Great Information taken from www.pregnancy.org for husbands and family members.
by Karen Kleiman
Understanding Postpartum Depression
Postpartum depression (PPD) affect 20% of all postpartum women.
PPD is a medical condition that can be treated successfully.
PPD is a clinical depression that can occur any time immediately after birth up to a year postpartum.
If your wife has been diagnosed with PPD, it's very important for you to be informed and part of the treatment.
PPD can strike without warning -- in women with no history of depression or women who have had it before. It can happen to women who are highly successful in their careers or women who stay home with their children. It can strike women in stable marriages and conflictual marriages, as well as single women, and adoptive mothers. It can happen to women who love their baby more than anything in the world. It can happen after the first baby, or after the fourth.
It can happen to women who swore it would never happen to them.
It is not completely understood why PPD affects some women and not others -- why women who have many risk factors may no experience it, and others who have no risk factors may end up with a full blown episode.
Women are twice as likely to experience depression than men.
Women are most at risk to experience emotional illness following the birth of a baby than at any other time.
PPD is a real illness.
She is not making this up.
This did not happen because she's a bad mother, or doesn't love her baby enough.
It did not happen because she's having negative thoughts about herself or about you or about your baby.
It did not happen because she is weak and not working hard enough to get better.
She cannot "snap out of it."
This is not fair. This is not what you expected. But if your wife has been diagnosed with PPD, it will take a while for her to recover. Recovery may take weeks to months.
She will get better. She will return to her "normal" self. She will begin to experience pleasure again. This will not happen overnight.
The more supportive you are of her treatment, the smoother her recovery will be.
PPD is nobody's fault. It is not your wife's fault. It is not your fault.
Try to reassure your wife that there is nothing she has done to make this happen.
Often, when we are struck by something we do not understand, we try to cast blame on someone or something. This will be counterproductive.
Remember that we do not know exactly why this happened. What we do know is what to do to maximize the healing process.
Do not spend excessive energy trying to figure out what went wrong or why this happened. Your search for reason will frustrate you and it will keep your wife spinning along side of you. Save your energy for navigating through this unfamiliar territory.
What to say
Her moods and emotional vulnerability will get in the way of good communication for now. Here's what you're up against:
-If you tell her you love her, she won't believe you.
-If you tell her she's a good mother, she'll think you're just saying that to make her feel better.
-If you tell her she's beautiful, she'll assume you're lying.
-If you tell her not to worry about anything, she'll think you have no idea how bad she feels.
-If you tell her you'll come home early to help her, she'll feel guilty.
-If you tell her you have to work late, she'll think you don't care.
But you can:
Tell her you know she feels terrible.
Tell her she will get better.
Tell her she is doing all the right things to get better (therapy, medication, etc.).
Tell her she can still be a good mother and feel terrible.
Tell her it's okay to make mistakes, she doesn't have to do everything perfectly.
Tell her you know how hard she's working at this right now.
Tell her to let you know what she needs you to do to help.
Tell her you know she's doing the best she can.
Tell her you love her.
Tell her your baby will be fine.
What NOT to say
Do not tell her she should get over this.
Do not tell her you are tired of her feeling this way.
Do not tell her this should be the happiest time of her life.
Do not tell her you liked her better the way she was before.
Do not tell her she'll snap out of this.
Do not tell her she would feel better if only: she were working, she were not working, she got out of the house more, stayed home more, etc.
Do not tell her she should lose weight, color her hair, buy new clothes, etc.
Do not tell her all new mothers feel this way.
Do not tell her this is just a phase.
Do not tell her if she wanted a baby, this is what she has to go through.
Do not tell her you know she's strong enough to get through this on her own and she doesn't need help.
Things you should know about her treatment
Good therapy can be expensive. But expensive therapy isn't always good.
Getting help for your wife has to be the priority here. If you are more worried about how much it costs, she will stay sick longer.
Her illness is real. She needs treatment.
So, how do you know if her therapist or doctor is good? Ask yourself these questions:
Did you feel comfortable with this person? (Yes, you should attend a session).
Does your wife like him/her? (This is more important than you might think. Connecting with this person is half the battle)
How does your wife feel about her sessions?
Does she think it's helping?
Does she feel good about going?
Does she trust this person and feel comfortable talking?
Try to find someone who works short-term and focuses on the here-and-now, rather than issues from the past. These issues are important, but not necessarily productive at the outset, when we want to manage symptoms.
The cost of treatment is a very real concern. But so is her staying sick, isn't it? Please do not let the financial issues get in the way of her getting the help she needs. There are options. Sliding scales. Insurance plans. Payment schedules. Bringing up your worries about the money can actually sabotage her recovery by making her feel guilty. Be careful how you do that.
Encourage your wife to discuss any financial concerns with her therapist. Contact your insurance company. Depending on your particular plan, find out whether you need a referral from your primary and if so, try to find a therapist who is a provider for your network. If not, find out whether or not they reimburse this particular therapist. Most insurance companies will ask you the therapist's credentials to determine reimbursement. If the therapist is not covered at all, find out what arrangement can be made.
Yes, you should go to a session with her. Some women like their husbands to join them for the first one. Others prefer their husbands wait until a relationship has been established with the therapist. Ask your wife if she'd like you to go with her and when. Then do it.
You are going for a few reasons:
To show your support;
To meet her therapist and see who's "taking care" of her;
To ask questions, to get information, to receive support;
To provide information to the therapist about your wife, your relationship, relevant history, etc.
PPD becomes a family issue. Do not let your wife carry the load of this illness alone. Supporting her decision to go to therapy is vital for her recovery. Remember, therapy for PPD should be short-term. In therapy terms, this usually means 3-5 months. But she should receive initial relief right away. Depending on the severity of her illness, she should start feeling somewhat better in the first few weeks.
Emergency situations
If your wife tells you she cannot take this pain anymore, it's a very serious statement that means it's time for an evaluation by someone who specializes in the treatment of depression.
Remember, her thoughts are distorted and it is possible that things feel much worse to her than they appear to you.
It is not up to you to determine whether she's at risk for hurting herself or someone else. A professional should determine it.
Stay with her. Ask her if she feels safe from harm. Help her make an appointment with some she feels can help her. Call her doctor. Do not leave her alone.
The following situations are rare, but warrant immediate intervention. Emergency situations mean you should take her to the closest hospital, call 911. DO NOT LEAVE HER ALONE FOR ANY REASON:
Talk of hurting herself;
Bizarre thinking patterns, hallucinations, delusions;
No sleep in several days. This means NO sleep, usually coupled with manic-like symptoms. Sleep deprivation can worse symptoms;
Noticeable withdrawal from all social contact;
Preoccupation with death, morbid ideas, or religious ideation;
Persistent feelings of despair and hopelessness;
Expressions such as: "My children would be better off without me here."
Karen Kleiman, MSW, Licensed, Clinical Social Worker, co-author of This Isn't What I Expected: Overcoming Postpartum Depression and author of The Postpartum Husband: Practical Solutions for Living with Postpartum Depression, has been working with women and their families for over 20 years. A native of Saint Louis, MO., Karen has lived in the Philadelphia area since 1982 with her two children and her husband. After graduating in 1980 from the University of Illinois at Chicago with her Masters in Social Work, she began her practice as a psychotherapist, specializing in women's issues. In 1988 she founded The Postpartum Stress Center where she provides treatment for prenatal and postpartum depression and anxiety
Thursday, October 1, 2009
Tuesday, September 29, 2009
Sunday, September 20, 2009
Healing Postpartum Depression
http://www.cbsnews.com/video/watch/?id=5293553n
Dr. Jennifer Ashton sits down with Dr. Elizabeth Fitelson to discuss post-partum depression. Dr. Fitelson's advice for new mothers includes counseling, nutrition and awareness to signs of depression.
Taken from www.cbsnews.com
follow blog in real time at www.condron.us and www.alphainventions.com
Dr. Jennifer Ashton sits down with Dr. Elizabeth Fitelson to discuss post-partum depression. Dr. Fitelson's advice for new mothers includes counseling, nutrition and awareness to signs of depression.
Taken from www.cbsnews.com
follow blog in real time at www.condron.us and www.alphainventions.com
Saturday, September 19, 2009
Postpartum Depession and Fathers, Study with Colic
Article taken from NY Times Magazine September 19, 2009
Motherlode, Adventures in Parenting
August 14, 2009
Postpartum Depression and Fathers
By Lisa Belkin
My older son had colic. Every day at about four in the afternoon he would start to scream, and he would not calm down until eight or nine. We checked for every medical cause, tried every folk remedy, and nothing worked. If you treat colic, our pediatrician quipped, it goes away in about twelve weeks. If you don’t, it takes about three months. In other words, there’s very little you can do.
I was already weepy with what I now realize was mild post-partum depression back then, and this was not the news I wanted to hear. The whole nerve-fraying, battle-scarring experience has left me more attuned than average to news about either colic or post-partum depression, though, and earlier this summer an article in the journal Pediatrics wrapped the two topics into one study. Researchers at the Erasmus Medical Center in Rotterdam, the Netherlands, surveyed 4,426 expectant couples when the mothers were 20 weeks pregnant, and found that 12 percent of fathers and 11 percent of mothers showed symptoms of depression at that point.
Then, when the babies were two months of age, the researchers tallied parental reports of “excessive crying.” Twice as many of the depressed fathers (4.1 percent) and mothers (4.8 percent) had infants who cried for three or more hours a day (a definition of colic) than the non-depressed parents (2.2 percent of both non-depressed mothers and fathers.)
The “news” here? That Dad’s mental health can affect a newborn. Previous studies have looked almost entirely at Mom’s mental health. The advice? That parents-to-be of either gender might be well served by addressing signs of depression before a baby is born.
“It is likely that a substantial part of the fathers who were depressed during pregnancy were depressed after childbirth as well. In this respect, one could imagine that fathers with chronic depressive symptoms are less sensitive to their children, make less effort to comfort their children, and could also react with irritability or aggression toward their children,” the authors conclude. “On the other hand, it is plausible that excessive infant crying will put fathers with depressive symptoms during pregnancy at a higher risk to remain or become more depressed after childbirth because of the higher demands of caring for a child who cannot be comforted.”
This comes on the heels of a study presented at the annual meeting of the American Psychiatric Association in May confirming that men, too, appear to get post-partum depression. The symptoms may differ, with women becoming sad and withdrawn and men becoming irritable, but it can be classified as post-partum depression nonetheless.
The study, by researchers at the Center for Pediatric Research at the Eastern Virginia Medical School, reviewed data on 5,000 couples when their children were nine-months-old. One in ten fathers met the criteria for “moderate to severe postpartum depression,” which is well above the three to five percent of men in the general population who meet those criteria. (In contrast, 14 percent of new mothers have post-partum depression compared with 7 to ten percent of women in the general population.)
But while both men and women who are depressed interacted “significantly” less with their children – less reading and singing and story telling – it was only paternal depression that seems to have a measurable effect on a child’s development later on. Children of fathers with postpartum depression had smaller vocabularies at two years than children of non-depressed fathers or those of depressed mothers.
Does it ring true to you that fathers get depressed in the months after a baby arrives? Or that a depressed father has as at least as much of an effect on their baby’s development as a depressed mother? Have you lived with colic in your newborn? Postpartum depression in your spouse? What got you through?
Follow blog in real time at www.condron.us or www.alphainventions.com
Motherlode, Adventures in Parenting
August 14, 2009
Postpartum Depression and Fathers
By Lisa Belkin
My older son had colic. Every day at about four in the afternoon he would start to scream, and he would not calm down until eight or nine. We checked for every medical cause, tried every folk remedy, and nothing worked. If you treat colic, our pediatrician quipped, it goes away in about twelve weeks. If you don’t, it takes about three months. In other words, there’s very little you can do.
I was already weepy with what I now realize was mild post-partum depression back then, and this was not the news I wanted to hear. The whole nerve-fraying, battle-scarring experience has left me more attuned than average to news about either colic or post-partum depression, though, and earlier this summer an article in the journal Pediatrics wrapped the two topics into one study. Researchers at the Erasmus Medical Center in Rotterdam, the Netherlands, surveyed 4,426 expectant couples when the mothers were 20 weeks pregnant, and found that 12 percent of fathers and 11 percent of mothers showed symptoms of depression at that point.
Then, when the babies were two months of age, the researchers tallied parental reports of “excessive crying.” Twice as many of the depressed fathers (4.1 percent) and mothers (4.8 percent) had infants who cried for three or more hours a day (a definition of colic) than the non-depressed parents (2.2 percent of both non-depressed mothers and fathers.)
The “news” here? That Dad’s mental health can affect a newborn. Previous studies have looked almost entirely at Mom’s mental health. The advice? That parents-to-be of either gender might be well served by addressing signs of depression before a baby is born.
“It is likely that a substantial part of the fathers who were depressed during pregnancy were depressed after childbirth as well. In this respect, one could imagine that fathers with chronic depressive symptoms are less sensitive to their children, make less effort to comfort their children, and could also react with irritability or aggression toward their children,” the authors conclude. “On the other hand, it is plausible that excessive infant crying will put fathers with depressive symptoms during pregnancy at a higher risk to remain or become more depressed after childbirth because of the higher demands of caring for a child who cannot be comforted.”
This comes on the heels of a study presented at the annual meeting of the American Psychiatric Association in May confirming that men, too, appear to get post-partum depression. The symptoms may differ, with women becoming sad and withdrawn and men becoming irritable, but it can be classified as post-partum depression nonetheless.
The study, by researchers at the Center for Pediatric Research at the Eastern Virginia Medical School, reviewed data on 5,000 couples when their children were nine-months-old. One in ten fathers met the criteria for “moderate to severe postpartum depression,” which is well above the three to five percent of men in the general population who meet those criteria. (In contrast, 14 percent of new mothers have post-partum depression compared with 7 to ten percent of women in the general population.)
But while both men and women who are depressed interacted “significantly” less with their children – less reading and singing and story telling – it was only paternal depression that seems to have a measurable effect on a child’s development later on. Children of fathers with postpartum depression had smaller vocabularies at two years than children of non-depressed fathers or those of depressed mothers.
Does it ring true to you that fathers get depressed in the months after a baby arrives? Or that a depressed father has as at least as much of an effect on their baby’s development as a depressed mother? Have you lived with colic in your newborn? Postpartum depression in your spouse? What got you through?
Follow blog in real time at www.condron.us or www.alphainventions.com
Friday, September 18, 2009
Coping with Postpartum Depression-For Dad
Article taken from http://today.msnbc.msn.com/id/32403497/ns/today-today_relationships/
Coping with postpartum depression — for dads
It’s not just for moms: Life changes for new fathers can trigger depression
By Ian Kerner, Ph.D.
Sex therapist and relationship counselor
TODAYShow.com contributor
updated 12:23 p.m. ET, Thurs., Aug 13, 2009
Ian Kerner, Ph.D
For new dads, is there a male equivalent of PPD (aka postpartum depression)? There isn’t much research into the subject, but in talking to other counselors and therapists, I would estimate that rates of paternal depression range up to about 25 percent when there isn’t concurrent PPD in the female partner and as high as 50 percent among men whose partners are also experiencing postpartum depression. Rates are even higher in dads who work from home or stay at home, so it looks like there are a lot of sad SAHDs (Stay At Home Dads) out there. While men might not experience the hormonal changes that give rise to PPD, they do experience substantial life changes that can trigger depression.
Dealing with the baby bluesThis is one of those issues I dealt with personally. After the birth of my first son, it didn’t take long for me to feel sleepless, sexless, stressed out and burnt out. And as much as I loved being a father, I also felt worn down by the routine and disconnected from Lisa. I often wondered why I couldn’t be like all the other new fathers in the playground who beamed with happy smiles.
My way of dealing with the baby blues was via alcohol. Not to say there’s anything necessarily wrong with that glass of wine or a cocktail, but when alcohol (or any substance, for that matter) becomes the main way of dealing with the natural disorder of parenthood, then it’s potentially a problem. As an only child, I grew up in a quiet home. Nothing in my past had ever prepared me for the “wall of sound” that I’d encounter coming home to a baby. Walking through the door, my life went from calm to cacophony in an instant.
Sure, nothing beats getting greeted at the door with those jubilant little shouts of “Daddy!”, but after the birth of my second son, Beckett, it didn’t take long for the wall of sound to wear me down. I’d never been a drinker, and in fact I’d always made a point of not imbibing in light of a family history replete with alcohol problems. But I soon found myself savoring the difference between a smoky scotch from the Islay region versus a smoother single malt from the Highlands. I knew things were getting bad when the holiday time came and everyone bought me ... well, take a guess.
Today I know I am not alone. Since dealing with this issue, I’ve become much more attuned to the scores of new parents who find themselves extending the boundaries of cocktail hour and self-medicating their way through parenthood: from guys knocking back a six-pack a night to “Deadwood”-style bourbon drinkers to mommies who like to lunch (and then some) over a bottle of white wine.
So, where am I today? Dealing. I’ve chilled out on the drinking. Not completely, but more than partially. I’ve also started exercising before coming home whenever I can, which is really the dose of self-medication I need: iPod-enhanced, sweaty-palm-inducing, feel-good time on the treadmill. On a good day (which is most days), the wall of sound doesn’t sound nearly so bad.
Diagnosing dad’s depression:All new parents deal with the baby blues, but postpartum depression isn’t just something moms need to worry about. Is dad seriously depressed?
Does depression run in his family?
Has his libido gone down?
Is he having problems sleeping, even though he’s exhausted?
Is he avoiding going out with the baby and generally isolating himself?
Do you feel like he’s trying to put on a “happy front”?
Is he drinking more than usual or self-medicating in other ways?
Not only is it important to support the dad who may be experiencing PPD, it’s also important to think about how to get him professional help — he may just have a case of the baby blues, or it could be something more serious.
Ian Kerner is a sex therapist, relationship counselor and New York Times best-selling author of numerous books, including "She Comes First" and "Love in the Time of Colic." He was born and raised in New York City, where he lives with his wife and two sons. He can be reached at http://www.iankerner.com/.
follow blog in real time at http://www.condron.us/ and www.alphainventions.com
Coping with postpartum depression — for dads
It’s not just for moms: Life changes for new fathers can trigger depression
By Ian Kerner, Ph.D.
Sex therapist and relationship counselor
TODAYShow.com contributor
updated 12:23 p.m. ET, Thurs., Aug 13, 2009
Ian Kerner, Ph.D
For new dads, is there a male equivalent of PPD (aka postpartum depression)? There isn’t much research into the subject, but in talking to other counselors and therapists, I would estimate that rates of paternal depression range up to about 25 percent when there isn’t concurrent PPD in the female partner and as high as 50 percent among men whose partners are also experiencing postpartum depression. Rates are even higher in dads who work from home or stay at home, so it looks like there are a lot of sad SAHDs (Stay At Home Dads) out there. While men might not experience the hormonal changes that give rise to PPD, they do experience substantial life changes that can trigger depression.
Dealing with the baby bluesThis is one of those issues I dealt with personally. After the birth of my first son, it didn’t take long for me to feel sleepless, sexless, stressed out and burnt out. And as much as I loved being a father, I also felt worn down by the routine and disconnected from Lisa. I often wondered why I couldn’t be like all the other new fathers in the playground who beamed with happy smiles.
My way of dealing with the baby blues was via alcohol. Not to say there’s anything necessarily wrong with that glass of wine or a cocktail, but when alcohol (or any substance, for that matter) becomes the main way of dealing with the natural disorder of parenthood, then it’s potentially a problem. As an only child, I grew up in a quiet home. Nothing in my past had ever prepared me for the “wall of sound” that I’d encounter coming home to a baby. Walking through the door, my life went from calm to cacophony in an instant.
Sure, nothing beats getting greeted at the door with those jubilant little shouts of “Daddy!”, but after the birth of my second son, Beckett, it didn’t take long for the wall of sound to wear me down. I’d never been a drinker, and in fact I’d always made a point of not imbibing in light of a family history replete with alcohol problems. But I soon found myself savoring the difference between a smoky scotch from the Islay region versus a smoother single malt from the Highlands. I knew things were getting bad when the holiday time came and everyone bought me ... well, take a guess.
Today I know I am not alone. Since dealing with this issue, I’ve become much more attuned to the scores of new parents who find themselves extending the boundaries of cocktail hour and self-medicating their way through parenthood: from guys knocking back a six-pack a night to “Deadwood”-style bourbon drinkers to mommies who like to lunch (and then some) over a bottle of white wine.
So, where am I today? Dealing. I’ve chilled out on the drinking. Not completely, but more than partially. I’ve also started exercising before coming home whenever I can, which is really the dose of self-medication I need: iPod-enhanced, sweaty-palm-inducing, feel-good time on the treadmill. On a good day (which is most days), the wall of sound doesn’t sound nearly so bad.
Diagnosing dad’s depression:All new parents deal with the baby blues, but postpartum depression isn’t just something moms need to worry about. Is dad seriously depressed?
Does depression run in his family?
Has his libido gone down?
Is he having problems sleeping, even though he’s exhausted?
Is he avoiding going out with the baby and generally isolating himself?
Do you feel like he’s trying to put on a “happy front”?
Is he drinking more than usual or self-medicating in other ways?
Not only is it important to support the dad who may be experiencing PPD, it’s also important to think about how to get him professional help — he may just have a case of the baby blues, or it could be something more serious.
Ian Kerner is a sex therapist, relationship counselor and New York Times best-selling author of numerous books, including "She Comes First" and "Love in the Time of Colic." He was born and raised in New York City, where he lives with his wife and two sons. He can be reached at http://www.iankerner.com/.
follow blog in real time at http://www.condron.us/ and www.alphainventions.com
Friday, September 11, 2009
Wednesday, September 9, 2009
Postpartum Depression Effects on the Baby
By Rick Nauert PhD Senior News EditorReviewed by John M. Grohol, Psy.D. on August 21, 2009
While it is fairly obvious that postpartum depression can hinder a mother’s ability to take care of her newborn, a new study looks at how the disorder can affect infant development.
Israeli researchers studied three infant outcomes — social engagement, fear regulation, and physiological stress reactivity — in a group of 100 mother-infant pairs at nine months postpartum. These three infant outcomes are considered foundations of social-emotional growth and are associated with the infant’s ability to manage physiological stress and regulate negative emotions.
The researchers found that the babies of depressed mothers scored the poorest on all outcome measures after 9 months. The infants showed the lowest levels of social engagement during interactions with their mothers, were unable to self-regulate during situations that introduced novelty, fussed and cried more often, and their physiological stress response showed both higher baseline levels and a more pronounced stress reactivity.
The researchers collected a large community cohort of 971 mothers who reported symptoms of depression and anxiety at 2 days postpartum and again at 6 months. Of these, a cohort of 100 mothers and infants were observed at 9 months and included three groups: Mothers who were depressed across the first nine months and were diagnosed as suffering a Major Depression Disorder at 9 months, mothers who reported high levels of anxiety across the first 9 months and were diagnosed with an Anxiety Disorder at 9 months, and control mothers who reported low anxiety and depressive symptoms across the first 9 months after childbirth.
To remove the influence of other known risk factors such as teenage pregnancy or premature birth, which could independently contribute to maternal depression, the researchers only recruited women who were in stable relationships, were physically healthy, educated, and those who delivered a healthy full-term infant.
Children of anxious mothers showed lower social engagement than children of control mothers but higher than children of depressed mothers. However, their physiological stress response was similar to children of depressed mothers.
The mother’s sensitive behavior played an important role in shaping infant outcomes. Sensitive mothering was related to the infant’s social engagement and protected against the effects of maternal depression on the development of the child’s social skills.
Maternal sensitivity also had a positive impact on the infant’s physiological stress response and reduced the degree of physiological reactivity as measured by cortisol reactivity to stress.
Sensitive mothering is important in an infant’s ability to develop social competence and further study of the effects of maternal depression on child development within the first year of life is warranted.
Feldman and colleagues stated, “By recruiting a large community sample, separating maternal depression from typically-occurring conditions, comparing cases of major depressive disorder to those of postpartum anxiety disorders, and assessing the chronicity of the mother’s mood from birth, the findings may illuminate specific pathways leading from maternal depression to child outcomes across the first year of life.
“Furthermore, the unique associations found between maternal depression and each outcome underscore the need to consider maternal depression in the context of the child’s global rearing environment and in relation to the attainment of specific developmental goals.”
The study is published in the August 2009 issue of the Journal of the American Academy of ChildAdolescent Psychiatry (JAACAP).
Source: Journal of the American Academy of Child and Adolescent Psychiatry
view blog in real time at www.condron.us and www.alphainventions.com
While it is fairly obvious that postpartum depression can hinder a mother’s ability to take care of her newborn, a new study looks at how the disorder can affect infant development.
Israeli researchers studied three infant outcomes — social engagement, fear regulation, and physiological stress reactivity — in a group of 100 mother-infant pairs at nine months postpartum. These three infant outcomes are considered foundations of social-emotional growth and are associated with the infant’s ability to manage physiological stress and regulate negative emotions.
The researchers found that the babies of depressed mothers scored the poorest on all outcome measures after 9 months. The infants showed the lowest levels of social engagement during interactions with their mothers, were unable to self-regulate during situations that introduced novelty, fussed and cried more often, and their physiological stress response showed both higher baseline levels and a more pronounced stress reactivity.
The researchers collected a large community cohort of 971 mothers who reported symptoms of depression and anxiety at 2 days postpartum and again at 6 months. Of these, a cohort of 100 mothers and infants were observed at 9 months and included three groups: Mothers who were depressed across the first nine months and were diagnosed as suffering a Major Depression Disorder at 9 months, mothers who reported high levels of anxiety across the first 9 months and were diagnosed with an Anxiety Disorder at 9 months, and control mothers who reported low anxiety and depressive symptoms across the first 9 months after childbirth.
To remove the influence of other known risk factors such as teenage pregnancy or premature birth, which could independently contribute to maternal depression, the researchers only recruited women who were in stable relationships, were physically healthy, educated, and those who delivered a healthy full-term infant.
Children of anxious mothers showed lower social engagement than children of control mothers but higher than children of depressed mothers. However, their physiological stress response was similar to children of depressed mothers.
The mother’s sensitive behavior played an important role in shaping infant outcomes. Sensitive mothering was related to the infant’s social engagement and protected against the effects of maternal depression on the development of the child’s social skills.
Maternal sensitivity also had a positive impact on the infant’s physiological stress response and reduced the degree of physiological reactivity as measured by cortisol reactivity to stress.
Sensitive mothering is important in an infant’s ability to develop social competence and further study of the effects of maternal depression on child development within the first year of life is warranted.
Feldman and colleagues stated, “By recruiting a large community sample, separating maternal depression from typically-occurring conditions, comparing cases of major depressive disorder to those of postpartum anxiety disorders, and assessing the chronicity of the mother’s mood from birth, the findings may illuminate specific pathways leading from maternal depression to child outcomes across the first year of life.
“Furthermore, the unique associations found between maternal depression and each outcome underscore the need to consider maternal depression in the context of the child’s global rearing environment and in relation to the attainment of specific developmental goals.”
The study is published in the August 2009 issue of the Journal of the American Academy of ChildAdolescent Psychiatry (JAACAP).
Source: Journal of the American Academy of Child and Adolescent Psychiatry
view blog in real time at www.condron.us and www.alphainventions.com
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