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More Than Blue

How Children Feel the Pain

How a woman's depression may influence her child -- even a newborn -- is unpleasant to consider. In fact, some researchers think that the degree of a depressed woman's stress may influence the hormone levels in utero.

The effects continue after birth. "Some women who are depressed are less apt to make eye contact with their children or engage in the typical excited cooing and baby talk that other mothers do," says Jeffrey Kelsey, M.D., director of the Mood and Anxiety Disorders Clinical Trials Program at Emory University School of Medicine. Depressed mothers are also less likely to be physically affectionate and more likely to be irritated by typical baby behavior.

For the mothers of toddlers and pre-schoolers, this irritability can pose a big problem. "When I became depressed about ten months after my first daughter, Brittany, was born, I became increasingly dissatisfied with both of us," says Susan Cappetta, a mother of two in Concord, Massachusetts. "Then, when she was a toddler, I expected her to behave like a little adult. I'd yell at her and then feel guilty. I thought I had a strong-willed child, but, looking back, I realize she was a totally normal two-year-old."

Lack of energy is another symptom that makes caring for a young child difficult. Elizabeth Novitz, of Canoga Park, California, had struggled for years with depression, trying both medication and therapy, but in 1996 she was truly happy after giving birth to the daughter of her dreams. For the first three months, Novitz immersed herself contentedly in Lianna's care, "but the happiness didn't last," she recalls. "Gradually, I began to think about death. I couldn't help it. It felt as if Lianna were the only reason I had not to kill myself." Though recent treatment has helped Novitz overcome the worst of her depression, some lethargy and sadness linger รณ and Lianna is now old enough to notice. "Sometimes, she'll bring me a blanket and say, 'Mommy, what's the matter?' I'll tell her I'm tired or a little sad, and she'll give me a kiss and go back to playing. She's sweet, but I worry about the long-term effect on her."

Equally worrisome is what children may think but not vocalize. "By age three, kids are extremely perceptive," says Dr. Kelsey, "and they have active imaginations. If Mom isn't looking at them, playing with them, or hugging them as much as she used to, they may think that she doesn't love them anymore."

Mary Duffy, a mother of two in Middlebury, Vermont, had been clinically depressed on and off for much of her life. But when she saw that a recurrence of her illness was clearly apparent even to her youngest child, it alarmed her enough to seek new treatment.

"By that time, I'd explained to Mimi, who was seven, that I was sick and that there were certain things I didn't have the energy to do. She'd help out in practical ways, such as carrying things to the car, and was always trying to do funny things to make me smile. But one day Davey, who was only three, handed me a toy and said, 'Here, Mommy, take this to work; it'll make you happy.'"

Some toddlers may act out rather than express their worries in words, says Martha Eidmann-Hicks, a licensed marriage and family therapist in Colts Neck, New Jersey. "Fighting with other kids or misbehaving is a way of forcing a withdrawn mother to be more involved," she says.

For this reason, parents should talk simply and directly about what's going on to children who are old enough to understand (see "How to Talk About a Parent's Depression"). But most important for a child's long-term happiness is that his mother gets help.

Click ahead for Obstacles to Seeking Help