This week's Parenting Challenge is to be good to ourselves. One of the reasons this is so important is that when we forget to take care of ourselves, to eat properly, get some rest (as much as possible, given the extenuating circumstances of parenting sometimes), to socialize, laugh, exercise, and so on, we are setting ourselves up for serious distress, even depression, and that's problematic for all sorts of reasons. When we are down in the dumps for weeks and months on end, that effects not only our own well-being, it effects how well we parent and connect to our children.
Here's just a smattering of some of the research findings on maternal depression:
- Maternal depression is VERY common, the prevalence rates are about 15% in the United States.
- Mothers' depression directly affects children’s emotional, behavioral, and social functioning (see Weissman et al., 2006 for a review of a bunch of studies).
- Children of depressed parents are at increased risk for
developing aggressive behaviour problems, NOT just through genetic
transmissions of risk, but through parenting practices that are
disrupted when parents become depressed (Kim-Cohen, Moffitt, Taylor, Pawlby, & Caspi, 2005).
- Children of depressed parents are also at risk for developing their own problems with depression and anxiety (Wickramaratne & Weissman, 1998).
- When mothers are feeling depressed, their actual parenting (of course!) is compromised; that's one of the main ways that the depression has an
impact on children's functioning. Here's a meta-analytic review that
covers the basics: (Lovejoy, Graczyk, O’Hare, & Neuman, 2000). -
- To summarize the review: depressed mothers are less attentive towards their children
(Gelfand & Teti, 1990), they provide less consistency and structure
(Goodman & Brumley, 1990), have pessimistic perceptions about
themselves (Teti & Gelfand, 1997), and often harshly judge their
children (Caughy, Huang, & Lima, 2009).
- To summarize the review: depressed mothers are less attentive towards their children
We also know that when you intervene and help alleviate mothers' symptoms of depression, their children's problem behaviours also improve significantly. In fact, some amazing findings have come out recently that have shown that mothers who participated in a prevention program aimed at boosting parenting practices and reducing depressive symptoms not only improved their own mood, but also improved their children's outcomes for over a decade to follow. Not everyone is in need of a formal intervention or prevention program, of course. We know that good ol' social support, exercise and mindfulness meditation can do wonders for alleviating or preventing depression. The obvious implication is that we should be trying to hook up with our friends more, get more "me time", and just generally do what it takes to make ourselves feel whole… as women (and men), not just as parents.
(The obvious RANT I could go on and on about is that it should not be left entirely up to women — and their sometimes helpful friends, family and partners — to deal with the incredible amount of stress that's heaped on mothers. It is a given to me that there should be government-supported / funded programs that can help moms connect with one another, obtain affordable health care, access affordable child care, and so on. No, I will NOT rant… But I could. I'm just sayin').
So… do all those links to hard-core empirical studies convince you to go on out there and try to take care of yourself? What are your biggest barriers to doing so?
You all know I'm not AT ALL trying to make light of this subject, right? For those of you who are feeling depressed or know that you are actually experiencing depression, if you're not already doing so, please reach out to someone that can help. Talk to your friends and family. But also talk to a mental health provider that you can trust (start with a family doctor for a referral if you don't know where else to turn). There ARE ways of making the load lighter, but when you're full-blown depressed, it's so hard to see it, so ask someone to help.
Everybody says the same thing: Ask for help. But nobody tells you what to do when asking gets you nowhere.
A post in October at Ask Moxie got my butt in gear a little on this. I made an appointment with my GP and started private therapy. The GP said I should get an appointment letter for a psychiatrist in the mail. That was December; there’s been nothing yet. I went to therapy for six weeks, during which the therapist convinced me that all my previous failures in therapy were due to failures on my part to do therapy properly. The therapist and I agreed I wasn’t making any progress and I stopped seeing him. This has made me sadder than anything. I had a lot of faith in the idea of therapy and now I feel like I’m going to be this fucked up forever. Since then I have been basically going to work and sitting at my desk crying all day, getting very little done. I used to be able to leave my work incompetence at work but that is getting increasingly difficult. It’s affecting my parenting. I really don’t want my daughter to grow up with a depressed, incompetent mother but I’m starting to run out of options.
@ Dr. Confused – call your GP’s office and find out where the letter is. Be pushy! Tell yourself you are calling for someone else – this usually helps me get over my inability to advocate for myself. I tend to not think I’m worth it but will try to move the moon for loved ones. I had a well meaning friend show me an Anthony Robbins video as motivation the other day. I can’t tell you how very unhelpful that was. (Google it – he’s sooooo not me) The fact that you are still reaching out and looking for answers tells me that you can do what it takes to feel better – you just need more help in getting those answers. Unfortunately, not all health practitioners are created equal and it’s up to you to keep pushing to find the one or two that will give you what you need. Hang in there!!!
The link between maternal depression and childhood aggression kind of freaks me out a bit. DS is randomly aggressive – more so than I think would be normal without much evidence to go on – and if it’s my fault for staying too long in an unhealthy relationship…well, that’s a really horrible thought. Articles on how to fix it out there anywhere?
@Dr.Confused: I’m SO very sorry you’ve been let down like this. That just really, really sucks. If you were in Ontario, I could probably hook you up with the right people to start talking to. As it is, I can only encourage you to not give up. I cannot tell you how fucked up it is for a therapist to BLAME you for your lack of progress in previous therapies. The thing people don’t tell you usually is that it takes some time and effort to find the right therapist for you. There is a bond that needs to happen in most cases for things to work well. Basically, you should like and respect your therapist and feel liked and respected in turn. That won’t happen with all therapists, so unfortunately there’s some shopping around for the right fit. But when you DO click with the right person, you’ll start feeling different so soon after. I’d go back to your GP and ask for other referral sources (and tell him/her what a failure the last one was). You can also go to your OB or midwife or whoever helped you with your birth. This is not an uncommon issue — your hospital (if that’s where you gave birth, if not, the midwife clinic might help) should have referral sources for mothers struggling with depression. I’m biased towards psychologists, to tell you the truth, especially if you’re paying for the services yourself. But that’s a bias that I fully own and there are plenty of good psychiatrists out there practicing competently (I am told).
PLEASE don’t give up looking. There ARE good therapists out there that will be able to help. Maybe some of our readers will be able to further suggest some options.
Clearly the solution is for me to move back to Ontario.
@Dr Confused- I want to go kick your GP in the pants. One of the insidious things about depression is that it saps the will to get treatment. You got over that hump and then your GP let you down. @mom2boys is right- please follow up! Or take @Isabela’s advice and go see your ob/gyn or midwife. Please get help.
I’ve been thinking about this issue a lot lately, due to a tragic story in my local news about a young woman who was apparently attacked and killed while out jogging. Of course, my heart breaks for her parents. But my heart also breaks a little for the attacker’s parents (they have him in custody and he is a repeat offender). No one wants to raise a rapist. I’m not at all BLAMING his parents. He is an adult and is fully responsible for his actions. But clearly something went wrong at some point. I wonder what, and wonder whether this tragedy could have been prevented if society had provided his parents with a little more support.
Parenting is high stakes in a way that I never really appreciated until I had kids. Our society does a really terrible job of helping parents do a good job. If I think about the services available in my community for struggling families, they are mostly supported by donations and perpetually short funded.
OK, with that little rant out of my system- @mom2boys, I only know you from what you write online, but you strike me as a very good mother. I’ll bet that your son’s behavior is perfectly normal. But if you’re concerned, maybe you should get an outside opinion. Do you trust your pediatrician? I know that is who I would start with if I had any concerns about my daughter’s behavior- but I have a wonderful pediatrician and would completely trust her recommendations for next steps.
@mom2boys: Please don’t think along the lines of “fault.” That is definitely not the gist of any of the articles I linked to or the way that I look at it at all. It often comes down to a straightforward connection: when we are depressed, we are less likely to have the energy and motivation to discipline effectively and express warmth and humour. That is the nature of depression — it sucks the life-blood out of you. Effective discipline like the strategies we’ve touched on in this blog, and consistent consequences for aggressive behaviour, have all been linked to the decrease of that aggressive behaviour.
SO, in terms of “fixing” it, that’s the good news. You can check out any of the discipline books I linked to a few posts ago. It’s very doable if you’re consistently giving the message that aggression is not ok (and following through with consequences). Of course, all this discipline can be balanced with lots of warmth and affection when he’s NOT being aggressive.
Oh… and it usually gets worst before it gets better (like with sleep training). Of course, if our kids are used to getting away with being aggressive without much feedback or consequences, when we DO enforce consequences, then they’ll rebel at first. They test whether this truly IS the new regime. But most parents find that after a couple of weeks of clamping down on aggression, it significantly decreases. The bonus is that that improvement in behaviour often feeds back to mom and makes HER feel better, which in turn helps alleviate some symptoms of depression, which in turn can help her feel more competent as a parent, and so on.
Does this make any sense?
Oy, REALLY, Dr. Confused?! You used to LIVE here. What a small world… I’m really sending you tons of good vibes (yes, so scientific of me), so I hope things start looking up for you.
@Cloud – I like my pediatrician a lot. She’s never said he appears to out of the normal range for any of his behaviors including his head banging tantrums. I think it’s more about mommy guilt for my decisions or lack thereof. Thanks for the voice of support – I appreciate it!
@Isabela – I have been enforcing boundaries/rules with consequences more consistently lately and no, he doesn’t seem to like it at all but he can verbalize back to me what I expect and when he decides he wants to meet that expectation. “I be good listener. Me not hit mommy anymore.” So that seems encouraging. And yes, the improvement in his behavior does make me feel better.
@mom2boys, I know what you mean, although I am in a good relationship. my ds is a lot more aggressive than I would have thought would be possible, but we have been working on it, and it has improved. I have depression in my past, and probably have gone up and down in the last 2 years since DS was born due to various things, all of which are better now. I too have had, “Don’t bite Sherwin anymore” success, and “Don’t hit mommy ever”, so that’s good. Mommy mentor has suggested that this behavior will come back (or be triggered) at certain developmental periods when he might be more frustrated (interesting), but now he knows the word frustrated. “I’m not screaming at you (aunt), I’m frustrated with mommy” I think his aggression is still in range of normal though so I wouldn’t ask my pediatrician. I just know what you are going through. Sometimes it would trigger a little depression in me, like, “why is my child so against me, and just me, why not daddy?” so I think there may have been a violent circle going on, just as indicated by this post.
oh yeah, and I should point out that the aggression was REALLY bad in that dreaded 18-22 month period with no language. OMG. Now, it is only occasionally. approaching 2.5 though and a little worried.
Have those of you dealing with aggression tried the “Hands Are Not For Hitting” book? We had a lot of luck with the “Teeth Are Not For Biting” book in the series, and against my firm prediction, the “Pacifiers Are Not Forever” one seems to be having an effect, too.
We struggled a lot with biting in early toddlerhood. The “Teeth Are Not For Biting” book and “playing it out” (basically playing out the bite-inducing scenario, with the outcome of the biting and then with the better response of saying “No, no, I don’t like that”) are what helped us finally tame that.
@Cloud, no, we haven’t tried those books. we’ve role played and did, “you hit, you sit” which works wonders. Now, we are also doing remembering spot. He knows it is wrong, but just choses to do it when he is frustrated/not getting his way/can’t express in words.
Question: is there a gender difference in aggression? mom2boys and I both have sons. I’ve been told that 2 year olds (or about that age) have tons of testosterone running through their bloods, almost as much as an 18 year old. Thoughts?
@Dr. Confused — there are good mental health services out there. Please keep trying! A curse on that terrible therapist who made you feel worse. I hope we can offer some guidance on what you can do and, at the very least, give you a place to vent.
The dark underbelly of maternal depression (having taken a dip or two in that direction since my son was born — I have seasonal depression), for me, is the guilt. Not only do you suck for simply being the flawed and horrible person you are, but you suck EVEN MORE because it has the potential to harm the people you love.Enter stage right — more hopelessness and less energy to take care of yourself. *sigh*
Sound familiar?
From someone who’s been on both sides of the couch (I’m a psychologist), this is where a solid and caring support network comes in (friends, family, blogspot commenters). For me, asking for help is almost as fun as pulling out my toenails, especially when it comes to my mental health. But I’ve found that I need my social network to help me get my engine going again once I’ve settled back in to a depressive groove of not eating properly, not exercising, retreating from friends, working too much etc.
Ok – now to leave work early so I can go for a longer walk with the dog than simply back and forth to daycare to get the wee one. Really…I can do it right? I can walk away from the mounds and mounds of work to do…and take care of me?
@Shelby- the books are relatively cheap, so maybe you should give it a try? I found that it was a really easy way to reinforce the message at a time when her behavior was good. She liked to read the book at bedtime.
I can’t remember anything about a difference in aggression between boys and girls. I can say that there are plenty of aggressive little girls in day care- we weren’t the only ones with a biting little girl.
I like the book Pink Brain, Blue Brain, by Lise Eliot for a discussion of sex differences. I can’t remember if she covers aggression. Her basic thesis is that there are small biological differences in some areas that we tend to amplify by how we respond to our kids. It was a very interesting read.
@Dr. Confused….that SUCKS. I’ve been up and down in my life emotionally. I’m not on meds, but in addition to therapy sometimes, the following help:
Cyber-hug.
-Get out of the house. There’s something about fresh air, movement that helps. You stated that you have problems crying in the office. Take your lunch outside and take a walk if you can and sit in a nice park to have lunch.
-Read a book that is not a parenting book and is for fun.
-Long shower/bath/get pretty. If outside looks pretty, then the inside sometimes follows.
-On advice of Moxie, check your vitamin levels/omega 3′s, iron levels. Really does help
-This too shall pass. A bunch of us have been there.
You might need another GP.
My midwife practice won’t be particularly helpful as it is on another continent.
My psychotherapist sounds really bad in this exchange… but I don’t think he is. I actually think that for many people he would be very good. He is better than all the other therapists in the past who just filled the time with talking and never admitted we weren’t making any progress. You know how sometimes you hear a friend complain about how all his past relationships have failed in various spectacular ways? And sometimes what you need to do is gently steer his attention to the one common factor in all those relationships – him. That’s all he did. And more gently than my brief summary makes it seem. By the end he was having a hard time hiding the fact that he personally disliked me, but whatever, it’s not his fault that I’m unusually perceptive about that kind of thing.
Anyway, I apologise for dominating so much of this discussion.
This subject so important to me. I have Seasonal Affective Disorder (SAD), so my depression will come every fall and go every spring. All I can do is prepare for it and figure out how to get through the fall/winter months. It was especially hard the first winter after having my spirited daughter and also while pregnant with my second.
If I may, I’m going to link to a post I wrote about how I was dealing with the depression last winter when I was pregnant: http://caramamamia.blogspot.com/2009/02/ways-im-dealing-with-depression.html
I also want to point out that medication can be a wonderful thing. I used to try to avoid any and all medication, and I dealt with my SAD solely with light therapy. But last winter, I decided to start anti-depression medication because I don’t have enough time to do the light therapy and because I was doing REALLY bad while pregnant. I took it all winter and started it again this fall. Here’s a link to my post when I decided to start taking it: http://caramamamia.blogspot.com/2008/11/better-living-through-modern-chemistry.html
It was probably the best thing I’ve ever done for my depression. This winter, once I got on top of the dosage, I have felt NORMAL most of the winter! It’s just a miracle. And all my friends and family have noticed what a difference this winter has been for me. Kids are perceptive, so I’m sure they would notice winters when I’m not on these meds.
@Dr. Confused – I found a great therapist my first winter after having a kid by asking my OB’s office for recommendations on therapists who specialize in PPD. Even though I knew my depression was seasonal, it was definitely becoming PPD and I definitely needed help dealing with my child during the winter. I saw you said they are on a different continent, but could you find an OB or even a pediatrician who might be able to recommend someone from that perspective? Keep trying! You’ll surely find help if you keep looking.
@Isabela – Thank you so much for this post and all those links. I’m going to read through them this week. I had heard somewhere that children were less likely to have symptoms of depression if their depressed parents were working on treatments and trying to get better. Is this true? Do you know of any studies that support that?
@caramama
I would think if you saw a parent being proactive about his/her depression, it would be a very positve thing. Hiding depression or any other mental problems from a child (of any age)would only convey the message that the illness is something to be ashamed of and something to be hidden away.
My MIL has been clinically depressed for a number of years and has always suffered from a cleaning related OCD. The first time I met her she was very frank about her illness and how she was dealing with it and I was bowled over seeing everyone I have ever known with depression or other mental illnesses has kept it a secret, or even failed to recognise it due to the stigma attached.
Also, if you have seen depression in a loved one, you would be able to recognise it more easily in yourself ( if you suffered from it, that is). I know hubby is very aware of this and has been keeping an eye out for depression in himself for years.
@paola – That’s so great to hear. Thanks!
@caramama- I think the research is mostly about untreated depression, and that what matters is how you interact with your baby. So I’d think that if your depression is being treated with some success, you’re probably interacting with your baby “normally” and all is well.
@Dr. Confused- don’t apologize. We can all click away or ignore your comments if we don’t want to read them! I understand what you’re saying about your therapist. If you’ll take more ideas from a random stranger on the internet- could you possibly be trying to solve the wrong problem? Maybe your therapy isn’t progressing because the problem isn’t in that area. Bear with me here… I’m thinking about a time in my life when things seemed pretty crappy, and I was blaming the absolute wrong thing. In my case, it turned out to be that I was really ambivalent about where my career was going, and that was spilling into other parts of my life. I got some career counseling and that helped immensely. (Interestingly, it took me several years to actually make any big career moves, but just having a plan made me feel better and let me get on with my life.)
The thing was, I spent a long time thinking the work funk was a symptom, not a cause, and trying to “solve” other things that were actually just fine.
@caramama: what i know about are the prevention and intervention studies that could speak to your question. So, women who participate in prevention programs aimed to decrease their children’s behaviour problems and their own onset of depression have kids who do well in the long term (so you could say that these women are indeed working on their own issues of depression and intentionally trying to strengthen their parenting skills). Also, for those women who are depressed and ARE in therapy, when researchers measure their children’s emotional well-being, there’s marked improvements that are linked to mothers’ depression improvements.
@Shelby: Yes, there’s a very consistent sex difference in aggressive behaviour. Boys are by far more aggressive, ON AVERAGE, than girls are. Lots of caveats though: (1) It’s not clear that this is about hormones.Too many other factors involved, (2) A large part of this is about how we socialize girls and boys differently — we tolerate aggression much more in boys than girls (girls are outright rejected and chastised for it, boys are often responded to with permissiveness and some chiding, but with much more tolerance than girls). (3) There are different forms of aggression: boys are more OVERTLY aggressive (outright physically hurtful) and girls are much more COVERTLY aggressive (telling lies, ostrasizing others, spreading rumours, teasing). But BOTH boys and girls are NORMATIVELY most aggressive from about 18 months to 2.5 years, with a precipitous drop in aggression usually starting around 3 or 4.
On a both professional and personal note though, I really think it’s about sticking to our guns in terms of providing clear messages about aggression not being tolerated and clear consequences when it occurs. That dogged persistence in getting that message across works wonders, EVENTUALLY, to change children’s aggressive tendencies.
@Dr. Confused – I wish you all the best, and most of all the energy to get through this. Thank you so much for sharing your struggles. Please keep talking about it.
@Shelby – Oh boy, do I ever hear you. My 28 mos old DS’s aggression is way more than we bargained for – ITA with everything @Isabela wrote about socialization. We totally see this cliched “boys will be boys” social sanctioning going on around us, and try not to reinforce it in our house. Hard to do. FWIW, months 22 and 28 have been particularly violent. Amen, @Isabela to “dogged persistence,” and @Cloud’s book recommendations.
@caramama – You write so well on some really tough subjects. Hugs to you!