Postpartum depression in adolescent mothers

Impact and prevalence

According to the DSM-5, postpartum depression (PPD), also known as postnatal depression, is characterised by psychological and physical symptoms – including anhedonia, depressed mood and abnormal differences in sleep patterns – with a postpartum onset within one month after childbirth. Long-term effects of PPD, which are the same for adult and adolescent mothers, include weaker attachment between the mother and the child and developmental delays in children.

Whilst treatment methods for postnatal depression have been more thoroughly investigated in adult mothers than in teenage mothers, prevalence rates of postpartum depression are found to be higher in adolescent mothers, with teenage mothers being twice as likely to be depressed as adult mothers. Postpartum depression in adolescent mothers is a prominent concern, as studies have found that up to 57% of teenage mothers report moderate to severe symptoms of PPD.

Risk and protective factors

A definite risk factor for postpartum depression in teenage mothers is a lack of social support. Research shows that adolescent mothers face more challenges but have fewer resources and less social support than adult mothers. This is prominent in Barnet et al.’s (1996) research, which found that adolescent mothers who received emotional support from either their mother or the baby’s father were less likely to exhibit depressive symptoms postpartum. Others support this research and suggest that social support has a direct effect on PPD in teenage mothers. Additionally, a lack of wider social support results in stigma, with a common assumption being that young mothers are incompetent parents and that children should not raise other children. Thus, another aspect of the lack of social support that might lead to PPD is stigma. However, an abundance of social support can also be detrimental, as it might make the young mothers feel incapable or inadequate, also leading to postnatal depression. Therefore, it is vital to determine the appropriate amount of support required for adolescent mothers.

Another important risk factor affecting adolescent mothers that leads to postpartum depression is stress, which can be, but does not have to be, caused by a lack of social support. Research shows that higher stress levels are positively associated with depressive symptoms, and teenage mothers who reported higher stress levels displayed higher levels of PPD than adolescent mothers with lower stress levels. Therefore, in order to reduce the rate of postpartum depression in adolescent mothers, interventions should focus on decreasing the mothers’ stress levels.

A crucial protective factor for PPD in adolescent mothers is self-esteem. Logsdon et al. (2005) found that lower self-esteem was predictive of postnatal depression in teenage mothers, and Caldwell & Antonucci (1997) found that self-esteem has a strong negative correlation with PPD symptoms in adolescent mothers. Therefore, higher self-esteem can shield young mothers from postpartum depression. 

Conclusions

Overall, adolescent mothers are a particularly vulnerable population due to the additional challenges they face and the common lack of preparation for motherhood amongst teenage mothers. Social support, both a lack thereof or an excess amount, is commonly identified in the literature as a key risk factor for PPD in young mothers, as well as stigma and stress. High self-esteem and confidence in one’s own parenting skills are prominent and promising protective factors.

The few interventions that are present demonstrate a promising start towards developing ways to tackle PPD in adolescent mothers. However, there has not been an extensive meta-analysis evaluating existing interventions, a clear limitation and a gap in the literature that should be addressed in future research. 

Written by Aleksandra Lib

Related articles: Depression / Depression in children / Childhood stunting / Gynaecology

REFERENCES

American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). 

Barnet, B., Joffe, A., Duggan, A. K., Wilson, M. D., & Repke, J. T. (1996). Depressive symptoms, stress, and social support in pregnant and postpartum adolescents. Archives of pediatrics & adolescent medicine, 150(1), 64-69.

Caldwell, C. H., Antonucci, T. C., Jackson, J. S., Wolford, M. L., & Osofsky, J. D. (1997). Perceptions of parental support and depressive symptomatology among black and white adolescent mothers. Journal of Emotional and Behavioral Disorders, 5(3), 173-183.

Deal, L. W., & Holt, V. L. (1998). Young maternal age and depressive symptoms: Results from the 1988 National Maternal and Infant Health Survey. American Journal of Public Health, 88, 266–270

Dinwiddie, K. J., Schillerstrom, T. L., & Schillerstrom, J. E. (2017). Postpartum depression in adolescent mothers. Journal of Psychosomatic Obstetrics & Gynecology, 39(3), 168–175. 

Field T. (1992). Infants of depressed mothers. Development and Psychopathology, 4, 49-66.

Logsdon, M. C., Birkimer, J. C., Simpson, T., & Looney, S. (2005). Postpartum depression and social support in adolescents. Journal of Obstetric, Gynecologic & Neonatal Nursing, 34(1), 46-54.

Radke-Yarrow, M., Cummings, E. M., Kuczynski, L., & Chapman, M. (1985). Patterns of attachment in two- and three-year-olds in normal families and families with parental depression. Child Development, 56, 886-893.

Schmidt, R. M., Wiemann, C. M., Rickert, V. I., & Smith, E. O. B. (2006). Moderate to severe depressive symptoms among adolescent mothers followed four years postpartum. Journal of Adolescent Health, 38, 712–718.