Incorporating treatment
But finding a way to integrate both screening and treatment into an already tenuous health care environment can be challenging. "We should be bringing this stuff right into pediatrics," Weitzman says. They have found that a simple screening, whether it is via a paper survey or simple questions from a pediatrician, is feasible to incorporate into a standard well-child visit. It will help, she notes, if pediatricians are aware of some of the red flags, such as infrequent (or overly frequent) doctor visits, negative description of young children or other behavioral signals. But once doctors recognize signs of depression, there are often few resources—especially for disadvantaged families—to recommend and even fewer on-site cognitive behavior therapy programs like the one in the study. And even in their study, Weitzman notes, there were high dropout rates, which emphasize the need for treatments that are easy for families.
Beyond the challenge of providing sessions and making sure those who need treatment get it, the cost of these programs can be prohibitive. Finding a way to establish screening and treatment protocols so they are not only convenient for families and practitioners but also integrated into the reimbursement structure is likely to be difficult. Because many programs address postpartum depression through six months, it can be hard to find reimbursable programs that will address maternal and parent-child bonding in treatment, Cooper notes.
As with other diseases, however, treating it is likely to pay off in the long run. Depressed adults often miss work or have trouble retaining consistent employment, resulting in lost productivity. "We know that depression is a huge cost to our society," Cooper says. And beyond the individual, improving parental state of mind pays long-term dividends for improved child development, she notes, adding that any booster to "foster those bonds and make sure those children have the most quality early childhood experience" is a solid investment. Citing a frequently used figure for cost-benefit analysis, Cooper notes that, "for every $1 invested in early childhood, we save $8.… If you think of it in terms of prevention, this is a huge benefit to society."
First, however, the concept surrounding maternal depression needs to change, Weitzman notes. "Depression is a chronic disorder—it waxes and it wanes," she says. "We just need to expand and broaden our thinking [from the idea] that there's this short time after the birth of a baby that someone can be depressed."
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7 Comments
Add CommentIt's very sad that, not everyone makes a good parent or produces a healthy child.
Reply | Report Abuse | Link to thisNot having healthy emotions is doing what you should do like a robot. That's learned behavior without feelings.
Hope there's some type of better help in the future. So many people have to work so hard to make it through life.
My friend works with autistic teens. My heart goes out to these kids. There has to be better ways to help prevent all these problems...they struggle for a lifetime.
Reply | Report Abuse | Link to thisWith helpers like Weitzman, who needs enemies? Cognitive therapy has shown itself to be less effective than core process therapy in depression; and depressed people actually tend to have a better handle on the actual realities that they are depressed about than do "positive thinkers". Studies bear both of these things out. Also, it is arrogant for the good doc to assume that mothers don't know that their depressive lows affect their children. It's probably the most heart-breaking part of the depression itself...
Reply | Report Abuse | Link to thisIt is all about of untreated / undiagnosed Obstructive Sleep Apnea which is never considered as a Comorbid Medical condition among Primary Care Providers or for that matter, Mental Health Providers as well. Great efforts are exercised in the Medical Industry to mantain this issue under close censorship for the sake of Mega American Corporate American Industry. Otherwise the fall-out would be catastrophic for it has been some years this cover up has been going on.
Reply | Report Abuse | Link to thisChildren need to be held physically. Are all of these mothers single? My wife had severe depression after our first child was born. Everyday I came home from work, I picked my daughter up and held her while I did a wide variety of things, including cooking, laundry, vacuuming and even changing the oil in the car. My daughter turned out just fine.
Reply | Report Abuse | Link to thisWhie pst partum depresion is dreadful and often disucssed, I was diagnosed with post=partum psychosis with my second chilld and it had devastating effects.
Reply | Report Abuse | Link to thisBecause of my condition, I was unable to respond effectively to almost everything. I was committed to state hosspital, without any help, then have been in and out of counselling for my lifetime.
I entrusted my children to a relative, my husband had vanished, I had no money, no job training or employment possibilities, and it was in the early 1960s, no emotional support and medication didn't helpand I lost my children as a result.. It took nine years to regain stability, of a sort,
Post-partum psychosis symptoms are depersonalization, hallucinations, misinterpretation of reality, horrendous nihgt terrors and other incapacitating disorders.
Perhsp our lack of instinctive behaviors for raising children in a human world leaves some mothers at a loss for what to do..
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