It can suck to be a child of a mom with clinical depression

Having nothing new to report on the foster care front (all is status quo, no visits for about a month now), I thought I would go back to what I had done in the past when I had nothing to say about foster care. I thought I would write again about topics I feel passionate about as a clinician, parent and human being.

There is a lot of talk about the effects of depression on fetuses, post-partum depression on newborns, if one should take medication if depressed when pregnant, which medications, how much, at what stage of pregnancy, etc. What is discussed less in pop culture and the media is what effects growing up with a depressed mother has on a child when the mother suffers from chronic depression or repeated depressive episodes.

Since I don't want to write a boring research paper here, I will be forthcoming about my agenda and then try to paint a picture for you. I not only want to urge mothers who suffer from depression to seek treatment for themselves for themselves, but I would argue that not getting help for yourself is unethical and can even be considered child neglect as we know how profoundly damaging maternal depression can be on children.

I have very little patience for people who refuse to understand that depression is an illness. It has both genetic and environmental causes and is treatable via psychotherapy, medication, exercise, nutrition and more. People often respond best to a combination of treatments with vigorous exercise and meditation gaining momentum in the research as what were once the lesser discussed interventions.

A chronically depressed mother, on medication for many years, was frustrated with the medication's side effects. After having been stable for a number of years, (but had a history of failing to maintain stability when trying to get off medication numerous times before) she called her doctor asking for his blessing to go off medication again, just to try. He reminded her of how debilitating her last depressive episode had been and told her that she couldn't afford to risk it. She has children.

Well, amen.

The depressed mother/child relationship could take endless forms but instead of give a list of well researched risk factors and potential disastrous outcomes, I thought it might be more instructive to paint a picture of just one possibility.

Imagine a mother who is too depressed to play with her infant and toddler. She leaves the toddler to learn to entertain herself in a playpen for most waking hours of the day. Playdates are limited because the mother doesn't have the energy for socializing. Because the mother is living in her dark hole, trips to the park are painfully exhausting. She is too depressed to have the reserves to smile and laugh with her young child or to express much affection. Her emotions are so numbed by her depression that she is unable to feel what comes naturally to most mothers, that ever binding attachment to her young child. While she can meet her child's basic physical needs, her depression keeps her from experiencing joy from her interactions with her child.

What happens when a mother cannot experience joy from interactions with her child? She smiles at her less, sings to her less, talks to her less, plays with her less and shows less excitement at each milestone. She doesn't ask much about her child's day in school, is less involved in making social arrangements for her child and she can only stand to do the bare minimum to get through the day. Unlike what happens as par for course in other homes, the child is unable to learn that she is worthy of attention, that she matters, that she is special and loved. She may very well have less active of a social life and poor social skills as compared to her classmates.

As this child grows older, if nothing changes, the emotional bond simply does not grow. Realizing now that she has a different relationship with her mother than other children, she wonders, subconsciously, what she is doing wrong and tries to do better. She may not assert her own opinions or stuff down her feelings all in efforts to earn her mother's approval. She may wonder what she can change in order to earn her mother's love and try to be as perfect as possible, never rocking the boat. She may do whatever she thinks her mom would want her to do, get straight A's, be quiet, not ask for anything, be skinny, etc.

When she realizes that she cannot succeed in earning her mother's attention or love she begins to believe that she must be defective, unlovable and undesirable. She develops her own depression as she realizes that she is powerless to change what is and unable to get the love that she so desparately needs. As a child, she is unable to realize that she is not the cause and her mother's depression is not about her. She may feel lethargic, lonely and chronically sad. She may have outbursts of anger, may rebel or may turn her depression inward, possibly even struggle with thoughts of suicide.

If you are a mother and suffering from depression seek help. Do not create an environment in your home that could breed another generation of people struggling with their own depressions. While you may not be able to control your genetics or what you give to your children via genetics, there are no excuses for allowing yourself to succumb to depression. Get help.