When Mom Is Depressed: What Families Need to Know
About one in 10 American women—including many mothers—experience symptoms of depression, according to the Centers for Disease Control and Prevention (CDC). But despite the prevalence of the condition, many mothers go for long periods of time without treatment.
What’s the reason behind the trend? “Our society portrays motherhood as a time of ultimate fulfillment, which promotes unrealistic expectations in the minds of new moms,” says Diana Lynn Barnes, Psy.D., a psychotherapist and founder of The Center for Postpartum Health, in Los Angeles. As a result, they may feel guilty or weak for having a difficult time with motherhood.
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But failing to seek treatment could negatively affect your life—and the lives of your kids. "Unrecognized and untreated depression among parents is a potent risk factor for children," says William R. Beardslee, M.D., chairman emeritus of the department of psychiatry at Children's Hospital Boston and author of When a Parent Is Depressed. For starters, depression interferes with a mother's ability to properly bond with her children. Studies from the National Institute of Mental Health now show that infants of depressed moms get less interaction, fuss and cry more often, and show higher levels of physiological stress than do babies of mothers who don't have the condition.
Some studies even hint at a connection between a mom's depression and a child's physical health. Research from Johns Hopkins Children's Center found that children with asthma whose mothers showed signs of depression experienced more frequent asthma symptoms.
What Causes Depression in Moms?
During the first days after giving birth, many women will experience "baby blues" marked by mood swings, crying, anxiety, irritability, and difficulty concentrating and sleeping. These blues usually go away within two weeks and don’t require treatment.
If the symptoms persist and worsen over the next several months, the condition is considered postpartum depression (PPD). Untreated PPD lasts for a year or longer. By that time, though, moms are less likely to connect their depression to childbirth.
No one yet completely understands the origins of depression, although researchers now believe that the condition is a dysfunction of the brain's neurotransmitter system that affects emotions, sleep, and appetite.
The textbook definition of depression is a constant state of malaise, lethargy, weight gain (or loss), and excessive sleeping (or insomnia). But it may take on different guises, especially in mothers. Often it feels like the worst kind of hopelessness, combined with an inability to cope with daily activities and a lack of interest in much of anything.
Risk Factors for Depression in Moms
Though fathers experience depression more often than was previously believed (a recent survey showed that 26 percent of dads show signs three to six months after their baby's arrival) women have always suffered at a higher rate. Experts think this could be due to the difficult role women have taking care of children while facing multiple other demands.
The condition is known to run in families, but environmental causes may play a much larger role. Depression can be in part a reaction to chronic stress—and the marathon of motherhood is definitely chronically stressful.
In fact, a survey conducted by Harvard Medical School and the University of Michigan found that 10 percent of women with children under the age of 18 had major depressive disorder in the last year. Stay-at-home moms with more than one child younger than 3 experience depression more than women with older kids; so do working moms who have trouble arranging or paying for child care, according to the American Psychological Association's National Task Force on Women and Depression.
What Does Depression Look Like?
"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, Thompson 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.
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.
What’s more, "moms 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."
Depressed Mom Treatment Options
Half of Americans who suffer from clinical depression don't receive any treatment, according to a survey by researchers at UCLA and at Wayne State University, in Detroit. But going without help only makes things worse, since the risks of untreated depression are worse than those of the commonly prescribed treatments, says Dr. Finley.
A doctor will evaluate your symptoms of depression and find the best treatment option for you, whether it’s talk therapy, support groups, or antidepressant medication. Some of these drugs can be safely taken while breastfeeding (they show up in breast milk, but in concentrations low enough that doctors don't believe they cause harm). Doctors generally start patients on the lowest dose. It may take several tries before they hit on the right drug, and once that happens, Dr. Finley recommends staying on it for at least six months because studies have shown that going off antidepressants too soon ups the risk of relapse.
Talking To Kids About Depression
Once a mother begins treatment, her children can also benefit, finds a study from Columbia University and the New York State Psychiatric Institute. As tempting as it is to dodge the topic entirely, experts say it's best not to shield your children from what you're going through. You can bring it up with kids as young as age 3.
Here’s some more advice for talking to your kids about depression.
Sit down as a family. Present a unified front with your spouse. Discuss any scary events the kids may have witnessed. Try something like, "I have an illness that's making me tired and cranky—you are not making me feel that way. And we've got a plan to help me get better." (Dr. William R. Beardslee recommends avoiding the word depression until a child is at least 8.) Above all, kids need to know that their parents are going to be okay.
Let them ask questions. Young kids might worry that they can catch Mommy's illness, or they might feel responsible and want to cure it. Encourage open communication; depression should never be stigmatized by secrecy or shame.
Reinforce the family bond. Recall earlier happy times and point out to your children that their beloved rituals—Sunday dinner, birthdays, holidays—will remain.
Keep talking. It takes time for children to understand depression and voice their concerns. Kids who do well in these circumstances are able to grasp that depression might recur, and they can articulate protective strategies, such as talking to other supportive adults and participating in activities