an inter-
personal context. The next stage of treatment focuses
on current interpersonal challenges identified by the
patient (i.e., difficulties with a partner or extended
family, role transitions, and/or losses related to the
birth). The final stage of treatment consists of rein-
forcing the patient’s competence related to symptom
reduction, as well as future-oriented problem solving
related to the potential recurrence of depressive
symptoms.
The second general strategy for treatment is to
focus on maladaptive relationship patterns or parent-
ing practices that are often associated with maternal
postpartum depression, in order to improve and en-
hance parent-infant interactions. There are a number
of techniques that have been examined, including re-
lationship-based intervention conducted in the fami-
ly’s home, interaction guidance, and touch or
massage therapy for infants. Although these ap-
proaches vary in technique, all are generally designed

POSTPARTUM DEPRESSION 313
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