Doctor's corner How depressed parents affect their children

Depression is an illness that affects not only the person suffering from the condition, but also family members, and children in particular. Children of depressed parents may have difficulty in school, in social situations, and in developing a positive self-image. In addition, they miss the loving bond they should have with their parent, as well as the activities and shared times that create memories and strengthen that bond.

Helping these children is a problem that needs to be addressed because cases of clinical depression among adults are on the rise. By some estimates, as many as one in five adults suffers from some form of clinical depression, so that is a lot of children who are also being affected.

The impact of depression

When people are depressed, they tend to feel fatigued, irritable and overwhelmed. They see most situations in a negative light, and can feel incapable of making even minor decisions. Caring for a child requires a lot of energy and involves making multiple decisions on a daily basis, from planning meals to determining what children should wear to fixing lunches, helping with homework, and deciding about play dates and field trips. If the parent has multiple children, the workload is only multiplied.

When a parent is deeply depressed, and not able to fully function as a parent should, the child is often forced to act like an adult, taking over the care of younger siblings, fixing meals, doing laundry and so on. On the outside, the child may seem “mature” and coping OK, but on the inside he or she is still a child and vulnerable to the stress of the situation. The repercussions from dealing with the parent’s illness can influence a child’s life for years to come.

Infants and toddlers

A new mother suffering from post-partum depression has difficulty bonding with her baby. She may be less sensitive to her baby’s needs and not as responsive to its behavior, or she may be inconsistent in how and how much she engages with her baby. As a result, these babies may be harder to comfort, appear listless and be difficult to feed. The babies may become anxious and fearful and, over time, if the situation is not remedied, can withdraw from interacting with people. Fortunately, if the mother gets prompt treatment, the mother-child bond can be re-established and the baby can get back on track in terms of development.

For toddlers and preschoolers the situation is more challenging as their young brains are influenced by how they interact with adults who are close to them. If their parent ignores them because of fatigue or is snappish and easily frustrated by their behavior, then the child can have trouble controlling their own moods and learning what is appropriate behavior for different situations. If there is no one to comfort them, they may act out all the more. Studies have also shown that toddlers with depressed mothers are apt to perform less effectively on tests of language skills and other measures of school-readiness.

School-age children

These children are the most at risk for having to assume adult roles far too soon. If their mother cannot function, then they must take care of themselves and of their siblings if need be. In addition to the loss of a mother’s care, they have also lost their mother’s support. There may be no one there to encourage and motivate them, to console and comfort. Depressed people are often harsh and critical, so the interaction they do have with the depressed parent may make the child feel belittled and affects their self-worth. Consequently, these children often act-out in school, which in turn gets them labeled as trouble-makers and left feeling even worse about themselves. Children of depressed parents are often also socially isolated as there may be no one to take them to play dates or after-school activities, and the parents themselves may more often leave the children to their own devices.

As these children become older, there is concern that they may be more likely to turn to drugs and alcohol to provide the comfort they have not received at home.

Children of depressed parents often score 4.5 percentage points lower when it comes to school grades then children of non-depressed parents. This may not seem like a lot--it’s roughly the difference between an A and a B or a C and a D, but it can add up. A child who consistently scores at the lower end may not receive the encouragement needed to fulfill his or her academic potential; some kids, frustrated by lower grades, drop out of school.

Children who drop out are at higher risk for taking up smoking, substance abuse, and in general, facing a poorer quality of life.

What can be done?

The good news is that depression is very treatable. Medications and psychotherapy can help as many as 80 percent to 90 percent of those with depression, especially if the condition is treated early on. When a depressed parent gets better, improvement is seen in the children, usually within a few months of the parent showing signs of recovery.

If you are depressed, get treatment. There is a wide range of medications available, so if the one you tried before did not work, there are others that may. It’s also important to have someone to help you. Enlist a spouse or other family member to interact positively with the children when you cannot, and to help lessen the burden of chores, decision-making and car pooling. Make sure your children are able to enjoy as many social and school activities as possible. This gives them some sense of normalcy.

Talk to your children about your illness. With younger ones, simply explain that when you have spells of crying and being cross, it’s not their fault, it’s your illness. With older ones, you can explain more about what depression is. Tell them you are getting treatment and are working to get better.

Parents with depression can still be good and loving parents, they just need to get the help they need.

—Dr. David Schopick is a psychiatrist in private practice in Portsmouth. He is board certified by the American Board of Psychiatry and Neurology in adult, adolescent and child psychiatry and has been serving patients in the Greater Seacoast area and beyond for more than 25 years. For information, call 431-5411 or visit www.schopickpsychiatry.com.