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Post-adoption depression syndrome, or PADS, is similar to postpartum depression (PPD). In fact,  the symptoms are the same in this condition because adoptive and biological mothers are exposed to many of the same environmental changes. The term itself was coined by June Bond in her spring 1995 article for Roots and Wings magazine. It is a depression that affects how people think and feel, as well as their behaviour and physiology. The incidence of depression in women is between 10% and 26%; for men, it is between 5% and 12%. Depression may result from a traumatic life experience, stress, a genetic cause, or some combination of these.

Definition:

Post-adoption depression syndrome (PADS) shares some characteristics with postpartum depression (PPD) and minor depression, and it may appear about a month after placement. However, adoptive mothers lack the exposure to the hormonal changes associated with parturition.

The symptoms:

In general, low mood and reduction in feelings of pleasure are accompanied by some of the following symptoms in a two-week period:

Feelings of panic, inadequacy, anxiety, being slowed down, inability to obtain enjoyment from life, guilt, low self-esteem, and loneliness.

Physical symptoms include lack of energy, sleep problems, tension headache, stomach problems, fatigue, forgetfulness, loss of or gain in appetite, and inability to concentrate.

Women suffering from PADS may experiencing feelings of despair, irritability, and anger. They may also exhibit a pessimistic outlook.

Causes:

1- Issues related to personal fertility: The adopted child may remind the mother of her inability to have a biological child.

2- Feelings of guilt for having another woman’s baby. The new mother may feel she has no right to have the adopted baby.

3- The related expenses. As a common problem, the increased financial responsibility can affect the couple if they have not done their homework prior to the adoption.

Contributing Factors to PADS:

1- Post-stress fatigue occurs when the adoptive parents feel tired or resentful due to the frustration and complexity of the bureaucratic process associated with adoption. Some adoption processes may go beyond the parents’ expectations, negatively impacting their emotions and sometimes causing them to feel out of control.

2- Parenting stress occurs when parents are taking care of a child for the first time. They may find they are faced with an unexpectedly difficult task, which may arouse confusion, fears,and feelings of defeat and inadequacy. They may worry they are not the committed parents they thought they were, which will elicit further confusion, feelings of sadness, and low self-esteem. Parents may also experience feelings like guilt because their adopted child is not as perfect as they expected or imagined.

3- High expectations: Some adoptive parents are may also prone to depression because of high and/or unrealistic expectations they place on the adoptive child and on themselves. This may be related to thoughts parents have that life might become easier when they become a family, without consideration of the need to adjust to a new life together. Such an adaptation requires patience, understanding, time, and wisdom—qualities that may not be easy to come by for many parents.

4- A lack of social support is an important factor, especially when others disapprove of the decision to adopt. This may force parents to doubt their decision. Additionally, some parents may discriminate in their treatment of the adopted child, which also may leave the parents feeling helpless and ashamed, and it may increase their negative feelings.

5- Doubts or negative thoughts linked to adoption occur especially when parents feel they have no right to the child since they are not his or her real parents. These doubts can lead to fear and concerns about possible failure.

Treatment:

1- Reaching out for help with the adoption agency: Agencies do offer  this kind of support after adoption.

2- Consulting a therapist: Talking to a professional who understands the unique nature and dynamics of the situation is important. A professional can provide options—from medication to family counselling.

3- Meeting other adoptive parents and joining a support group, online or in person, is important. Making connections with other parents with similar issues, especially in online communities, will help reduce feelings of isolation.

4- Taking a break: Taking some time off to think and reach out to family members and trusted friends can give adoptive parents a break from their duties, even if only for a few hours.

5- Taking control of one’s emotions and seeking a therapist for help—with or without medication—will help improve the situation  in the long term.

Breastfeeding

The value of breastfeeding in supporting the growth and development of infants is recognised worldwide and widely accepted. Breastfeeding can play a significant role for the baby and mother to develop an attachment relationship.

With regards to breastfeeding for adoptive mothers, it might be possible to induce lactation without pregnancy with considerable dedication and preparation. The natural production of breast milk is triggered by three hormones—progesterone, oestrogen, and human placental lactogen—in a complex interaction during the final months of the pregnancy. To initiate milk production, the levels of oestrogen and progesterone fall at delivery. A health care provider might prescribe hormone therapy, such as oestrogen or progesterone, as a supplement to mimic the effects of pregnancy, which can take six months or more.Then, a mother can begin pumping her breasts using an electric breast pump to encourage the release of prolactin and stimulate further milk production.

The effort:

Lying down with the baby skin-to-skin for a long period of time.

Taking a bath with the baby.

Sleeping very close/near the baby.

Holding the baby while breastfeeding him/her.

The impact:

Breastfeeding is not just a provision of nutrition. The suckling has impacts on both the mother and the child:

•             reduces metabolic and heart rates.

•             calms infants and provides analgesia.

•             reduces the ability to perceive pain to infants during suckling.

•             suckling at the breast stimulates the infant’s mechanoreceptors and oropharyngeal tactile stimulation, which also focuses attention on the mouth and reduce the outside influence.

•             the absorption of fat from milk stimulates the release of cholecystokinin, a hormone which activates a mechanism that induces relaxation and pain relief.

•             the skin-to-skin contact that occurs during breastfeeding stabilises body temperature, respiration rate, and blood glucose level.

•             reduces blood pressure and stress hormone release

•             involves intimate social interaction between mother and baby, which may release the anti-stress hormone, oxytocin ..

References

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