By Holly A. Swartz,M.D., and Erika E. Forbes, Ph.D.
Mother’s Day is a chance to honor our moms, sisters,
grandmothers and daughters with flowers, chocolates, and breakfast in bed. But Mother’s Day is also a reminder about the
challenges moms face, including maternal depression. One out of five women will experience an
episode of depression in her lifetime, and two-thirds of those women are
A number of recent studies have shown that maternal depression
is the number one risk factor for children developing psychiatric and
behavioral problems later in life – more so than even peer experiences such as bullying.
At the same time, when more than one family member experiences mental health
challenges, it becomes increasingly difficult for the entire family to
heal. This is important because mental
illness tends to cluster in families, so that mothers struggling with
depression may also face additional mental health problems themselves while
trying to find help for their kids who suffer with attention deficit-hyperactivity disorder (ADHD),
conduct problems, depression or anxiety. This is especially hard for
families when the mother herself—someone on whom everyone relies—is affected
with mental illness.
Unfortunately, when a child is being treated for a
psychiatric illness and the child’s mother suffers from depression, the child
is much less likely to recover from his own illness, despite treatment. As it
turns out, when children face other challenges such as poverty, neighborhood
violence or family conflict, “maternal warmth” is a key protective factor against
depression and behavioral problems. Furthermore,
successful prevention efforts for emotional and behavioral problems in kids can
also help with improvements in maternal depression, and successful treatment of
maternal depression can help kids recover from their own illnesses. In
fact, the pathway of many successful prevention programs targeted toward kids
is through improvement in moms’ depression. So, healthy moms mean healthier
kids, and healthier kids mean healthier moms.
Importantly, interventions exist to encourage maternal
warmth and to help mothers and kids have more positive interactions. Some interventions target the quality of
interaction (e.g., parent-child interactive therapy which focuses on parents of
preschoolers, or parent training, which teaches parents to support their
children’s positive behaviors), and others focus on mothers’ mood (e.g., interpersonal
therapy, cognitive behavioral therapy). In research studies, maternal warmth
toward kids can be “measured,” as it can be reported by moms themselves,
observed in the lab or home (e.g., mother-child interactions about
problems/conflicts or happy experiences), or reported by kids or other adults.
More good news is that maternal depression can be treated. There are evidence-based psychotherapies and
pharmacologic treatments for depression available to moms, sisters,
grandmothers and daughters. Be sure to
talk to your doctor to find out which treatment approach is right for you or
your loved one.
Here in Pittsburgh, two studies are currently examining maternal
depression. The MOMS study
looks at the impact of treating maternal depression on children who are
experiencing a range of mental health difficulties. The study is testing two
psychotherapies as possible treatments for maternal depression and looking at
the impact of maternal depression treatment on both mothers and their children.
Also, the Pitt
Mother & Child project has studied boys from low-income backgrounds and
their mothers over a nearly 20-year period to determine how early social
context risks, including maternal
depression, dangerous neighborhoods, and harsh parenting throughout childhood,
can influence the development of problems such as antisocial behavior,
substance use and depression. This study is also investigating how boys’ early
social experiences are related to their brain function during adolescence and
We know that moms want to be the best moms they can be. To
be at your best, however, you need to address your emotional health as well as your
physical health. Emotional health is important
not just for mothers but also for the entire family.
Holly A. Swartz, M.D., and Erika E. Forbes, Ph.D. are associate professors of Psychiatry, at Western Psychiatric Institute and Clinic of UPMC and the University of Pittsburgh School of Medicine.