To deal with her depression and anxiety issues, JD Bailey does not use prescription drugs. She uses the delicate-fabrics setting on the dryer.
Four years ago, Bailey was prescribed a low dose of Zoloft to offset the overwhelming sadness and irritability of the postpartum depression that followed the birth of her youngest daughter, Grace. But over time the Zoloft stopped working, and the side effects—swelling, weight gain, trouble sleeping, nonexistent libido—were brutal. So her doctor switched the script to Celexa.
Thus began a carousel of selective serotonin reuptake inhibitors: Zoloft, Celexa then Zoloft again, then Viibryd, then Prozac.
Today, Bailey is not taking anything. For the past few months, her drug of choice has been five minutes in the laundry room.
“Last week I had to step away when my six-year-old, Annie, was having a full meltdown,” says Bailey, who chronicles her depression on her blog, Honest Mom. Bailey's mind started to spin, and her chest tightened. “I felt like the worst parent in the world because I didn't want to make her feel better,” she admits. “I just wanted to get out of there.”
So that's what she did. Bailey went into the laundry room, turned on the dryer, and breathed until “I knew I could be levelheaded, hug her, and talk her through it.”
Bailey's therapist says she has “situational depression.” “And you know what my situation is, what triggers my anxiety and sadness?” Bailey asks. “My kids.”
Bailey lives in a suburb of Boston, where children ride bikes in front of split-level colonial homes and locals make brownies for the neighborhood bake sale. It's the kind of charmed hamlet that teaches an important lesson: Depression and anxiety live everywhere. One in every ten Americans reports being depressed, according to the Centers for Disease Control and Prevention. Anxiety disorders affect 40 million adults in the U.S.
But parents are arguably the most vulnerable to these issues. From pregnant women to fathers to mothers of multiples to stay-at-home moms, they experience depression at rates twice that of the general population.
“Parenting is a tough job, one that is exhausting on a good day,” says Jenn Berman, a licensed psychotherapist in Beverly Hills and author of The A to Z Guide to Raising Happy, Confident Kids. “If you're also prone to depression, it can push you over the edge.”
Yet to the naked eye, the line that separates these mental issues from everyday parenthood is as thin as the chalky blue strip on a pregnancy test. From our children's health to their development to their performance at school, there's always something for moms and dads to be happy—or anxious—about. The common definition of depression states that a multitude of the following symptoms be present for a two-week period: fatigue and decreased energy, feelings of pessimism, overeating or appetite loss, insomnia or early-morning wakefulness, loss of interest in hobbies and activities once found pleasurable and irritability and restlessness. That describes half the parents I know.
Our awareness of depressive and anxiety issues is at an all-time high (thank you, TV commercials), and our family physicians and ob-gyns can write scripts as easily as psychiatrists. It all adds up to our becoming Generation Medication: More than one in five American adults now take at least one type of medication to treat a psychological or behavioral disorder, a 22 percent rise since 2001. For women ages 20 to 44, the use of ADHD medication is up a staggering 264 percent over the past decade.
But very little talk surrounding depression and anxiety focuses on parents, which is hard to believe, since their mental well-being has a significant effect on our most precious cargo. “Depression…can have serious biological, psychological, behavioral and social consequences, especially on children who rely on a parent for caregiving, support and nurturance,” according to Depression in Parents, Parenting and Children, published in 2009 by the National Research Council. It's associated with poorer physical health, especially in infants, difficult temperament and aggression, lower cognitive performance and higher rates of anxiety and depression. Sixteen million children are living in households with a depressed parent, so there are an enormous number of young lives at stake.
What does it mean that more kids are being raised with the help of Xanax, Cymbalta and Wellbutrin? And is there an answer beyond the chemicals that live in a small, oval, baby-blue pill?
It's 3 a.m., and Hope Chanda is awakened by another panic attack. Not again, she thinks. But sure enough, the symptoms are all there: tightening in the chest, pressure on the rib cage, shortness of breath. “Every time, I feel like I'm going to die,” she says.
There have been many emotional hours—and days and weeks and years—leading up to this particular 3 a.m. For the past two years, Chanda and her husband, Joe, parents of twin 6-year-old boys in Melbourne, FL, have been trying to get pregnant: six rounds of fertility shots and three cycles of the fertility drug Clomid. “All the hormones made me crazy,” she adds. But toughest of all were the two miscarriages, a kind of invisible, unspoken tragedy that moms largely grieve alone.
“After the second miscarriage, it all came out,” she says. “I had this feeling that something was really wrong. But at the same time, I felt like I had to be this rock for my family.” She didn't want to end up like her mother, who was hospitalized for anxiety issues when Chanda was 10.
“You know how on an airplane the flight attendant says to put on your own oxygen mask first, then your child's? That applies here,” Berman says. “It's really hard for moms to put their well-being first, but they have to help themselves before they can help their children and families.” Unlike a cut or a broken bone, depression is an unseen enemy that can be pushed to the margins of life. Add T-ball and stomach bugs and bake sales and carpools into the mix, and getting help falls to the end of the to-do list. For this reason, Berman believes there is a large population of undiagnosed parents, particularly moms: Women suffer depression at a rate twice that of men.
After one too many midnight panic attacks, Chanda talked to her family doctor. Now she takes half a milligram of Xanax twice a day, and 20 milligrams of Celexa at night.
“It helps me be a better mom,” says Chanda. “I look forward to taking my medication. I'm more flexible, tolerant and rational. Before, when the kids were being a problem, I would get frustrated and yell immediately. Now, we work through the problem.”
Allan Horwitz does not like those gauzy, dreamlike TV commercials for antidepressants and anti-anxiety medications, the ones where people ride mountain bikes as the voice-over prattles on about dry mouth, constipation, and difficulty breathing.
He may be biased. Horwitz is a professor of sociology at Rutgers University and author of The Loss of Sadness: How Psychiatry Transformed Normal Sadness Into Depressive Disorder. This is the guy who tells me “the psychiatric community has reclassified normal human sadness as an abnormal experience.” In layman's terms, we're using meds to deal with the emotional roller coaster of parenthood.
“Let's say you have a colicky baby,” says Horwitz. “Colic means your baby is not sleeping, which means you're not sleeping. Now you have resulting symptoms from that—fatigue, irritability, feeling overwhelmed. And there's a good chance the colic will last well beyond two weeks, which is the standard criteria for measuring depression. By the experts' definition, you're depressed. But circumstances change. Things get better. We've become less tolerant of negative emotions. It's much easier to take a pill.”
So how can we make these distinctions? With anxiety, it's the difference between worrying about paying bills and an unsubstantiated worry that causes significant distress. For depression, it's not about feeling overwhelmed on a bad day; it's persistent feelings of hopelessness. But Berman makes clear that it's not a parent's job to self-diagnose. “That's what therapists are for.”
Every morning John Buffington, a father of two in Philadelphia, pops a Claritin and 20 milligrams of Celexa. “While it was different for my dad's generation, I'm taking on a more nurturing role at home. To do that, you have to be in touch with your feelings,” says Buffington as he gives his 9-month-old son a bottle. “Celexa helps me do that.”
What about talk therapy? “I spent a couple years in therapy, but then the insurance stopped covering it and it became too big of an expense.”
This is a common scenario: Getting the medication is relatively cheap and easy, and talk therapy is expensive and hard. If the meds make you feel normal, why do anything else?
“You should not take psychiatric medication unless you are in psychotherapy,” says Carole Lieberman, M.D., a psychiatrist and faculty member at UCLA's Semel Institute for Neuroscience and Human Behavior. “The medication is a Band-Aid to combat the symptoms while you work on the root of the problem.”
The American Psychological Association (APA) is working to promote talk therapy, which is an uphill battle against the seemingly endless TV commercials. “Compared with medication, psychotherapy has fewer side effects and lower instances of relapse,” states Katherine Nordal, Ph.D., the APA's executive director of professional practice.
“If your partner is dealing with these issues, push them to start—and stick with—talk therapy,” says Berman. “Therapists give you the tools to manage your triggers.”
One evening at bedtime, Bailey's daughter Annie said, “Mommy, I'm sad and I don't know why.” Her heart sank. Shortly thereafter, Bailey weaned herself off the meds “under my doctor's supervision and my husband's watchful eye.”
“I'm exercising, eating better and making sure my spouse and I have time together,” she says. Things are going well, but she's on eggshells. Bailey is not far removed from the days when the tears came too easily, when she had to tell her daughters, “Mommy's not feeling well today.” But she's been on this battlefield before, and she's ready for a fight.