How to Parent While Depressed
When Maddie was single and in her early 20s, she began experiencing intense fatigue and lack of motivation, "a quiet undercurrent of sadness that was never so debilitating that I couldn't get out of bed but that would flare up for months at a time." (Along with the other parents quoted in this article, her name has been changed due to the sensitivity of the subject.) Negative thoughts with themes of insecurity and fear of abandonment played on a loop in her mind. Upon seeing an Instagram pic of friends enjoying a night out, for instance, she'd hear a voice in her head, taunting, "Of course they didn't invite you; you're boring and annoying."
When the Seattle-based teacher was 29 and her elder daughter was 2 years old, the thoughts returned. Except now, they accused her of being a horrible mother. "I'd be bathing my daughter and worrying about when she'd stop loving me, or lying in bed next to my husband, thinking, 'When will he figure out what a fraud I am and leave?' The kids were at a hard age, motherhood still felt new, and I was overwhelmed with working and parenting, feeling like I was doing everything poorly," Maddie says. "I'd get them to bed and sit on the stairs and cry, thinking, 'They deserve better than me,' but I had nothing left to give."
Although Maddie felt alone, her experience was far from uncommon. About 20 percent of U.S. adults will be diagnosed with clinical depression at some point, and "women are at highest risk during the parenting years," says Megan Smith, Dr.P.H., M.P.H., associate professor of psychiatry and child study at the Yale School of Medicine and an expert in maternal mental-health research. Anxiety disorders with symptoms including persistent worrying and rumination (from "Why isn't my toddler talking more?" to "Will my kids die in a car crash today?"), nervousness, and sleep issues are also rampant among parents.
A 2009 study found that more than 15 million children lived with a parent who was severely depressed, a figure that's likely higher today—especially given the life-upending events of the past year. During the pandemic, 49 percent of women with children under age 18 and 40 percent of dads with children of the same age have reported that their mental health has suffered due to coronavirus-related stress, according to research from the Kaiser Family Foundation. In addition, the Centers for Disease Control and Prevention says rates of depression in adults are up fourfold since 2019.
Long-simmering issues of racism, social unrest, and political turmoil also reached a boiling point in 2020, fueling a spike in mental-health conditions among people of color. "We were already dealing with virtual learning, the stress of making sure my kids always have their masks on, they need to eat 90 times a day, and then I had to talk with my 12-year-old about why people were protesting," says Catina Smith, 35, a Black Air Force veteran, private chef, and mom of three in Baltimore.
But even in these challenging times, and even if feelings of fear, sadness, and worthlessness seem insurmountable, there is still hope. We live in a golden age of mental-health treatment, and there are numerous forms of therapy, dozens of medication options, and much less of a stigma associated with mental-health problems. Once, these disorders were considered shameful secrets; now public conversations about parental mental health occur regularly. Actor Kristen Bell, Untamed author Glennon Doyle, and Olympian Michael Phelps have all spoken publicly about the challenges of parenting with anxiety and depression. Perhaps most notably, Meghan Markle revealed in March that she had suffered from depression and suicidal thoughts during her first pregnancy.
In other words, there has never been a more accepting atmosphere for those who find it difficult to manage their mood. If you're among them, health experts want you to know this: Help is available, and it can make a difference in your life and that of your family.
- RELATED: How Depression Affects Your Family
What Depression Is and Isn't
Of course, it's hard to seek treatment if you're not sure what it is that you're experiencing. Both depression and anxiety—which may occur in tandem—can show up as irritability, forgetfulness, and anger. And although rage has long been ascribed to men, it can signal that a mom feels unheard and overburdened, her needs are not being fulfilled, and an underlying mood disorder may be brewing, says Sarah Oreck, M.D., a reproductive psychiatrist and mom in Los Angeles.
The National Institute of Mental Health uses the terms clinical depression and major depressive disorder interchangeably to refer to a severely low mood that persists for an extended period. (If the depression is chronic, it's referred to as persistent depressive disorder, or dysthymia.) These disorders go beyond feeling overwhelmed or having "the blues," causing what experts term functional impairment, meaning a person is unable to parent, work, or go about the day as they once did. This impairment can arise when certain risk factors—genetic predisposition, personality, brain chemistry, a history of mental-health issues, or adverse life events—converge, explains Dr. Smith. In the case of postpartum depression, which afflicts roughly one in four new moms in the three years after they give birth, it can erupt from "hormonal changes, sleep deprivation, and the burden of caring for a baby's every need," Dr. Oreck says.
It's imperative that parents who suffer from depression and anxiety seek help for managing their symptoms. Emma, 39, a mom of one in New Jersey, has been in treatment for several years. First diagnosed with depression in college, she suffered from suicidal thoughts in her early 30s. Now she combines weekly therapy with mood-stabilizing medications and says she can't imagine parenting without them. "Depression can make minor setbacks feel like all is lost," says Emma, "and that's a real problem, since parenthood is full of minor setbacks."
In terms of stressful jobs, parenting has being a neurosurgeon or an airline pilot beat. "You're a full-time caregiver, not only providing material comforts like food and clothing but also being responsible for nurturing and creating strong emotional bonds with your child," says Dr. Smith, mom of two kids, ages 9 and 12.
While research has found that parents typically report feeling a greater sense of purpose, raising kids can certainly involve more stress, anxiety, and other negative emotions than nonparents experience. Yet family holiday cards never show pictures of a mother sobbing in the bathroom while her kids build a cushion fort. The "triple threat of guilt, perfectionism, and martyr mode" causes millions of depressed parents to feel weak and isolated when, in fact, they are in good company, says Pooja Lakshmin, M.D., clinical assistant professor of psychiatry at The George Washington University School of Medicine & Health Sciences and founder of GEMMA, a women's mental-health digital education platform.
Although research has found that women are about twice as likely to develop depression as men, fathers are far from immune. Andy, a stay-at-home dad of 6-year-old twins in Boston, has felt loneliness and isolation, which he says have been compounded by being a gay parent in a mostly straight area. Early on, the former college counselor thought, "Is this going to be my life for the next 18 years?" When his twins were around 2, Andy found himself yelling more than he would've liked, which made him "feel guilt, shame, and anger toward myself." He suspected that he was suffering from depression.
Feelings of being perpetually overwhelmed, physically and mentally exhausted, mired in cynicism, or plagued with the belief that you're an incompetent parent are signs of parental burnout, says Dr. Oreck. Emotional detachment from one's child is another. Untreated, burnout can progress to depression or anxiety.
Other parents at risk of depression and anxiety include single or younger mothers; those from socially disadvantaged backgrounds; and those parenting kids with special needs, who "are often seen as superheroes, but who need help juggling fear, sadness, and isolation with managing multiple medical issues and arranging for academic accommodations," says Eliana Tardio, a mother of two children with Down syndrome and a Latinx inclusion activist in Fort Myers, Florida.
The Effects on Children
For parents with depression, there are the obvious detrimental symptoms—emotional pain, lack of motivation, loss of joy in once-joyful activities—and even physical troubles such as gastrointestinal distress and reduced immunity. But research has found that children of depressed parents are about three times as likely to suffer from major depression, anxiety disorders, or substance abuse as children whose parents hadn't been depressed.
All kids have developmental needs that include feeling securely attached to a safe, caring adult and having a caregiver who is both physically and emotionally present and can model adequate coping mechanisms, says LaToya Gaines, Psy.D., a clinical psychologist and former school psychologist in New York City. Untreated mental-health concerns can threaten a parent's ability to fulfill these needs. "When we're depressed, we have difficulty connecting," says Kristen Granchalek, LCSW, a Chicago-based therapist specializing in women's issues, anxiety, and emotional reactivity. "Our faces don't respond in a way that mirrors our children's emotions, which they need for healthy development and to feel cared for." With anxiety, kids can absorb their parent's chronic worrying and, says Granchalek, "internalize the belief that the world is not okay."
Emma, the mom in New Jersey, says it's the fear of this very dynamic that frightens her most. For instance, whereas a nondepressed parent might be annoyed at their toddler's disinterest in potty training, Emma considers it a failure on her part and silently ruminates over her son's doomed future, including worries that he'll get kicked out of preschool for being the only 3-year-old still in diapers. "My husband will assure me that our son will get it eventually; meanwhile, I'm pasting on a smile and suppressing a volcano of panic."
The potential effects of a parent's depression on their child make treatment imperative—and extensive research shows that clinical depression is highly responsive to treatment. But in the best-case scenario, only about half of depressed adults receive proper care, says Dr. Smith, and "rates for mothers may be even lower." Part of the issue is what Granchalek says is a deep societal discomfort around mothers admitting they need help with anything: "We spend a lot of emotional labor convincing ourselves that 'I'm lazy and I should be doing a better job,' or we blame our partner or children, thinking that if they were more helpful or better behaved, we wouldn't be struggling so much."
This kind of thinking weighs heavily on Black mothers, Dr. Gaines says, "who are taught to think about everyone else first, going back to when we were enslaved and had to take care of our family as well as other peoples' families. Many Black women feel we have to be on it all day, every day, because if we don't do it, who will?"
And for all depressed parents, there are the twin barriers of little time and low energy. It can feel impossible to carve out an hour a week for therapy when there's barely time to shower, and when parenting and depression are both known to cause exhaustion.
The first step in recovery is believing that mental illness is a health concern like any other—there's no shame in having anxiety or depression, just as there's no shame in having lupus or the flu, Dr. Gaines says. Next, it's helpful to have an honest conversation to assess whether your daily battles are more than just a rough patch or stress. An objective, empathetic partner, friend, or relative can serve as a sounding board, as can a primary care physician, who can help plan next steps, including making a referral to a mental-health expert.
Therapy is a safe space for venting and helps address damaging beliefs, like "I'm worthless" or "My kids would be better off without me," says Dr. Gaines. Talk therapy, specifically cognitive behavioral therapy or an offshoot called acceptance and commitment therapy, can challenge such thoughts and reframe them as "It's a pandemic, and I'm doing the best I can."
Therapy has been transformative for Andy, who says that treating his depression with the help of a therapist who had walked in his shoes (in his case, another gay father) has helped him "unpack what is normal parenting angst versus what might be something more serious." At first, he says, therapy almost felt selfish, with so much laundry to be folded and dinner to be made. "I had to have a heart-to-heart with myself, saying, 'This isn't like getting a facial; this will help you and help the kids so you're not taking your anxiety out on them.'"
For many, medication is also helpful. And given how many kinds are now available, those seeking care can be assured that if one doesn't help or causes unpleasant side effects, there are other doses and drugs to try. The most common class of medications, selective serotonin reuptake inhibitors, or SSRIs (Prozac and Lexapro are examples), also treat anxiety, and an internist or an ob-gyn as well as a psychiatrist can prescribe them.
Some people worry that taking an antidepressant will change their personality, but it actually makes the patient feel more like themself. Medication won't eliminate all negative thoughts, but it will likely make a person's mood more stable, lifting their outlook out of despair and nudging it closer to neutral. "A psychiatrist prescribed Prozac for my depression, and a few weeks later I was walking the dog, and I saw the sun setting and thought, 'That's pretty,'" says Danielle, a 41-year-old mom of two in Illinois. Her desire to read and bake with her girls—activities she adored before her depression set in—also returned. Both were encouraging signs that her depression was finally lifting.
Protecting Your Child
Dr. Smith says it's important to realize that having depression or anxiety does not mean your children will too. Talking to them about feelings from a young age will make them more likely to ask for help if they need it. A big step in mitigating the genetic and environmental risk factors involves sharing struggles with your kids in an age-appropriate way so they learn that all emotions are normal, there are constructive ways to deal with yucky-feeling ones, and it's okay to ask for help.
Dr. Gaines suggests saying, "Mommy feels sad today, and that's okay. We all have sad days. But I know some things I can do to make myself feel better." This chat works with frustration, anxiety, and anger, too, and makes the most sense to have with kids around age 4. If their children are closer to elementary-school age, parents can introduce more advanced concepts like depression and medication: "Everyone has sad days, but sometimes I feel sad for a longer period of time. Just like when I have a cold, I need to take good care of myself, and that means sleep and maybe medicine."
Underscore that your kids are not the cause, because it can be easy for them to blame themselves for Mom or Dad not wanting to play. That internalization ("It's my fault that Mommy is sad") can increase their own risk of developing depression or anxiety, according to a new study in the Journal of Family Psychology. Parents can also mention that they often talk with a "feelings doctor," which kids may recognize from their school social worker. Doing so normalizes getting help.
If depression or anxiety makes it difficult for a parent to effectively connect with their child, it's important that the child can consistently interact with another adult caregiver, such as a grandparent, a trusted teacher, or a family friend. "It's a huge protective buffer," Dr. Smith says, and strengthens a child's resiliency muscles.
Even if you don't have depression or an anxiety disorder, there's no doubt that times are extraordinarily tough for all of us right now, Dr. Gaines notes, and being a "good enough" mom or dad is, in fact, enough. Giving your child just 15 minutes of undivided attention makes a huge difference to them, says Dr. Smith. It doesn't take much: Sink into an easy yoga pose while the kids have a snack; join them for one page of coloring; brush your teeth together.
"My therapist is constantly reminding me that when I'm sure I'm 'failing' my child, he likely doesn't even notice," Emma says. "If I'm struggling and I tell my son I can play in a little while, it won't scar him for life. All he'll remember is the part where his mom had fun with him."
This article originally appeared in Parents magazine's May 2021 issue as "Parenting While Depressed." Want more from the magazine? Sign up for a monthly print subscription here