The Case Study Of Dorothy Essay


You are to write an essay which analyses a case study in order to discuss appropriate biopsychosocial factors and nursing management or interventions relevant to that case.


Case study summary

The case study refers to a female 29 years old Dorothy who has been a mother for 4 weeks. She underwent too much pain during her delivery since she had a protracted labor after which a forceps delivery was conducted on her. Since then, Dorothy has lost interest in her new born and only tends to her after being pressurized by her husband or mother in law. Dorothy feels that having the child was just too painful. Alan who is her husband is intolerant at her lack of affection for the child. Dorothy has developed post natal depression, feeling tired, insomnia, low tolerance levels, panic, screaming. She has a feeling that her family is not supportive enough. She has then lost appetite and in turn lost weight. Dorothy has also had other factors associated to stress and trauma as discussed in the paper.


Post natal depression is a common cause of psychological disorders alongside other factors in most people. Depression expresses itself in a variety of factors such as lack of sleep, appetite, and weight loss, lack of commitments, trauma, stress, restlessness, drug abuse, suicidal thoughts and pain in various parts of the body among other psychosocial factors. This paper attempts to discuss the appropriate bio psychosocial factors and nursing management interventions related to post natal depression as presented in the case study, and the ethical issues that has erupted from the post natal depression and care (Depression, (2015).

Bio psychosocial factors that contribute to depression

Post natal depression refers to a kind of depression that develops in women after giving birth to a child. It may also affect fathers and other family members although on very rare cases. There are several causes of depression and it leads to several adverse effects if it is not handled well. Depression is a turmoil influencing state of mind and general self. Lost enthusiasm for exercises or feeling miserable and down are side effects that describe this condition. Despite the fact that the vast majority feel pitiful or down for brief periods, post natal depression is beyond feeling dismal. Depression is a genuine therapeutic condition and individuals for the most part aren't ready to simply get over a depressive state. Untreated depression that can cause adverse conditions such as work issues, strain on connections, medication and drug misuse, self-destructive musings or endeavors among other conditions.

Depression occurs to almost all individuals, post natal depression however mostly occurs to women of about 0-1 year after giving. Rubertsson, et al (2014) there are several myths and misconceptions. Most of these range from emotional balance and hormonal influences. The depression may also be caused by pain as presented in the case study. However, there are a variety of causes that are mostly associated with depression. Depression isn't a basic condition with a known reason. A few people are more defenseless to depressive scenes while others are definitely not.

Norhayati, et al (2015) explains that heredity is one of the core assertions associated with depression. Depression might be an acquired condition. One may have a higher probability of encountering a depressive issue sooner or later in their life on the off chance that one has a relative who has suffered the same condition. The real qualities included are not known. It's trusted that numerous qualities may play a factor in causing this type of depression.

Biochemical reactions are also a common cause of post natal depression in many mothers. A few people have recognizable changes in their brains with discouragement. Despite the fact that this potential reason isn't comprehended, it suggests depression begins with cerebrum work. Few scholars have associated depression with despondency, pain and pleasure that a mother encounters in their life.

Neurotransmitters in the cerebrum particularly serotonin, dopamine, or norepinephrine influence sentiments of bliss and joy and might be out of adjust in individuals with depression argues Goodman, et al (2015). Antidepressants work to adjust these neurotransmitters, for the most part serotonin. Changes in hormone generation or working could prompt the beginning of depressive states. Any adjustments in hormone states including menopause, labor, thyroid issues, or different issue could cause depression.

In relation to post natal depression, as is the case of Dorothy, moms create side effects of depression in the wake of conceiving an offspring. It's typical to be enthusiastic due to the evolving hormones, but post birth depression is a genuine condition. As sunlight hours get shorter in the winter, many individuals create sentiments of laziness, tiredness, and lost enthusiasm for ordinary exercises. This condition was called regular full of feeling issue presently it's known as real depressive issue.

According to Webb, R., & Ayers, S. (2015) situational causes of stress is another major cause of stress. Situations an individual may be having in life may trigger several changes in the emotional wellbeing of an individual. Injury, a major change, or battle in life can trigger an instance of sadness. Losing a friend or family member, being terminated, having monetary inconveniences, or experiencing a genuine change can bigly affect individuals. Situations that trigger emotions may cause depression in mothers for example, change of roles, feelings and attachment to family members.

Depression does not just develop. There are several predisposing factors that make it it more likely for some people to suffer from stress other than others. These factors are mostly related to an individual other than general conditions. Some of these conditions include gender where the women are more likely to get depression other than men. Low self-esteem, other mental disorders such as bipolar disorder, drug and substance abuse, having some illnesses or taking various medications may also pre dispose one to depression.

Barry, et al (2015) argues that post natal depression expresses itself in three ways. In some women, depression may develop before birth which is commonly known as perinatal depression. However, post natal depression may include maternity blues which is very common. In this type, a mother feels down and depressed a few days after a child is born. This however disappears after a few days. Post natal depression is similar to maternity blues but more serious in terms the period it takes. It can occur at any period in the first year after a mother has had a child.

The last type is post natal psychosis. This has also been commonly referred to as post-partum psychosis. Post natal psychosis is commonly rare and exemplifies symptoms of psychosis. Psychosis in major cases begins after a period of two weeks from the birth of a child. Post natal depression may affect women who do not have a period of mental illness as well (Brummelte, & Galea, 2016).

Nursing management interventions of post natal depression

According to Murgatroyd, et al (2015) diagnosis of depression is done through a full examination of the medical history. A patient may be referred to a psychiatrist for an in depth examination of the signs and symptoms of depression at around the pregnancy period. In spite of the fact that there have been a few examinations into avoiding postnatal dejection, there is no proof that there's anything particular one can do to keep the condition growing, aside from keeping up as sound a way of life as one can.

There are several treatment options for post natal depression. These treatment options and nursing interventions revolve around medication, psychotherapy and physical fitness of the body. Giving advice counselling and psychotherapy is one of the most important milestones in the event of offering help to troubled clients of such disorders as associated to depression. Strong advising is a treatment for milder types of postnatal depression, where it is as compelling as energizer drug. More particular treatments, for example, intellectual conduct treatment, are exceptionally compelling. Individuals figure out how to utilize their own particular abilities and assets to adapt to stresses and issues.

Figueiredo, Can?rio, & Field, (2014) holds that counseling about postnatal depression can be critical to help the new mother, their family and supporters to comprehend and help in their recuperation. Health professionals should give relevant advice on the various preparedness os such conditions, make recommendations and help clients to overcome their fears and to adapt easily to the new environments. As for the case of Dorothy, the fact that she had stayed for so long without being able to get a child is enough cause for alarm that necessitates psychiatric counseling before and after birth. The counselors should also equip her with a variety of alternatives to ensure that she has enough preparedness to deal with the outcome.

The specialist may endorse antidepressants for stress. Finding the correct solution can involve experimentation there is no real way to foresee which drug will be successful and endured by any one individual. The health professional should also put into the after effects and the side effects of various medications that affect the life of the mothers adversely in order to prevent such occurrences.

In the case that one is buying medicines from the counter, it is always advisable for one to seek the advice from the specialist before taking on any path of medication. Consequently, it is essential not to quit taking antidepressants all of a sudden without restorative counsel. Correlative treatments are also considered to be effective in treating depression. The term correlative treatment is for the most part used to show treatments and medications that contrast from ordinary western pharmaceutical and that might be utilized to supplement and bolster it. Certain correlative treatments may upgrade life and help one to look after personal physical health (Verreault, et al (2014).

Dennis, & Dowswell, (2013) explains that physical fitness is one of the most effective non medicinal methods of solving stress and distress in post natal depression patients. It's likewise truly critical to take care of physical wellbeing. It is necessary that Dorothy should engage in rigorous physical exercise and a good diet in order to reduce her stress levels. She should also conduct an examination with the health professionals in order to improve her physical well-being.

Ethical implications for post natal depression

According to Borra, Iacovou, & Sevilla, (2015) the avocation most ordinarily used to join screening is that the potential advantages of recognizing intercession adequacy adjust the danger of individual damage. Be that as it may, impressive dangers do exist. The revelation of new data may bring about further despondency or stresses, individuals may feel loaded, open to additionally chance, uncertain of whether to uncover data to relatives and disillusioned in the event that they are designated to a control gathering. Independence is said to be regarded in light of the fact that members give attention to take an interest.

Pediatric experts are being solicited to give an expanding cluster from administrations amid well-kid visits, including screening for psychosocial and family issues that may straightforwardly or by implication influence their pediatric patients. One such administration is normal screening for post pregnancy depression at pediatric visits. Post pregnancy depression is a case of a parental condition that can have genuine negative impacts for the youngster. Since it is a maternal condition, it raises a large group of moral and legitimate inquiries regarding the limits of pediatric care and the pediatric supplier's obligation and risk. There are however several dangers and risk factors associated with either screening or not screening for, post birth depression at pediatric visits.

Grekin, & O'Hara, (2014) despite the fact that an extensive variety of parental emotional wellness issues can affect child rearing practices and wellbeing results, one major clinical condition that has gotten expanded consideration concerning routine screening inside pediatric visits: post pregnancy anxiety. With expectations of empowering a more extensive discourse of the limits of pediatric care, utilization of this particular issue to examine lawful contemplations that develop from the social insurance framework and moral contemplations that are all inclusive.


In conclusion, it is evident that post natal depression and all major types of depression are caused by a variety of risk factors such as heredity, situational conditions, pain, sudden changes in the way of life and other social factors such as esteem and economic status. Pearson, et al (2013). It is also very clear that there are several clinical interventions that and non-medicinal interventions that can be carried out in order to relieve the post natal depression such as physical fitness, medication and psychotherapy. Some of the ethical considerations include screening during pediatric visits for the clinical depressions.


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