Archive for January 8th, 2012
Depressed parent, depressed child?
Depression is one of the most common mental health problems in the United States, affecting about one in six adults at some point. About 7.5 million of those affected each year are parents. When a parent is depressed, the likelihood increases that his or her children will develop this mood disorder as well.
In the population as a whole, for example, surveys indicate that about 20% of young people develop depression by age 18. In families where one parent is depressed, however, about 40% of youths develop depression by age 20, and 60% do so by age 25.
As with other psychiatric disorders (and health problems in general), part of the reason that offspring of depressed parents develop depression is genetic. But psychological factors also come into play. Parents who are struggling with depression may not be able to cope as well as others with the stress of raising children. Or the sheer physical exhaustion that is typical of depression may prevent them from being able to nurture and support their energetic young ones.
Recognizing these challenges, researchers and clinicians have been searching for ways to reduce the burden of depression on parents and children alike.
Treating a parent’s depression benefits children as well, according to findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D)–Child study, which followed children of 151 mothers who participated in a large federally funded study of depression treatments.
The researchers found that when the mothers achieved remission (nearly complete relief) of depression symptoms during treatment, their children also experienced improvement in mood. One year after treatment ended, children whose mothers attained remission from depression continued to benefit.
Although the STAR*D–Child Study was observational and cannot prove cause and effect, the results support the notion that helping mothers — and perhaps fathers as well — achieve remission from depression will also help their children.
Several groups of researchers are testing interventions aimed at strengthening parenting skills and building resilience in all family members as a way to reduce the burden of depression.
Researchers at Vanderbilt University recruited 111 families in which at least one parent had a history of depression. Parents and children participated in two months of group cognitive behavioral therapy (CBT) sessions where they learned about depression, practiced ways to recognize and deal with stress, and learned adaptive coping techniques. Both immediately after the intervention ended and one year later, symptoms of depression were significantly less in children assigned to the intervention group than those assigned to a control situation.
A separate team at Vanderbilt recruited 316 teenagers whose parents currently had major depression or had had it in the past. The youths all had some symptoms of depression themselves, but not enough to meet the criteria for a diagnosis of major depression. The researchers randomly assigned half the teens to eight weeks of a CBT intervention, followed by six months of booster sessions. The other group received usual health care.
At the end of the study, 21% of the youths assigned to CBT had developed depression, compared with 33% assigned to usual care. As such, the study confirmed that it is possible to prevent depression in some youths at risk.
However, the intervention did not help children whose parents were suffering from depression during the study. These findings suggest (as have other studies) that youths whose parents are struggling with depression may require more intensive interventions to benefit.
All of these efforts demonstrate that depression is often a family affair — and that the family may be the best place to begin looking for solutions.
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