Inside a Mom's Mind
"It's especially difficult to recognize depression in mothers because they're so busy taking care of others and they appear competent," says Dr. Beardslee. Washington, D.C., journalist Tracy Thompson fought depression when her daughter was a toddler. She knows it can be hard for family and friends to spot the warning signs. "Nobody can see anything wrong with you and yet you're in agony, so you just suffer through," Thompson says. As the author of The Ghost in the House: Motherhood, Raising Children, and Struggling With Depression, she surveyed nearly 400 mothers who'd been diagnosed with depression. The most common symptoms they reported were irritability, an inability to set limits with the kids, and a craving for solitude.
During the first days after giving birth, many women will experience what's known as "baby blues," marked by mood swings, crying, anxiety, irritability, and difficulty concentrating and sleeping. It usually goes away within two weeks and doesn't require treatment. If the symptoms persist and worsen over the next several months, the condition is considered postpartum depression. When PPD isn't treated, it can last for a year or longer. By that time, though, moms are less likely to connect their depression to childbirth. (In rare cases, untreated PPD can take a dangerous turn into suicide or psychosis, which occurs when a mother becomes delusional and harms or even kills her children.) Trina Mallett most likely had PPD -- along with anxiety -- that became chronic because it wasn't addressed.
It's a vicious cycle: Mom wants to be alone, but her kids want her to play with them. When the little ones inevitably push the boundaries, she is so depleted that rules go out the window; baths get skipped, one hour of TV slips into two. Betsy Landis, of Los Angeles, who was diagnosed with depression when her daughter Josie was 1, remembers a need to escape. "I wanted to be away from Josie," she recalls. "I felt like I was in a black hole." These thoughts are common for depressed moms. "They may say they won't go outside because they don't want anyone to touch or hurt the baby, and when you probe further it often turns out that they're afraid of hurting the baby themselves," says Patrick Finley, M.D., professor of clinical pharmacology at the University of California, San Francisco. "Anxiety often accompanies depression." Landis only began to feel better after taking the antidepressant Celexa, starting therapy, and joining a PPD support group. "The moms were suffering in different ways: One wouldn't smile, one was frantic, one was agitated, one wouldn't let you touch her kid," she recalls.
Happily, once a mother begins treatment, her children can also benefit, finds a study from Columbia University and the New York State Psychiatric Institute. Trina Mallett remembers the first time she felt genuinely content after starting her treatment of Lexapro and psychotherapy. Hailee was 3 and Mallett's son was 5, and she took them on a Western-themed trip to Wyoming. "We went to a dinner show and on a wagon ride, and I found myself laughing with my kids," she says. "I was able to enjoy myself like I hadn't been able to in many months. I think my kids were a little too young to know what a milestone it was, but they knew that we'd finally done something fun."