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Inside the minds of those who call for help Nicole Moldovan can recall the exact date she fell apart at her Orange County home and had to accept that she needed professional help for depression. It was March 28, 2003. Her second daughter, Jessica, was about 7 months old. Moldovan, 33, who lives with her husband and two daughters in Rancho Santa Margarita, was having a tough day with her two little girls. The baby wouldn’t stop crying, and her preschooler wanted more attention than usual. The harried mother was looking forward to her husband coming home from work to get some relief. Then he phoned to say he had to work late. “I just couldn’t handle it anymore,” Moldovan says. “I put my daughter in her crib, went in the shower and curled up in the fetal position and started crying. My husband came home and said, ‘You need help.’” For two or three months leading up to that day, Moldovan had been feeling overwhelmed, angry and severely depressed. She says she often felt like staying in bed or sitting on the couch all day. She resented her husband and kids and the fact that she believes society expects stay-at-home mothers to be happy all the time. Moldovan reached out for help. She joined a local Mothers of Preschoolers (MOPS) group and started going to church. As she began to open up about her depression to her new mom friends, Moldovan says she was amazed to learn that “there were a lot of other women feeling the same way.” Medication, therapy from a family counselor and a supportive husband helped Moldovan. Her experience with depression is not unique. Statistics show that twice as many women suffer from depression as men, and experts say moms with children at home are a particularly vulnerable group. Women ages 25 to 44 are the hardest hit with clinical depression, the years when most moms are raising their children. Studies show that mothers with children at home are at a higher risk of suffering from depression than childless women and empty-nesters. For men and women, the rates of major depression are highest among separated, divorced, and unhappily married women, according to the National Institute of Mental Health. Anxiety also often accompanies depression for mothers. Name your poison We can blame hormones, heredity, career stress, multiple family responsibilities, women’s lower economic and social status in society, the pressure on moms to enrich their children, single parenting, domestic violence, unplanned pregnancies, poverty, struggles with infertility and the dozens of everyday things for which we hold mothers responsible. There’s no one cause for depression, but the key is to seek help as soon as possible. “Let’s face it, motherhood is the hardest thing there is,” says Dr. Nada Stotland, a professor of psychiatry at Rush Medical College in Chicago and a specialist in women’s mental health issues. Dr. Stotland also is vice president of the American Psychiatric Association and a practicing psychiatrist. Feeling “the blues” is a normal part of being human. But for many mothers, a more intense case of the blues lasts longer and impairs how you function and how you parent. Clinical depression hurts the mother and her children, who experts say are more likely to feel lonely and act out for attention. Just being a mother does not cause depression, says Dr. Stotland. She treats many depressed and anxious mothers who are overworked, under pressure and do too much with too little support or help with tasks such as childcare. “It isn’t that women want to have it all, it’s that women have to do it all. Nobody says that a man with a job and children wants to have it all,” says Dr. Stotland. Examine the family tree Experts say chronic stress in general can contribute to depression in people biologically vulnerable to the illness, such as those with a family history of depression. A majority of mothers in America work outside the home, feel they don’t get adequate post-partum paid leave from work after giving birth, do most of the housework, and may feel pressure from their peers to be supermoms, says Dr. Stotland. Stress can affect the chemicals in the brain and lead to severe depression, says Dr. Julianne Toohey, an obstetrician and gynecologist at UCI Medical Center. She sees many depressed mothers and refers them for treatment. Depression can be successfully treated with a variety of medications, just like other diseases. Still, society must overcome its bias against those with depression and stop thinking that the victims are just weak. “There’s a stigma to it. If you’re a mom, you’re supposed to do it all and be happy all the time,” says Nicole Moldovan. Depression is high among American women for another reason, experts say. We tend to move away, living far from our family and friends, the old neighborhood, school and church, all of which provided a support system. “A lot of times it has to do with isolation. In our society we’re moving a whole lot more than we used to. People feel disconnected,” notes Cathy Bisson, a licensed marriage and family therapist in Temecula who frequently speaks at women’s retreats about the importance of self-care. Bisson and other experts say mothers who have a tendency toward depression must build a support system. Dr. Stotland agrees. Whether a mother suffers from depression, she says, “depends on the level of support you have for all the things you are trying to do. Being overburdened with too many responsibilities and not enough support puts you at risk for depression across the board.” Left untreated, depression can have a major impact on family life and healthy parenting. Doctors and mental health experts urge women who show the symptoms of depression to be evaluated and seek treatment, which may include psychotherapy, antidepressant medication, or both. Seeking treatment is vital to a mother’s mental health and the mental well-being of her children. Research shows that infants and young children of clinically depressed women also suffer poor emotional health. Preschoolers of withdrawn mothers have been found to be less socially responsive and more inhibited. Depressed mothers often do not provide as much stimulation or attention to their children, according to studies. Bisson says children of depressed moms may act out to get attention. “You can’t parent right and you can’t bond either,” says UCI Medical Center’s Dr. Toohey. “I know of depressed moms who never go out of their rooms. How can a teenager talk to his parent?” Still, there is hope for recovery with treatment and support from others. There are a variety of antidepressant medications and talk-based therapies, and a doctor can best monitor medications for effectiveness and possible side effects. Nicole Moldovan encourages moms with depression to seek help, join a moms club and take time for themselves. “Do something,” she says. Amy Bentley of Temecula is a regular contributor. For Letters: ocfamily.com and click on Feedback Depression in women Did you know: • Approximately 12 million women in the United States experience clinical depression each year, about a quarter of all women. • Women experience depression at about twice the rate of men. Depression occurs most frequently in women ages 25 to 44. • Biological or women’s reproductive factors can cause depression in women, including hormonal and genetic factors, infertility, premenstrual syndrome, menopause, pregnancy and childbirth. • Social factors are also thought to lead to higher rates of depression in women, including job stress, family responsibilities, the many roles and expectations of women, sexual abuse and poverty. • Fewer than half of the women who experience depression seek care. Most suicides are the result of untreated depression. Sources: The National Institute of Mental Health, National Institutes of Health, www.nimh.nih.gov; and The National Mental Health Association, 800.96.NMHA; www.nmha.org. Parental depression Parenthood is not only hard work, it can be downright depressing. A study reveals that having children, unlike the mental boost that full employment and marriage typically bring to adults, can have the opposite effect, according to researchers Ranae Evenson and Robin Simon. They published their findings last December in the Journal of Health and Social Behavior, basing the results on 13,000 Americans interviewed by the National Survey of Families and Households. The findings have mountainous holes in them because of a lack of niche studies into parenthood. It is, after all, a multi-layered, decades-long process and to tie the degree of depression to parenthood absent really complete studies appears to be the challenge. What the researchers determined is that certain types of parents – those with younger children and single parents, for example – show more depression than other parents. And, “no type of parent reports less depression than nonparents.” This would include empty-nesters. The conclusion is that parenthood is not a magic pill that produces better mental health, despite the national assumption that children make a family whole. The lack of support for family life – this would include help from extended family and meaningful childcare required for working parents – seems to play a role in the stresses of everyday life. The next step into examining parenthood, the researchers suggest, will be found in breaking out the variations of raising children to better understand stresses and strains. These would include “the quality of their relationships with children, their perceptions of their ability to satisfy role expectations, their self-evaluations as parents, the social and economic resources available to them, the stressfulness of the role, and the emotional gratification and sense of purpose and meaning they derive from parenthood.” – By Craig Reem Postpartum depression Based on her child’s age when her depressive symptoms began, many might conclude that Nicole Moldovan suffered from postpartum depression. The Rancho Santa Margarita mom’s second child was 7 months old when she realized she needed help. Her diagnosis, though, was clinical depression. How do the experts distinguish between the two? “It’s definitely related around the birth of a child. When people have postpartum depression, normally it will occur within the first few weeks after delivery, but it can last up to a year,” says Dr. Carol A. Major, an OB/GYN specializing in maternal-fetal medicine at UCI Medical Center. In Moldovan’s case, the onset of symptoms began five months after her daughter’s delivery. “A lot of (the symptoms) are really confusing right after you have a baby because you’re tired all the time, you don’t really want to eat, you lose interest in everything else because you’re totally preoccupied with your child, so it’s kind of hard to tell,” says Dr. Major. On the other hand, she adds, if there is no inkling beforehand, you’re not going to wake up one morning several months after delivery and suddenly have postpartum depression. About antidepressant drugs The brain communicates thoughts and feelings through special chemicals that send messages. Two important chemical messengers, called neurotransmitters, are serotonin and norepinephrine. There is a strong connection between the amount of these chemicals in the brain and mood. If levels of serotonin and norepinephrine get too low, people usually feel depressed. Drugs can help correct the imbalance of these brain chemicals. Certain antidepressants can interact with other prescription and over-the-counter medications, herbs, alcohol and even foods. Talk to your doctor or pharmacist before starting treatment to learn the appropriate precautions. Healthy parenting and recovery Seek treatment and stay with it. You can get help from your primary care doctor, a mental health specialist like a psychologist or psychiatrist (a psychiatrist is also a medical doctor who can prescribe medications), a community mental health center, your local hospital, a private clinic or your employee assistance program. Talk to your children about your illness. Have an age-appropriate discussion with them so they understand why mommy doesn’t feel well and that they are not to blame. Tell them you are trying to get better. Involve your spouse and supportive friends and relatives in your recovery. “People who are good for you and not people who put you down,” says Dr. Julianne Toohey of UCI Medical Center. Allow them to help with preparing meals or picking up your kids from school so you can have time for your treatment. Seek support from other mothers or parents with depression. Ask your doctor, therapist or hospital for a referral to a support group. Stay connected as a family. Share time with your children, such as going to the park with them or reading to them, and spend time alone with your husband when the children are asleep. Watch your diet. Eat small, frequent meals to keep nourished when busy. Avoid excessive caffeine and sugar because they raise your heart rate, blood sugar and anxiety levels. Take vitamin B complex, which helps with mood stabilization. Get some exercise to help you feel energized. “It also gets you out of the house. If you feel the blues, get out, get some sun and get some fresh air,” advises Dr. Toohey. Source: The National Mental Health Association and the National Institute of Mental Health. |
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