Adult Women and Depression - Research Paper Example

Adult Women and Depression Introduction Binge Eating and Depression Binge Eating which is one of the major problems facing people who are obese is defined as "eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time. . .or a sense of lack of control over eating during the episode" (Diagnostic and statistical manual of mental disorders. 4th ed. 2000) the main concern for obese binge-eaters are eating and shape, size and weight of the body and “report depression, anxiety, and obsessive behaviour Stunkard AJ, Wadden TA, 1992) binge-eating also involves disparagement of body-image, low self-esteem (Gilbert SE, 1986; Flack R, Grayer DG, 1975; & Stein RF, 1987) and “negative moods.” Marcus MD, Wing RR, Hopkins J, 1988) Obesity and Depression Obese people have the tendency of easily shifting into depression and experience drastic mood swings and a general urge to eat a lot. Even while being treated they revert back to excessive eating which leads them into obesity. During the treatment of obesity, the psychological problems of the individual are not addressed. Since obesity and negative moods go hand in hand, treating one problem and then the other is the best way. For the Successful treatment of binge-eating, the Cognitive- therapy in self-help programs (Carter JC, Fairbum CG., 1998) and in group settings . Telch CF, Agras WS, Rossiter EM, Wilfley D, KenardyJ, 1990 & Wilfley DE, Agras WS, Telch CF, Rossiter EM, Schneider JA Cole AG, et 1993) are made use of. Literature Review A telephone survey was conducted in Alberta in 2006 between February and June in order to assess the knowledge of the general public with regard to people’s attitude towards those suffering from depression and the kind of treatment available. Random phone calls were made to a cross section of the community to identify the right choice of participants. Many questions were put forward to gauge their knowledge on the subject of depression and attitudes towards mental health care. The rate of response was 75.2%. Among those who took part in the survey, about 75.6% of them clearly recognized what depression was. In being asked who were the best people to deal with those suffering with depression, most of them agreed that family doctors and general practioners were the most suited. 35% of the participants agreed with other health professionals that proper interventions were an important factor to deal with depression. 28% of the participants preferred to deal with depression alone, 43% of them believe that “weakness of character” was the primary cause of depression. The study also found that mental health literacy was far less in men that in women, but women make use of alcohol to cope with depression. Education and promotion of mental health are important factors to improve public awareness on literacy of mental health. Depression in Pregnant Women There is a link between depressive symptoms in pregnant women and the resultant negative birth outcome and poor health of the newborn (Field et al 2004). Negative aspects during pregnancy have adverse effects on the neuro-development of the fetus. One factor that has emerged as risk factor for depression among women in prenatal and postnatal phase across diverse cultures is the history of her relationship with her own caregivers. Women who had harsh or negative early caregivers report of depression during pregnancy and show an increase in depression from prenatal to postpartum period (Matthey, Barnett, Ungerer and Waters, 2000). The attachment theory propounds the belief that humans form attachment with their caregivers as they are born with an innate potential for it (Bolby 1988). From this perspective it becomes relevant to study the history of the relationship between a caregiver and the pregnant person. It helps in the understanding of the mental health of a woman during her transition to motherhood. Among young women who faced insecure attachments characterized by anxiety there was great risk for depression as compared to secure attachment resulting out of avoidance by the caregiver (Burge, Hammen, Davila, & Daley, 1997). Women whose fathers were either hostile or unavailable during childhood demonstrated higher levels of depressive symptoms during prenatal period irrespective of the behavior, either good or bad, of their mothers. In the pregnant adolescents depressive symptoms were found when the maternal caregiver was unavailable. There is no such symptom in the case of inconsistent maternal association on a pregnant adolescent. In the case of the young adult pregnant person it is vice versa. Inconsistent maternal behavior resulted in depressive symptoms during the prenatal period. Inconsistency in affection by the maternal caregiver is taken as an indication of lower interest in their pregnancy which leads to heightened stress levels causing depressive behavior. Adolescents who underwent negative caretaking experiences during their childhood showed chronic emotional distress during pregnancy. Interpersonal risk factor differs between pregnant women of different ages and socio -economic background. Adolescent and young adult pregnant women who face socio-economic stressors show heightened depressive symptoms during pregnancy. This is especially true in the case of women of color, as they are disproportionately affected by poverty. There is an increased risk of them undergoing stress and depression during pregnancy (Deal & Holt, 1998). The meaning and implication of pregnancy differs among various cultures. This influences the pregnant women in their emotional experiences during their prenatal period (Beck, 2006). Depression in later life Depression in old people and the ageing is a modern malady which is only slowly being recognized as a clinical disorder. Some of the main reasons why this comes about is because of the physical problems brought on by old age, but it is in no way a part of the ageing process. The symptoms of this disease in the old are same as those in young people, but often it is less obvious. Lack of sleep, loss of appetite and low levels of mental functioning are brushed aside as symptomatic of old-age but often these are signs of depression which in extreme cases lead to suicide. Demographics Depression is seen in more than 16 per cent of those above 65 years, while only one per cent of the general population is found to be afflicted by the disease. The percentage of white males is greater than others. The history of depression manifests itself in old age although sometimes it is brought on due to chronic physical problems, alcohol abuse, life stresses and brain disease. Depression is seen more in women than in men and 15 per cent of widowed adults are seen with serious depression for as long as a year on the death of a life partner. Adults in late life show greater symptoms of sub-syndromal depression which turns into major depressive disorder subsequently and here to females are more prone to this. Causes and symptoms Depression may be brought on in old individuals due to already existing medical conditions like coronary artery disease, certain neurological disorders like Alzheimer’s and Parkinson's disease as well as dementia, metabolic disturbances like diabetes, cancer particularly pancreatic and other diseases like arthritis, chronic pain and sexual dysfunction. Medications taken by the elderly may sometimes lead to a depressive state. These include certain cardiovascular drugs, chemotherapeutics, drugs that treat Parkinson’s disease, anti-inflammatory drugs, sedatives, anti-psychotics, anticonvulsants, certain stimulants, and hormones. Elderly people rarely speak about their depression, considering it a part of the ageing process and also because they do not hope for any intervention. The symptoms seem in them are different from those seen in younger people. This can include unexplained physical complaints, a feeling of helplessness leading to hopelessness, unfounded anxieties and worries, complaints about memory loss, anhedonia, or a feeling of loss of pleasure. They also exhibit slow movement and stooped posture, irritability and disinterest in care of the self, disturbed sleeping patterns, lowered appetite, weight loss, fatigue and poor concentration. Diagnosis A clear diagnosis shows lack of energy, sleep disturbance, anhedonia, low mood, feeling of worthlessness, low concentration and difficulty in making decisions, anorexia, retardation and suicidal ideation which are the nine parameters to diagnose depression and a person is so diagnosed if he has five of these present for almost every day for a two-week period. Depression in elderly is also diagnosed if there is a score of 10 or more on the Beck Depression Inventory (BDI) or on the Geriatric Depression Scale. It is also advisable to do an electrocardiogram, in addition to analysis and other routine tests for elderly while trying to diagnose depression. Treatment and Prevention The most effective way of treatment for the elderly is a combination of medication and psychotherapy, which includes both talk and behavior therapy. In mild cases improvement may be seen in a couple of weeks but the full effects are seen after several months. In cases of severe depression, the timeframe may extend from anywhere between six to 12 months. Drugs used to treat depression are generally well tolerated by the elderly but close monitoring is advisable. The recovery time taken for older adults is longer than for the general populace. Depression is not avoidable but it can be prevented by following few simple rules. These include a balanced diet at regular times along with regular exercise. Regular sleep patterns and avoidance of drugs and alcohols may help to keep depression at bay. Elders living alone should have a good social network and the emphasis on having friends cannot be denied. References Beck, C. (2006). Acculturation: implications for perinatal research. American Journal of Maternal and Child Nursing, 31, 114–120. Bowlby, J. (1988). A secure base: Clinical applications of attach-ment theory. London: Routledge. Burge, D., Hammen, C., Davila, J., & Daley, S. E. (1997) The relationship between attachment cognitions and psychological adjustments in late adolescent women. Development and Psychopathology, 9, 151– Carter JC, Fairbum CG. Cognitive-behavioral self-help for binge eating disorder: a controlled effectiveness study. J Consult Clin Psychol 1998;66:616;623 Field, T., Diego, M., Dieter, J., Hernandez-Reif, M., Sachanber, S., Kuhn, C., et al. (2004). Prenatal depression effects on the fetus and the newborn. Infant Behavior &Development, 27, 216–229 Flack R, Grayer DG. A Consciousness - raising group for obese women. Soc Work, 1975, 20: 48F 487. Gilbert SE. Pathology Of eating. New York. Routledge, Sc Kegan Paul; 1986. JianLi Wang,  Carol Adair,  Gordon Fick,  Daniel Lai,  Beth Evans,  Brenda Waye Perry,  Anthony Jorm,  Donald Addington. (2007). Depression Literacy in Alberta: Findings From a General Population Sample. Canadian Journal of Psychiatry, 52(7), 442-9.  Retrieved February 19, 2009, from CBCA Marcus MD, Wing RR, Hopkins J J. Obese binge eaters: affect, cognitions, and response to behavioral weight control. J Consult Clin Psychol 1988;56:433-439. Matthey, S., Barnett, B., Ungerer, J., & Waters, B. (2000). Pa-ternal and maternal depressed mood during the transi-tion to parenthood. Journal of Affective Disorders, 60, 75–85. Stunkard AJ Wadden TA. Psychological Aspects of severe obesity. AM J Clin. Nutr 1992; 55: 524 – 532. Telch CF, Agras WS, Rossiter EM, Wilfley D, KenardyJ. Group cognitive-behavioral treatment for the nonpurging bulimic: an initial evaluation. J Consult Clin Psychol 1990;58:629-635 Wilfley DE, Agras WS, Telch CF, Rossiter EM, Schneider JA Cole AG, et al. Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: a controlled comparison. J Consult Clin Psychol 1993;61:296-305. Read More