Introduction
Research studies have shown the importance of leisure activities on mental health (Laursen et al., 2011). Strategically designed leisure activity programs can improve the mental health conditions of children and adults. Depression is one of the prevalent mental disorders in adults. Post-natal depression is a popular form of depression in women. This paper presents an activity plan for the use of leisure as a therapeutic response to post-natal depression. The prevalence of post-natal depression compels the creation of the proposed leisure program.
Women pass through three mood disorders after child delivery. The earliest stage women pass through after delivery is called the ‘baby blues’ stage. 80% of women experience this mental disorder after they give birth, which typically transpires within the first ten post-natal days. ‘Baby blues’ are characterized by symptoms such as nervousness, watery eyes, mood swings and petulance. This stage of post-natal mental disorders is temporary and fades with support and empathy (Wisner, Parry & Piontek, 2002).
The last stage of post-natal mental disorders is referred to as post-natal psychosis. Post-natal psychosis occurs during the first month after birth and affects one out of five hundred women (Ian et al., 2007). This condition affects the mother’s awareness of reality and she may not know that she is unwell. Post-natal psychosis is characterized by mood swings, interruptive cognitive patterns, strange imaginations, sleeplessness and strange reactions to the infant (Robertson, 2005). This mental disorder exposes the baby and the mother to life-threatening risks if left untreated. Patients must be admitted to the hospital and offered professional treatment till they gain full recovery (Almeida, Merminod & Schechter, 2009).
Post-natal depression is another mental disorder and occurs between ‘baby blues’ and post-natal psychosis. About 15% of the women that give birth in Australia annually have post-natal depression. The percentage may be greater because other women suffer this illness without visiting healthcare centers. Research indicates that most women are not informed about post-natal depression and may blame other factors or their families for their depressed state. Other women fail to understand that they cannot control the symptoms of post-natal depression. Women must understand the symptoms of post-natal depression and seek apposite therapeutic help (Laursen et al., 2011).
Although women are exposed to various post-natal mental disorders, this activity plan focuses on post-natal depression because of its prevalence amongst women and the possibility that women may not know the cause of their depressive conditions (Laursen et al., 2011). Also, the other post-natal mental disorders are easier to manage since they have defined treatment regimens. The following section of this paper presents an activity plan for an eight-week leisure-based program for managing post-natal depression.
Activity content and process
This activity plan is designed for clients with post-natal depression. The aim of each activity is to reduce or eliminate one or more symptoms of post-natal depression. The following section examines the content and procedures of the program. Table 1 below summarises the activities of the ‘Flexercise’ program.
‘Flexercise’ is an eight-week leisure activity plan designed for women with post-natal depression. Activities in Flexercise are designed based on a review of proven theories from literature that investigate the influence of leisure activities on depression. The program is divided into eight weeks and participants are exposed to three leisure activities weekly. These activities are repeated weekly for the span of the program.
Facilitation techniques of the program will determine its effect on the participants. Facilitation of the ‘Flexercise’ program will be made successful by delivering the activities to the clients at the same time. Although the activities selected for the program are easy and achievable at home, participants will be encouraged to take part jointly and perform all activities within the same environment.
Although the activities included in the program are selected from literature that has proven their efficiency, the success of the program can be guaranteed only when the participants’ conditions are tested before and after the program. The program will be tested as a unit and the effectiveness of the activities will not be tested singly. Participants will be subjected to the Edinburgh Post-natal Depression Scale (EPDS) before, midway, and after they are exposed to the program. The EPDS is an effective scale for measuring the efficacy of activities designed to manage post-natal depression (Vivilaki, Dafermos, Kogevinas, Bitsios & Lionis, 2009).
Several variables may influence participants’ participation in the program, which will reduce the efficiency of the planned outcome. The symptoms of post-natal depression may reduce participants’ willingness to partake in the activities. Participants will need to put in extra efforts to engage in the program because the symptoms of post-natal depression increase their willingness to be alone (Laursen et al., 2011). ‘Flexercise’ is a group-based program and participants will need extra motivation to partake in the program. The program coordinator will encourage participants to engage in the course by spreading the activities across the span of the program and offering incentives to punctual and dedicated participants.
Activity 1: Group Discussions
Through group discussions, the participants will become acquainted with each other. The first activity of the ‘Flexercise’ program comprises group discussions. Subsequent group discussions will be held for 20 minutes every Monday for the remaining seven weeks of the program and referred to as ‘Motivational Mom’. Group discussions are highlighted blue in Table 1. Three hours and thirty minutes will be dedicated to group discussions. Previous research studies have highlighted the significance of group discussions for managing post-natal depression. Using group discussions as an intervention method proved effective by reducing the EPDS score from 6.98 to 4.48 in six months (Stevenson et al., 2010). Group discussions will reduce anxiety and depression amongst participants.
Activity 2: Yoga
The participants will be exposed to eight 20 minutes yoga sessions. Research suggests that yoga is an effective therapy for depression. A multiple linear regression study indicated that one yoga session reduces cognitive and physical levels of anxiety. From the research findings, yoga reduces depression and improves metabolic activities (Newham, Anja, Janine, Aplin & Westwood, 2014). The participants will be exposed to yoga activities such as 3-part breathing, cobra, child’s pose, modified plank, and legs up the wall (Sareet, 2010).
Activity 4: Spa, Massage, Sauna
The ‘Spa, Massage, and Sauna’ activity is included in the ‘Flexercise’ program because of the effect of these activities on depression symptoms, such as anxiety and mood swings. Findings from a research, comprising fifty adults exposed to 15-min massage over five weeks, showed that massage improved mood stability among participants. The ‘Flexercise’ program integrates a comprehensive spa, massage, and sauna session that spans one hour. Participants will become less anxious and petulant after they are exposed to the spa, massage, and sauna session.
Activity 5: Gardner Mom
Gardener mom is another activity that will be included in the program. By the end of the program, participants will be exposed to 3 hours of gardening. Gardening, and other household chores, have been identified as a mitigating factor of post-natal depression (Zewditu et al., 2011). Participants are expected to record improved interpersonal skills after taking part in the gardening activities. Some participants may find it difficult to engage in this activity because women with post-natal depression are reluctant to go outdoors. The program encourages participants to engage in the activity by placing a dance lesson after every gardening class. Gardening activity will reduce depression by promoting interaction between participants and engaging them in outdoor activities.
Activity 6: Dance Class
The dance class is included in the program due to the identified efficiency of dance therapy in curbing depression. One research investigated the influence of dance therapy on post-natal depression by randomly exposing participants to different therapeutic methods. The outcome of the research indicated that participants exposed to dance therapy had more stable moods than those exposed to other therapeutic methods (Stewart, McMullin & Rubin, 1994). Post-natal depression was minimal shortly after participation in dance therapy.
Activity 7: Long Walk in the Park
This activity is more physical. Participants will be exposed to long walks in the park. ‘Flexercise’ pays attention to this activity and dedicates two hours to it. Research studies show that hiking and walking reduce depression and improve mood stability (Pate Pratt & Blair, 1995). The study further states that group activities motivate participation and increase the distance covered by participants (Pate Pratt & Blair, 1995). Participants will be engaged in this activity to improve their physical and cognitive conditions. This activity will have positive outcomes by eliminating mood swings and anxiety (Pate Pratt & Blair, 1995).
Activity 9: Leisure Sports
Leisure sports are sporting activities that are not performed for competition but physical fitness. In the fifth week, participants will be exposed to uninterrupted leisure sports for one hour. Participants will engage in leisure sports, such as tennis and throwing balls. Leisure sports and physical activities have been explained to reduce post-natal depression (Saeed, Antonacci & Bloch, 2010). To eliminate the possibility of rivalry and subsequent depression, no sporting activity will be competitive. Leisure sports will have a positive outcome on the participants’ moods because it will eliminate anxiety and improve interpersonal interaction.
Activity 10: Picnic Time
This activity is an outdoor group discussion integrated with light meals. The benefits of the activity are similar to the benefits of group discussions and leisure sports.
Activity 11: Board Games
This activity is comparable to leisure sports but it does not require the participants to exert physical energy. The benefits are the same as the cognitive outcomes of leisure sports.
Activity 12: Baby Fashion
Participants will be taught how to sew clothes, produce beads, and knit. The benefits are the same as the cognitive outcomes of gardening.
Activity 13: Cook for Fun
Participants will be taught how to cook, bake, and grill. The benefits are the same as the cognitive outcomes of gardening.
Activity 12: Shopping Time
Participants will walk to a mall and shop for items. The benefits are the same as the cognitive and physical outcomes of taking a long walk.
Conclusion
This paper developed and presented an activity plan for women with post-natal depression. The program is titled ‘Flexercise’ and comprises twelve activities spread across eight weeks. Each activity contributes to eliminating one or more symptoms of post-natal depression. The courses included in the program are supported by findings from research studies performed to determine the influence of different activities on post-natal depression. Implementing the ‘Flexercise’ program will improve the conditions of women with post-natal depression.
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