Loneliness contributes to perinatal depression

Key takeaways:

• Perinatal depression and loneliness share self-isolation, symptom hiding, emotional disconnection and lack of support.
• Researchers found a double loneliness burden for women from disadvantaged communities.

Loneliness frequently plays an important mental health role for women who experience perinatal depression, according to a meta-synthesis published in BMC Psychiatry.

“Using a qualitative meta synthesis methodology, we aimed to provide an overview of the available international research, to gain a higher order understanding of the data and to identify major overarching themes about the role loneliness plays in the day-to-day lives of women with perinatal depression,” Katherine Adlington, of the division of psychiatry at University College London and East London NHS Foundation Trust, and colleagues wrote. “Intersectionality theory states that factors like gender can interact with other socioeconomic categories, such as class and race, to influence the exclusion and marginalization of people in society.”

For a qualitative meta-synthesis, Adlington and colleagues searched Ovid MEDLINE, PsycINFO, Embase and Web of Science and identified 27 relevant primary qualitative studies that included data from 537 women (mean age, 27.7 years) on the experiences of loneliness for women with perinatal depression and worsening factors for loneliness among this population.

Researchers observed themes related to the interactions between perinatal depression and loneliness that included the following:

• self-isolation;
• hiding one’s symptoms due to stigma and fear of judgment as a “bad mother”;
• a sudden sense of emotional disconnection after birth;
• a mismatch between expected and actual support from partners, family and community;
• validation from trusted health care professionals;
• peer support from other mothers who experienced perinatal depression;
• practical and emotional family support;
• lack of professional support, groups and facilities; and
• conflict and separation from partner, family and community

In addition, researchers noted a “double burden of loneliness” for women from disadvantaged communities due to the increased stigma and decreased social support. Important factors that might aid loneliness included validation and understanding from health care professionals, peer support from other mothers with similar experiences and practical and emotional family support.

According to the researchers, previous findings demonstrated that a person’s sense of belongingness to and identification with social groups has important benefits to health and well-being, and community-level interventions that enhance community identification and peer support may improve loneliness and depression.

“The results provide a solid foundation for further theories about the role of loneliness in perinatal depression,” the researchers wrote. “They also provide evidence on which the development of future psychological and social interventions could be based, to address the stigma faced by women experiencing perinatal depression and to offer personalized and culturally appropriate support that might reduce the risk of both loneliness and depression.”