Social Support and Postnatal Depression: Causes and Treatment

Introduction: The Spectrum of Postnatal Mood Disorders

In Parker et al. there is a lengthy discussion about postnatal depression and the argument that the phenomenon is not one disease with a single set of symptoms. Instead, it is a depressive disorder of varied degrees, symptoms, and effects, ranging from the postpartum "blues" to postnatal depression and, finally, to a form of psychosis associated with extreme mood swings and harmful — even homicidal — thoughts. According to this extensive assessment of the group of mood disorders, the best treatment begins with reducing stress, allowing for social support, and creating a restful environment for the mother, including permitting her to sleep for longer intervals (Parker et al., 2002, p. 40). All of these treatment options have one thing in common: the need to ensure that the woman has adequate support during a difficult transition.

The connection between support processes and postnatal depression is a relatively strong one. As many researchers and clinicians stress, with depression of any kind, social support is frequently the key to addressing the problem and may even alleviate it to some degree. This occurs through the development of normal social interactions that allow the individual an opportunity to explore feelings and deal with them in a system of checks and balances — much in the same way that patients with dementia are offered daily reality checks such as date and time quizzes.

Social Support as a Key Factor in Postnatal Depression

One important point is that postnatal depression is often treated without medications, partly because of nursing practices that can themselves help with the problem. It is therefore essential to include social support in the repertoire of solutions. Some clinicians support the use of hormone therapy in extreme cases, as hormones are the accepted cause of the problem (1995, p. 3). Clemmens stresses that this is especially important in young mothers, as they are at greater risk for lacking social support (Clemmens, 2002, p. 551). This sentiment is shared by other researchers in this area as well (Frye & Garber, 2005, p. 1).

The link between social support and the early development of healthy parenting and healthy adjustment has been established over many years in the study of postnatal depression. Postnatal support and pregnancy support are essential to the avoidance of depression and, therefore, to the development of adequate coping skills as a parent — especially during the early postnatal period.

Pregnancy Support and Healthy Parenting Outcomes

Social support is associated with adaptation to parenthood and positive mother-infant interactions. Research has shown that if a woman lacks adequate social support during pregnancy, negative outcomes such as postpartum depression and insensitive parenting behavior may follow (Cutrona, 1984; Crockenberg, 1981). Women who receive support during pregnancy experience more positive mental and physical health outcomes during the labor, delivery, and postpartum periods than women who do not receive support (Collins, Dunkel-Schetter, Lobel, & Scrimshaw, 1993; Cutrona, 1984) (Goldstein, Diener & Mangelsdorf, 1996, p. 60).

Years of literature on the subject support the idea of building stronger social networks and access to support, especially for women who are disenfranchised — including minorities, women of low socioeconomic status, unmarried mothers, and young mothers. Park and Dimigen make clear that financial and practical support are only the beginning, and that the social-emotional aspect may actually be even more important (Park & Dimigen, 1994, p. 345).