When
Trina
Mallett’s third child, Hailee, was born, nothing went
the way Mallett had planned. Unlike her older siblings,
Hailee had colic, so for the first
12 weeks she cried nonstop from 6 p.m. to 10 p.m.
Nothing would soothe her, including being fed. In fact,
nursing was a disaster. “She just wouldn’t latch on
properly or take a bottle, so I could never leave her
with anyone,” recalls Mallett, a stay-at-home mom in
Idaho Falls, Idaho. Very soon, Mallett grew as weepy as
her baby. Life became a total daze—she couldn’t sleep,
eat, or focus on anything. Her husband tried to be
supportive, but he traveled frequently for work and
didn’t fully understand how bad things had become.
Mallett struggled in silence, thinking she was just
going through a hard time. Then, after about a year, the
panic attacks started. Every morning she’d wake at 5
a.m.
and promptly throw up, and she grew so paralyzed with
fear that she couldn’t even go to the grocery store
without another adult. One day her two older children,
then
3 and 11, asked to go to the playground, and Mallett
realized that a minor outing like this had become
insurmountable. “I had to tell them we couldn’t go
because Mommy wasn’t feeling well,” Mallett recalls. “I
felt like such a failure. Why couldn’t I handle this?”
Hailee was almost 3 years old when Mallett finally
sought help, at her mother’s urging. She described her
problems to her ob-gyn, who immediately suspected she
was depressed. “I thought, ‘What do I have to be
depressed about?’ I’d always
been a happy person,” Mallett recalls. “I had no idea
that my problem could be an actual illness until my
doctor explained it to me.” Like many depressed moms,
Mallett thought that if she could just soldier on, she’d
overcome her troubles on her own.
This isn’t surprising to Diana Lynn Barnes, Psy.D., a psychotherapist and founder of The Center for Postpartum Health, in Los Angeles, who herself was hospitalized for postpartum depression (PPD) after the birth of her second child. Our society portrays motherhood as a time of ultimate fulfillment, which promotes unrealistic expectations in the minds of new moms, she explains. “As a result, women go for long periods of time without treatment because they feel unbearable guilt. They also worry that they’ll be considered weak,” says Dr. Barnes. In fact, 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.
“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. To begin with, 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. Recent research from Johns
Hopkins Children’s Center found that children with
asthma whose mothers showed signs of depression
experienced more frequent asthma symptoms.
“Fortunately,” says Dr. Beardslee, “many treatments for
depression have been proven to work.”
What
Is Depression, Really?
No one yet
completely understands depression’s origins, 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.
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 than men. 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 stress, especially stress that is chronic, and the marathon of motherhood is 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.
Inside a Mom’s Mind During the first days after giving birth, many women will experience what’s known as “baby blues,” marked by mood swings, crying, anxiety, irritability, and difficulty concentrating and sleeping. It usually goes away within two weeks and doesn’t require treatment. If the symptoms persist and worsen over the next several months, the condition is considered postpartum depression. When PPD isn’t treated, it can last for a year or longer. By that time, though, moms are less likely to connect their depression to childbirth. (In rare cases, untreated PPD can take a dangerous turn into suicide or psychosis, which occurs when a mother becomes delusional and harms or even kills her children.) Trina Mallett most likely had PPD—along with anxiety—that became chronic because it wasn’t addressed.
“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, she 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. Betsy Landis, of Los Angeles, who was diagnosed
with depression when her daughter Josie was 1, remembers
a need to escape. “I wanted to be away from Josie,” she
recalls. “I felt like I was in a black hole.” These
thoughts are common for depressed moms. “They 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, Pharm.D., professor of
clinical pharmacology at the University of California,
San Francisco. “Anxiety often accompanies depression.”
Landis only began to feel better after taking the
antidepressant Celexa, starting therapy, and joining a
PPD support group. “The moms were suffering in different
ways: One wouldn’t smile, one was frantic, one was
agitated, one wouldn’t let you touch her kid,” she
recalls. Happily, once a mother begins treatment, her
children can also benefit, finds a study from Columbia
University and the New York State Psychiatric Institute.
Trina Mallett remembers the first time she felt
genuinely content after starting her treatment of
Lexapro and psychotherapy. Hailee was 3 and Mallett’s
son was 5, and she took them on a Western-themed trip to
Wyoming. “We went to a dinner show and on a wagon ride,
and I found myself laughing with my kids,” she says. “I
was able to enjoy myself like I hadn’t been able to in
many months.
I think my kids were a little too young to know what a
milestone it was, but they knew that we’d finally done
something fun.”
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