Depression Screening Linked to Pregnancy
Category : Conceptual Options News
Guest Author | Katleen Brown
In light of all the advancements attributed to the 21st century, it is quite a wonder that the social stigma of mental health issues still lingers around stubbornly. Despite all the clinical trials and research studies conducted, many people still avoid these issues as though they are deadly viruses.
One such mental disability is depression. It is estimated that 7% of Americans suffer from depression annually, and it is the primary cause of disability among adults in developed countries. Depressive patients not only experience a lower quality of life for themselves and their family members, but they are also exposed to a higher risk of death.
Other independent studies have also shown that depression is the leading cause of disease-related disability in women across the world. More alarmingly, statistics have proved that depression is more prevalent in pregnant women and new mothers. 9% of pregnant women will experience major moments of depression while every 1 of 10 new mothers will suffer from depressive episodes.
In a bid to tackle this problem, the US Preventive Services Task Force released its latest report advising that all adults undergo screening for depression, especially pregnant and postpartum women. This report by the country’s leading preventive medicine expert panel endorses the suggestion made by the American College of Obstetricians and Gynecologists last year.
It also explains that undiagnosed and untreated depression in this high-risk group not only harms the mother, but the newborn child is also equally susceptible as well. Infants and toddlers who are exposed to depressive mothers will display altered characteristics regarding behavioral, emotional and social aspects. More often than not, they are less interactive, more difficult to calm and will experience disrupted sleeping patterns.
While the US Preventive Services Task Force’s publication strong advocates for depression screening, the groundwork have to be laid down by respective clinics and doctors. Nonetheless, this latest publication is a step in the right direction. Screening for depression can be conducted relatively easily.
The most common method subscribed by current health professionals are in the form of questionnaires, whether on paper or electronically. A widely popular choice is the Patient Health Questionnaire. This simple 9 question procedure seeks to gauge the condition of each patient through exploring different topics such as:
• Personal Mood
• Level of Fatigue
• Ability to Focus
• Interest in Activities
• Thoughts of Self-Harm
Ultimately, the ideal solution is for universal depression screening to be made available to all healthcare facilities.
Although the aim of this publication by the US Preventive Services Task Force is to create awareness among the general public, the impact of it is restricted to many areas.
First and foremost, it does not contribute towards dismissing the social stigma against mental health issues. In fact, this report might serve as a caution to others that potential depression patients should be avoided. As a result, patients who choose to avoid such situations will lie in their depression screening tests, rendering it useless.
On the other hand, these tests are not specifically catered to diagnosing depression only. They have the capability of identifying other forms of disorders such as alcohol affects pregnancy. For patients who are suffering from other forms of mental disabilities have an added incentive to lie on these screenings. Until the social stigma is addressed conclusively, screenings at healthcare facilities would only serve as an avenue for those who are against the social norm and are seeking professional help towards their mental issues.
Also, the publication can only be referred to as a guideline towards healthcare practices. It does not have any standing in the legal industry. As such, clinics and doctors who do not wish to provide these screenings are under no legal obligation to do so. For other healthcare experts who actively participate in offering these screenings, their patients are not legally bound to respond to the screenings truthfully.
While many women might not readily acknowledge that they are suffering from depression, doctors and therapists are encouraged to identify signs of depression in their patients during medical examinations. Health professionals should form a positive relationship with their patients to effectively offer their professional opinion. However, healthcare professionals have to draw the line somewhere and not cross over to unethical practices.
They are only able to offer their thoughts and diagnosis to the patients but cannot force treatment on them without consent. Even if a patient displays symptoms of depression but refuses to acknowledge or accept treatment, doctors are not able to release the status of their medical condition to other family members. Each and every patient is protected by the doctor-patient confidentiality.
After all the fuss about the social stigma surrounding mental health issues and the screening process, another issue presents itself in the form of medical treatment. While prescribed antidepressants can be used to treat effectively depression, pregnant and postpartum women are most likely to reject it. Given that their body systems are especially vulnerable to this period in their lives, the side effects of these medications can have a detrimental effect on them, and in the case of pregnant women, the unborn child.
It restricts the treatment options for this high-risk group of women and the second best choice would be to treat them with therapy. Through personal interactions with these patients, therapists can review the situation and recommend the best course of action for them.
Alternatively, cognitive behavioral therapy or light treatment are also viable options for treatment. Through light therapy, the body’s production of the serotonin hormone is altered and helps to alleviate symptoms of depression.
Depression Screening in Canada
In contrast to the United States, the Canadian Task Force on Preventive Health Care took a different stance towards the matter of depression screening at primary care facilities. Having initially supported the practice of screening in 2005, the decision was reversed in 2013.
Citing the lack of evidence about the benefits of these routine screenings, the committee concluded that these preventive measures are not conclusively effective towards identifying cases of depression in the general population. Nonetheless, the Canadian Task Force on Preventive Health Care does highlight the need for individual doctors to be on the lookout for patients who display characteristics of depression.
Mental health issues remain largely a mystery in modern society. As scientist and health experts continually explore the cause and effects of each disease, more information will become available to the public and help to dismiss the common social stigma.
With the recent report publication by the US Preventive Services Task Force, it highlights the urgent need for depression screening in pregnant and postpartum women. However, this report only serves as a guideline to healthcare professionals. The effectiveness of the publication is still restricted by other social, ethical and legal implications.
Perhaps the United States will soon learn from its neighboring country, Canada. Having issued guidelines for routine screening, they took the unusual action of reversing their decision in 2013. This decision is largely backed by the ineffectiveness of these screenings.
Nonetheless, the effectiveness of these screenings in the United States remains to be seen. Until the existing implications and social stigma can be eliminated, these screenings will only serve as an avenue for patients who are ready to acknowledge their mental disability.
Katleen Brown is a health, beauty and fitness writer. She loves to publish her articles on various health related websites. In her spare time, likes to do research, recently working for Glozine global magazine. Recognizing the unity of body, mind, and outlook, she helps empower women to tune into their innate & inner wisdom to transform their health and truly flourish. Get in touch with her on Google+, Pinterest and Twitter.