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The Informed Parent

Maternal Depression

by Peter W. Welty, M.D., F.A.A.P.
Published on Jan. 21, 2002
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A good friend of mine has a sister who is causing grave concern to the family. She has two small children, four years apart. The sister has always suffered from depression, and although she is seeing a counselor and is receiving medication, she is still very depressed. This is a serious concern because their mother committed suicide twenty years ago. The children seem terribly withdrawn all of the time.

This concern is justified. Besides recent news reports about postpartum mood and psychotic disorders, it appears that even moderate maternal depression can have negative effects for the mother as well as the mother-child interaction. A depressed mother may interfere with her child’s normal development.

Depression is a disorder that profoundly affects a person’s interpersonal and social functioning. It is common in mothers of young children, although the reasons for it are diverse. They generally have good outcomes. Postpartum depression is an uncommon disorder, even though it has received much attention recently. To state that depression is generally inherited within families is an important factor.

A mother’s depression can have great effects on early child interaction, infant thought development, and emotional development. Even a mother’s depression during the prenatal period is debated. Can it have an effect on the developing baby? Increased stress levels are often related. Maternal stress in animals during pregnancy has had long-lasting or even permanent effects on the fetal brain of animals, with likely effects on the behavior and coping skills of the offspring.

Similar effects are noted in humans. Symptoms of dysregulation have been found among newborns of prenatal-depressed mothers. This undoubtedly has an affect on the early mother-child relationship. The mother may have poor health behaviors during pregnancy, possible physiological effects of depression and negative feelings toward the baby or in her role as the baby’s mother.

Depression, agitation, irritability, moodiness, and low energy may manifest depressive symptoms in both mother and child. There may also be symptoms of poor concentration, poor sleep and appetite, feelings of worthlessness, hopelessness and helplessness. There may even be suicidal thoughts or wishes that one were dead. One thinks of wanting to run away. For children, this may lead to disturbances in school behavior, poor school performance or negative interactions with others.

A recent study from the Journal of the American Academy of Child and Adolescent Psychiatry looked at mothers’ depressive symptoms while she was pregnant, after the baby was born, and when the child was young. They asked the question as to whether a mother’s depressive symptoms had an effect on the functioning of the child. The study specifically looked at the level of psychosocial functioning. They also looked at the degree of emotional or behavioral problems in school-age children, which did seem to be affected by maternal depression. However, these impairments in interactions became improved when the mother’s depression was altered.

It is important to have my friend’s sister continue in her therapy and medication appointments. If her therapist is not helping her, she should find someone with whom she can relate. Helping to decrease her stress in a supportive way would be very valuable. Better psychological health in the mother promotes optimal psychological health in the children, even from the very beginning.

 




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