Winter 2006

Maternal Depression and Its Effects on Children

Beth Troutman, PhD, ABPP; Tracy Moran, MA
Christina Franklin, MA; and Kimberly Nylen, MA
Departments of Psychiatry and Psychology, University of Iowa

Children of depressed mothers are at increased risk for impaired functioning in a number of domains. The types of adjustment difficulties vary depending on the child’s age, and typically reflect the developmental tasks associated with that age. For example, children of depressed mothers begin to exhibit social, emotional, and cognitive problems during infancy, but do not exhibit increased rates of depression until adolescence.

Children of depressed mothers Cry more and are harder to soothe Are less likely to form secure infant-mother attachments Are at risk for delays in cognitive, motor, and language development Are at risk for aggressive and oppositional behaviors in childhood, and for depression in adolescence

Child problems Children of depressed mothers cry more and are more difficult to soothe, according to reports of their mothers and independent observers. Infants of mothers who receive anti-depressants for clinical depression during pregnancy or are clinically depressed during the postpartum period are less likely to develop secure infant-mother attachment relationships. Such relationships typically develop as mothers respond sensitively to their infant’s distress signals (i.e., crying) and positive bids for interaction (smiling, reaching out. Development of a secure attachment relationship by the end of the first year of life is an important milestone associated with positive emotional functioning at later ages. Maternal depression is also associated with delays in cognitive, motor, and language development during infancy and early childhood. This is especially true when maternal  depression is chronic or  accompanied by additional risk factors such as low socioeconomic status or impaired mother-infant interaction.

Some studies have found that these delays persist for several years after the maternal depression resolved. During childhood, children of depressed mothers are at increased risk for aggressive and oppositional behavior. Sons of depressed mothers are at greater risk for these types of problems than daughters. In adolescence, depression and anxiety disorders are more common among children of depressed mothers, and daughters are at greater risk than sons.

Parenting difficulties
A lack of confidence in the ability to carry out parenting tasks is often associated with maternal depression, and may be one of the first indicators observed by healthcare providers. Providers may be understandably hesitant to ask about maternal depression in the context of assessing and treating children, for mothers struggling with depression and feeling demoralized about their parenting abilities may become defensive if concerns are raised about their mental health. The stigma associated with mental health concerns can make it difficult for providers to inquire about maternal depression, and for mothers to acknowledge depressive symptoms.

By openly and matter-of-factly asking mothers about their stress levels and mental health, healthcare providers can make mental health concerns, including maternal depression, a little less frightening. A dialogue about maternal mental health might begin with a reference to the relationship between child functioning and maternal depression. For example, “Parents often find it really stressful to deal with a new baby who cries a lot. How are you doing?”

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