A new study in the Journal of Affective Disorders found that maternal depression is indirectly associated with the development of depression and anxiety symptoms in children, and is prompted by parental stress. This research was based on a secondary analysis of data from the Fragile Families and Child Well-Being Study to assess anxiety and depressive symptoms of both mothers and children over a decade.
The Study
This long-term research was based on an analysis of interviews conducted with the parents of a group of 4,898 children born within 75 hospitals in 20 large cities in the US between 1998 and 2017. Researchers found that the association between a mother’s depression and childhood depression held true in both directions. That is, greater maternal depression significantly predicted higher depression and anxiety in children, while greater depression and anxiety in children significantly predicted subsequent maternal depression. Parental stress was a main cause of this maternal depression, which in turn triggered depression and anxiety symptoms in kids. In this study, depressed mothers reported feeling less attached to their children, more concerned about raising children, and less parenting support from their spouse, and were more likely to feel that their children were less acceptable and viewed parenting as less personally rewarding. While this longitudinal study included a large ethnically diverse sample, its reliance on parent reports to assess the mental health of children, as opposed to measures from clinicians was a limitation of this research.
Family Mental Health Is Often Intertwined
Licensed psychologist, and parenting coach at Atlas Psychology, Amy Nasamran, PhD, says, “The key takeaway here is that parent and child mental health are often intertwined and strongly related." “This is no surprise, given that children’s development depends so much on their parents. Children learn about the world from their parents. They learn a lot from watching and observing how their parents handle stress and life’s challenges,” says Nasamran. Since there is also longstanding research about how parents’ mental health can affect children’s mental health, Nasamran highlights that parents are the main caregivers and source of support for kids. “Parents with mental health challenges, like anxiety or depression, can face unique challenges keeping up with the demands of parenting,” she says. As noted in the study, Nasamran states, “One manifestation of this may be difficulty providing the level of warmth and support that kids often require at that age, which can impact a child’s mental health and wellbeing.” Nasamran says, “While we know that mental health needs have significantly skyrocketed during the pandemic, an important point that this study sheds light on is the importance of addressing parental stress, the mental health needs of family units, and the systems in which a child lives.” While therapy for children is important and can be helpful, Nasamran notes that therapy approaches that work with parents and children together can be an effective way to manage the mental health needs of the whole family. “A child’s mental health starts with parent mental health, and making sure parents have the support and resources they need can make a huge difference in a child’s mental health development too.” In noting that children are like sponges, Nasamran highlights how they can pick up on a lot more from their parents than sometimes imagined. “Their mental health depends on a lot more than what they can get from working with a therapist for an hour each week,” she says. Nasamran highlights, “One of my favorite evidence-based therapy approaches to working with families is Parent-Child Interaction Therapy (PCIT) as parents and children attend therapy and learn skills together.” A unique aspect of this study was the finding of a cyclical and bi-directional relationship between a parent and child’s mental health, as she notes that children’s mental health symptoms of anxiety and depression also affected mothers’ future mental health. Nasamran says, “A caveat of this study was that it focused on single-parent households and parents who were at a greater socioeconomic disadvantage. In general, we know that both of these factors already contribute significant sources of stress for parents.” Since parenting can be even more overwhelming due to the lack of support when you are the sole caregiver and lack resources due to financial constraints, Nasamran notes that these parent and child dyads may have been particularly vulnerable to anxiety and depression. Nasamran explains, “As a child psychologist, I often see parents bring children in for treatment, and that’s a wonderful step. But parents can be inclined to overlook their own needs, especially when children struggle.” In this way, Nasamran notes that it is crucial for parents to think about their mental health and ability to support their children. “Stressed parents will have a harder time helping stressed children,” she says. She recommends that parents who can prioritize and take care of their own mental health needs first, or maybe simultaneously, will be in a better headspace to model good coping skills to support their children.
Protective Factors Make a Difference
Licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center, Mayra Mendez, PhD, LMFT, says, “This study provided longitudinal information that explained the impact of parental depression and stress on the child over a 15 year period.” Mendez explains that it is important to understand how protective factors such as secure parent-child attachment, early intervention for the child, parenting training support, mental health treatment for the parent, stress management training, and family therapy can improve outcomes. While the study demonstrates how parent-child interactions inform mental health impacts and outcomes across developmental stages of the child, Mendez notes the bidirectional impact of mental health factors from a developmental perspective carries through into adolescence. “It is important for the public to be aware of protective factors to promote interpersonal, relational, and familial well-being even in the face of challenges such as exposure to depression, anxiety, and stress,” says Mendez. Over the past two decades, she notes that there has been prolific research on parent-child mental health issues. “This study magnifies the importance of the parent-child relationship and validates the global connections that inform risk and resiliency factors in the development and transmission of mental health wellness as well as challenges,” she says. Mendez recommends reinforcing public awareness about the value of mental health treatment for prevention and mitigation of negative outcomes. “More emphasis on parenting wellness programs such as mindfulness, stress reduction programs, positive imagery, and healthy lifestyle choices can result in successful self-care, stress management, and parent modeling of effective coping options for the child,” she says. Since this study is consistent with the literature on this topic, Mendez notes, “The parent-child variables are the most important to understand as within the relationship is where there is the greatest impact for growth, development, and well-being as well as adverse influences.” Mendez highlights, “A caveat is that little emphasis has been given to the topic of resiliency. The fact is that most children raised by parents diagnosed with depression do not experience major negative consequences.” Given that resiliency is best informed by the bond and secure attachment between caregiver and child, Mendez notes, “The formation of secure attachment provides the foundation for resiliency that mitigates adverse experiences and promotes the development of positive coping skills for the child and strengthens the parenting foundation of the caregiver.” Mendez explains that challenges such as depression and stress can interfere with optimal functioning, but the relationship between parent and child may benefit from intervention. “There is strength in the seeking of help when needed and the outlook for positive outcomes heighten,” she says. Mendez notes, “In my work, when parents understand that the engagement between them and their child is foundational to the overall wellness of the family, then the individuals and the family functioning thrives.” When attention is diverted from a critical issue such as symptoms of depression, anxiety, or other mental health challenges are ignored, Mendez explains that the individuals and the family are compromised and suffer. Depression and anxiety can result from complex interactions of genes, environment, and social-emotional competence, so Mendez recommends building self-confidence and competence, managing stress, and striving for emotional stability in an effort to mitigate mental health challenges.
