Effects of maternal mental disorders after birth on the mother, infantand family
After the birth, the depressed mother may fail to adequately eat,
bathe or care for herself in other ways. This may increase the risks
of infection and anaemia. The risk of suicide is also a consideration,
and in psychotic illnesses, the risk of infanticide must also be
considered.
Very young infants can be affected by and are highly sensitive to the
environment (largely represented by the mother) and the quality of
care, and are likely to be affected by mothers with mental disorders –
especially if the mother has low mood, social withdrawal,
irritability, impaired thinking and feelings of hopelessness.
Prolonged or severe mental illness hampers the mother-infant
attachment, breastfeeding and infant care. Depressed and anxious
mothers are less likely to look at their infants’ faces and
emotionally connect with them, and they are also less likely to
understand cues of hunger, happiness or distress and, therefore, are
less responsive to the baby.
Infants of chronically depressed mothers show less sociability with
strangers, fewer facial expressions, smile less, cry more, and are
more irritable than infants of normal mothers.
Children of chronically depressed mothers do not perform as well on
thinking and intelligence tests at 18 months of age and this is
especially true for boy babies’ speech development.
Children of depressed mothers are also more distractible, less playful
and less social up to age 5.
The effects of maternal mental disorder in older children in the
family may include neglect, abuse and slower social, emotional and
cognitive development, including higher rates of school and behaviour
problems.
Maternal mental illness may have serious effects also on the marital
relationships, especially in the case of prolonged or serious mental
disorder. These may include disruption of the marriage and/or spousal
abuse by either partner.
What to do?
Although in many settings, different levels of mental health care
continues to be provided in isolation from general health care, we
know now that it can be integrated into general health care; this is
also valid for maternal mental health care.
Prevention.
The most common preventive strategy has been to modify risk factors
for maternal mental disorders. Numerous studies have evaluated
preventive interventions including social support, as well as
educational, psychological and pharmacologic models of care; other
interventions, such as exercise, massage, herbs and rituals have also
been used.
Identification of maternal mental disorders:
Simple questions asked during pregnancy and in the postpartum period
may help to identify women at greater risk for mental disorders, for
instance:
Depression: “How much of the time during the last month have you felt
down hearted and blue?”
Anxiety: “How much of the time during the last month have you been a
very nervous person?”
Psychosis: “Have you been receiving any special messages from people
or from the way things are arranged around you?”
v Management and Care
The hopeful message is that 70-80 per cent of women with maternal
mental disorders can be successfully treated and recover! This is good
news for the woman, her infant and her family! The woman and her
partner, if appropriate, should be involved in education about
maternal mental disorders, treatment and decision-making.
Another positive message is that to a large extent, the identification
and management of most of these mental disorders can be done at
primary health care level, by first line interveners, incorporated
into primary health care routines.
The Way Ahead For Mrs. Eke
Please, take her for proper assessment with a psychiatrist. She may
need medications depending on the severity of the depression, but
counseling and therapy is a MUST. Taking the children from her will
not help, rather this may make the depression worse. The good news
like I said earlier is that depression is treatable. All the best.