More than the “Baby Blues”
Many women experience severe depression during pregnancy and after childbirth. In fact, depression is a major public health issue for childbearing women around the world. Unfortunately, depression during this time period often remains undiagnosed and untreated.
As the Canada Research Chair in Perinatal Community Health, Dr. Cindy-Lee Dennis, appointed at U of T’s Lawrence S. Bloomberg Faculty of Nursing, aims to improve the provision of care to women in the perinatal period (that is, from pregnancy to the first year post-partum). Her research focuses on post-partum depression, a condition with, often, disabling symptoms such as sadness, insomnia, confusion, anxiety, guilt and suicidal feelings. Low self-esteem, an inability to cope, and feelings of incompetence and loneliness frequently exacerbate those symptoms.
Dennis’s research has found that health professionals can play a significant role in detecting and managing depression among pregnant women and new mothers. She and her team have identified a variety of barriers that keep mothers from seeking help, including the inability to identify signs of depression, the fear of stigmatization, and simply not knowing where help can be found.
There are also cultural differences that complicate detecting and treating this condition, such as traditional post-partum rituals and even culturally-unique depressive symptoms. These differences can present problems in identifying depression in non-Western populations if Western-developed tools (which rely on self-reporting of feelings and emotions) are used. Because of Canada’s increasing immigrant population, and because recent research suggests immigrant mothers are significantly more likely to develop depression than Canadian-born mothers, it is vital to understand this cultural component in order to adequately detect depression among this population.
Dennis’s multidisciplinary research program is also looking at innovative approaches to preventing and treating depression during the perinatal period. She is the principal investigator of two major research projects. The first is evaluating the effectiveness of mother-to-mother support in preventing post-partum depression among high-risk women. The second, involving more than 25 health regions across Canada, is evaluating the effect of telephone-based psychotherapy in treating post-partum depression among women in rural and remote areas. Both trials will include complete economic evaluations and, if they are found to be effective, will offer planners virtually all of the information required to implement these techniques in their own jurisdictions.