Mental Health: A Report by the Surgeon General

Depressed parents may be withdrawn and lack energy and consequently pay little attention to, or provide inadequate supervision of, their children. Alternatively, such parents may be excessively irritable and overcritical, thereby upsetting children, demoralizing them, and distancing them (Cohn et al., 1986; Field et al., 1990). At a more subtle level, parents’ distress— being pessimistic, tearful, or threatening suicide—is sometimes seen or heard by the child, thereby inducing anxiety. Depressed parents may not model effective coping strategies for stress; instead of “moving on,” some provide an example of“giving up” (Garber & Hilsman, 1992). Depression is also often associated with marital discord, which may have its own adverse effect on children and adolescents. Conversely, the behavior of the depressed child or teenager may contribute to family stress as much as being a product of it. The poor academic performance, withdrawal from normal peer activities, and lack of energy or motivation of a depressed teenager may lead to intrusive or reprimanding reactions from parents that may further reduce the youngster’s self-esteem and optimism.

The consequences of maternal depression vary with the state of development of the child, and some of the effects are quite subtle (Cicchetti & Toth, 1998). For example, in infancy, a withdrawn or unresponsive depressed mother may increase an infant’s distress, and an intrusive or hostile depressed mother may lead the infant to avoid looking at and communicating with her (Cohn et al., 1986). Other studies have shown that if infants’ smiles are met with a somber or gloomy face, they respond by showing a similarly somber expression and then by averting their eyes (Murray et al., 1993).

During the toddler stage of development, research shows that the playful interactions of a toddler with a depressed mother are often briefer and more likely to be interrupted (by either the mother or the child) than those with a nondepressed parent (Jameson et al., 1997). Research has shown that some depressed mothers are less able to provide structure or to modify the behavior of excited toddlers, increasing the risk of out-of-control behavior, the development of a later conduct disorder, or later aggressive dealings with peers (Zahn-Waxler et al., 1990; Hay et al., 1992). A depressed mother’s inability to control a young child’s behavior may result in the child failing to learn appropriate skills for settling disputes without reliance on aggression.

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