Michelle Falli's three children bear no outward scars of their mother's depression. But 35-year-old Falli is a nurse as well as a mother, and she is trained to look for signs of need or trouble. Every day, she says, she searches her children's faces for signs of the despondency, anger or hopelessness that have haunted her, on and off, for most of her life.
And sometimes, when she studies the face of her 6-year-old, Allison, Falli can't help but imagine she sees the searing redness left by a slap she delivered almost two years ago during a particularly angry bout of depression. It is in those moments that Falli sees the injury that might be--or could have been.
Since that "rock bottom" day of the slap, Falli has undergone psychotherapy and found medication that tames her depressive symptoms and cuts through what she calls "the fog" in which she tried, for years, to parent. She's dropped the "talk therapy" but stuck with her antidepressant. Without that, says Falli, "I would not function as a mom at all. I might not even be here. ... These pills saved my life."
And, she hopes, the lives and well-being of her kids.
In Texas, the five drowned children of Andrea Yates have been buried for three months--victims, apparently, of a mother's chronic depression spun out of control in the wake of childbirth. The legal proceedings that will decide Andrea Yates' accountability for her children's deaths are set to begin this week.
But across the nation, the cost--to children and their families--of a mother's depression are only beginning to be tallied. Researchers and mental health professionals, however, say the evidence is already strong and growing stronger: When a mother suffers from chronic and untreated depression, her children are likely to pay a heavy price. They are the unseen victims of their mother's misery.
A welter of recent research shows that few other factors have the potential to suppress a child's emotional and intellectual trajectory more dramatically than a mother's depression. In some studies, it has proved to be nearly as strong a predictor of a child's future as family income and mother's education--two of the most potent factors known to researchers. As a group, the children of depressed mothers have rates of depression themselves that are two to four times higher than those with healthy moms, and they have much more problematic relationships with their mothers, as well. In seemingly unrelated measures like language and other cognitive skills, their performance lags behind that of their counterparts whose mothers were free of depression. They fare more poorly in school, on average, and as adults, in work and in social situations. And they are five times more likely to fall prey to alcohol dependency.
In 30 years of clinical practice, Brentwood psychiatrist Marjorie Braude has treated a long line of children of depression, most of them seeking her help as adults. Her experience tells her three things: The damage a mother's depression can inflict on a child can be profound; it can be remarkably lasting; and with the therapies and medications available today, it can be avoided.
"I've heard it over and over: 'If only my mother had had these medications, her life--and my life--would have been different.' It's a statement I've heard many times, frequently with a tear in the eye," Braude says.
A parent's depression "is a very strong predictor of the outcome of a child," says epidemiologist Myrna Weissman of Columbia University's School of Public Health, who is one of the nation's foremost trackers of depression and its toll. Either parent's depression can have major impacts, Weissman says. But she says that for two reasons, the impact of mothers' depression is more studied and better understood than the effects of paternal mental illness: First, depression in women is more widespread--the rate is twice as high as for men; and second, women are far more likely to be their children's primary caregivers, so their emotional well-being is likely to have a direct impact on a child. As dads take on greater roles in their children's care, many researchers say, future studies should do more to measure how fathers' mental health affects their kids.
To understand the impact of a mother's untreated depression over time, you might think of her disease as a wet baby blanket, issued at birth--a chilly, heavy blanket that can bind the free movement of a little one that turns to her for warmth and protection. If the depression persists, the blanket can get heavier and ever more entangling to the growing child, dampening her spirit and suppressing her emotional and intellectual growth.
But, as in a game of peek-a-boo, baby blankets are meant to come off, and therein lies the potential good news. If depressed moms and their families get help, most researchers believe, the blanket can be lifted from the child, possibly without lasting effects.
Michelle Falli is counting on it.