Babies are resilient. There’s no doubt about it. But babies and children may be negatively affected by a mom’s untreated depression, anxiety, or other mood disorder during pregnancy or postpartum. And it seems to me that this might not be a risk worth taking. Moms need help for PPD.
Please note carefully the specifics of what I said above: “Babies and children may be affected by a mother’s UNTREATED depression, anxiety, or other mood disorder during pregnancy or postpartum.” Many, many of you can attest to the fact that children whose mothers suffered from prenatal or postpartum depression or anxiety and received treatment are just fine- even thriving.
Moms who make it a priority to get help for PPD, follow treatment recommendations from a trained professional, get well, and take care of themselves do so to benefit not just themselves but also their children. And most of these kiddos go on to be happy and healthy preschoolers, teens and adults.
What we worry about is when a mom’s depression or anxiety goes untreated. It is these instances when there is high potential for emotional, social and developmental delays in babies and children. I say this fully knowing that this fact may bring additional layers of anxiety to women who already suffer, and I am hopeful that those women understand that this post is not a condemnation or a finger shake. It is, instead, a compassionate offering through a realistic look at the risks that may come to those who do not reach out for the support that they deserve.
I am motivated to write this after reading an article in the New York Times Magazine that talks about Depression in Preschoolers. While we know that there are many factors contributing to the development of depressive symptoms in children this young, and that often these children do not have parents who are depressed themselves (and, conversely, having a depressed parent does not necessarily mean that a young child will also be depressed), we do know that many of these little people may not have received the empathetic attunement and emotional mirroring from their mothers that they need to thrive. Babies need to be attended to and heard, they need to be held and comforted, they desire eye contact and voice recognition, and if a mother is unable to provide these things because she is depressed or anxious, a baby may suffer the consequences.
So, here are some of the risks for babies and children whose mothers suffer from UNTREATED antenatal or postpartum depression and anxiety:
- Pregnant women who are depressed are less likely to take adequately care of themselves and their unborn babies.
- Preterm labor has been linked to depression and anxiety in pregnant mothers.
- Preeclampsia has been linked to depression and anxiety in pregnant mothers.
- Depression and anxiety during pregnancy has been linked to low birth weight in babies.
- Babies whose mothers were depressed or anxious during pregnancy are more likely to have eating and sleeping challenges and are more likely to be difficult to soothe.
- Attachment and bonding may be negatively affected and this can have an impact on a child’s ability to form healthy relationships during school-aged years and on through adulthood.
- Fathers, whose partners are depressed, are also more likely to develop depressive symptoms in the postpartum period. If this happens, neither parent may be able to attend to the emotional needs of their newborn.
- Mothers who have postpartum depression tend to spend less time engaging in eye contact, mirroring facial and voice expressions, and casual play with their babies. All of these activities are important for bonding and attachment.
With this said, we know that other caregivers, such as a father, grandparent, other family member, friends, and nannies can provide the emotional reciprocity that is needed if and when a mom is temporarily unable. While a baby needs its mother first and foremost, that child will absolutely be okay if, temporarily, it is getting all of its physical and emotional needs met by someone else. What matters most, truly, is that mom gets the support that she needs to feel well so that she can care for her babe in the ways that are important to both of them.
So, moms, if you are suffering, please get help. For you and for your little one.
Kate Kripke, LCSW
I didn't get help for my PPD until it was almost gone (about 8 months PP) and now my son is delayed in his social really bad. He is a happy kid but he doesn't interact very well and he doesn't talk much. He didn't smile until he was nearly 6 months old. I used to blame myself, but I know I was ill and it's not my fault. I just won't let it happen again. Next time we are getting help.
Thanks so much for your honesty around this, Jeanette. It sounds like you are a mom who is attuned to your kiddo's strengths as well as his challenges. Also remember that what is important is that moms get well and the growth that occurs as a result. That little guy is lucky to have you.
Warm wishes-
It is very sad and unfortunate for all parties involved when women are too scared or ashamed to get help. It is also sad when a mom is not cured by medication, as is the case with many…otherwise, women would not ever have to suffer for six months, a year, or beyond. My point here is that moms with ppd need to focus on rebuilding their health; mental, emotional and physical, as well as their social support system to help them heal. Relying on meds alone, and hoping for a quick fix is going to leave some women even more devastated and hopeless…Please women, if you use meds and do not get relief, or only complete relief, you NEED to consider other options. Best, Kris
I think it's important to note that "is linked to" does not mean "is caused by." I think there's strong reason to suspect that links such as depression/anxiety and preterm labor, depression/anxiety and preeclampsia, depression/anxiety and low birthweight, stem from a common root cause. Few women are adequately tested for hypothyroidism (with a full blood panel and assessment of symptoms, rather than a simple TSH test) or adrenal fatigue (which most doctors haven't even heard of). Vitamin D is only now beginning to get priority, although the RDAs are still abysmally low. And the dietary recommendations given to most pregnant women and postpartum women are very far off the mark; the Brewer Diet makes more sense and has better outcomes than does the USDA food pyramid based diet.
Thanks, Jeni. When we say that some of these issues in pregnancy as "linked" to depression/anxiety, what we are referring to is the common reality that many women who are moderately or severely depressed or anxious are LESS likely to take good care of themselves (less likely to eat well, get adequate sleep, make it to doctor appointments) and MORE likely to engage in unhealthy behaviors such as smoking, drug use, and drinking alcohol than women who are not suffering from depression/anxiety. By this, we mean that it is not the depression or anxiety that cause these problems, per se, but the effects of the depression or anxiety. I think that this is important to note, and it goes back to the basic message in the post. When women are suffering, caring for themselves is important for both their own well being as well as for the health and wellness of their little ones…
Checking thyroid levels during the perinatal is so important- thanks for mentioning this. Hyperthyroidism and hypothyroidism do mimic symptoms of anxiety and depression and so these medical cuases of symptoms should always be ruled out.
Thanks for sharing your wisdom-
Ahh, yes- thanks so much for this Kris. Many times doctors (obgyn) might prescribe medication without recommending the simultaneous support of a therapist. We do know that while PPD is primarily a biochemical issue, many other psych and social stressors play a role, and psychotherapy is often a hugely important part of the recovery process (as is healthy nutrition and adequate sleep!!). While the first stop in PPD recovery used to be medication, it is a recommendation by many that the first stop be a therapist who can then refer to appropriate medication support if needed.
Thank you for posting this. I am especially thankful for the last paragraph in which you stated that babies will be just fine with temporary caregivers while the mother is unavailable. I have to work at not beating myself up for not being able to take care of my boys when I was hospitalized over and over that first year or afraid to go near the baby. I am so thankful I had my husband and other friends and family to take care of and love my children when I was unable to be there for them. I had my youngest 41/2 years ago and he is absolutely thriving in every way. If it hadn't been for my support system things could have turned out very differently.
Did u take any treatment,how long it took for u to recover,how do u feel when u start recovering.
I am applauding you, Marcie. It certainly does take a village and we are one of the only cultures where it is assumed that Mom must do it all herself. It sound like your boys were not only getting adequate care, but they were benefiting from the many layers on love at the same time. Three cheers for you.
My son has sensory processing disorder, and his primary issue is anything oral. His diet is very limited, and getting him to eat anything new is a struggle that takes months for each new food.
Did my (poorly treated) PPD cause this?
Dear Karin-
What I hear in this post is the ever-so-common guilt that accompanies many, many women who have suffered from PPD. Please know that this post is written to encourage moms who are suffering to reach out and not, by any means, to bring layers of guilt to those who did not receive the support that they deserved- for whatever reason. As mothers and as women we all do the very best that we can and that is what we need to remind ourselves of on a daily basis. I do not know the specifics of your situation to be able to answer your very heart felt question with the accuracy and detail that it deserves. What I do know is that there are many disorders that babies and children struggle with which have absolutely no connection to a mom's battle with depression or anxiety. And many, many women with children who have sensory processing disorder did not struggle with PPD. I am certain that parenting a kiddo with the challenges that you describe must not be easy and must be trying on you.
Please be kind to yourself.
My son, with whom I had PPOCD, does not have sensory processing disorder. My daughter, with whom I did not have any perinatal mood or anxiety disorder, does have SPD. I can't tell you what caused it. I can tell you that when she was younger, she wouldn't eat anything but milk, butter, cheese and noodles. We called it the white diet because it seemed like the only things she'd eat were white. Now, at the age of 5, she eats everything. She's been going to occupational therapy since she was 2 and is doing very well. I also know others who children's oral issues have not resolved, so please know that I'm only sharing my own experience here.
Postpartum Progress has always focused on sharing all evidence-based treatments, including but not limited to meds. Therapy, for instance, has been shown to be very effective for PPD.
And, as I have always said, there is no quick fix for PPD, regardless of the treatment method used.
I hid my ppd from everyone and now my little girls 20 months and I am not the same person I was I have severe anxiety hot sweats depression I can’t tell now if this is still ppd untreated or my other issues pmdd and a history of depression. I love my daughter but I feel ive been badly let down by all my care professionals I was illnand needed help I was high risk I feel ive let my baby down as I couldn’t bond with her and I feel very sad that I lost that precious time with my baby …
Hi Sarah – It’s never too late to get help. Many women don’t reach out right away for many reasons, but you can reach out now. Whether it’s PPD or PMDD or just depression in general, there are treatments available to you and you will get better. I’m sorry more healthcare professionals didn’t notice you were high risk and suggest things to you sooner. This happens to many women and it’s a real problem we are trying to change. You can make a positive step forward now by calling a doctor or therapist and asking for help. You’re not alone.
Unfortunately in my mams day there was no support, she did not receive help and has suffered depression and anxiety for the rest of her life. My earliest memories are of her going in and out of psychiatric care, I have had to try and be there for her most of my adult life after my dad died. It has been a night mare for me. She is now 80 and it is still going on. She is now addicted to a lot of medication and I have not had the mam I would of liked. I feel I was robbed of that.