Eight-month old Carrie stayed with me and my toddler for a week while her mother joined her sailor-husband for a much needed shore leave. When she arrived Carrie's mother took her out of her infant carrier and put her down in a playpen that she brought along. She handled the baby like all the other baggage. The baby made not a sound, just laid where she was placed. Carrie looked more like a shriveled old woman than a baby girl-her skin dry and gray-like there was hardly any life in her. I did nothing special, just folded her into our daily routine. The transformation was astonishing. I saw Carrie's smile for the first time the next morning. Her eyes got a little brighter each time I said her name. I could almost see her gaining weight. By the end of the week she had rosy baby cheeks and a ready giggle. Her mother was overcome when she picked her up. "I never knew she could be so beautiful!" she said through tears and smiles. The question is...Can Young Babies be Depressed? Depression: A mental state characterized by dejection,
absence of cheerfulness, feelings of sadness, despair, discouragement,
inactivity, and low vitality. Often accompanied by low self esteem, self reproach,
and somatic symptoms such as eating, and sleep disturbances.
Scientific studies since
the 1950s suggest that babies get depressed. The term “infant depression”
recognizes the infant as a person, someone who can suffer psychic pain. It
suggests the baby has
exhausted all solutions for keeping his psychological balance. Yet current
discussion of depressed infants is limited to a small community of specialists
in Infant Mental Health and we know relatively little about depression in very
young children, especially before age 2. There is now a tendency to diagnose
“Major Depressive Disorder” in children as young as 3; this may be reasonable,
or over-diagnosing.
In the scientific
literature, the focus is on mothers' depression during and after pregnancy.
About 70% of women report negative moods during pregnancy; 10% to 15% are
diagnosed with major depression,
although most depression
may go undetected. Several controlled studies report 12% to 16% of all women
experience postpartum depression, up to 26% in teen mothers. Estimates of
depression in low-income mothers of young children consistently run near 40%
and higher. Effects of mothers' depression are well documented
Bowlby first described a profound negative impact on the child's
environmental and intellectual well-being over 55 years ago. Animal studies
over many species consistently show that babies deprived of competent mothering
suffer significant adverse effects through adulthood.
Research done in the 1990s
strongly suggests that young babies do indeed get depressed themselves and
might actually be born depressed. Brain studies of neonates whose mothers are
depressed show reduced activity in the area of the brain that mediates social
behaviors and positive expression. Neonates with this brain activity variation
may be predisposed to affective disorders later in life. At 14-15 months,
babies with similar brain activity variation show less affection and touching,
higher levels of negative affect, Another
meta-analysis verified that maternal depression has a significant negative
effect on infants' cognitive and emotional development. In one study, 6- and
12-month-olds of depressed mothers showed reduced attention span and
persistence, lower frustration tolerance, and more fear of unfamiliar people
and situations. Infants' and toddlers' whose mothers are depressed have more
sleep problems than other infants. How is depression transferred from mother to baby
Brain activity variations
signaling depression in the first week of life suggest that depression may
start in the womb. Some scientists believe that a mother communicates
depression to her fetus biochemically. When she is distressed, her body
produces cortisol and other hormones which cross the placenta. Cortisol – the
stress hormone – has been shown to interfere with cognition in adults – it’s
what makes it hard to think straight and concentrate under pressure. When a
mother is distressed during pregnancy, her baby may be born with depression “in
his blood”. Depression may lead mothers to smoke, drink alcohol and take
recreational drugs during pregnancy. Findings also suggest that depression
contributes to complications such as preterm birth and low birth weight.
After birth, the baby’s
acquired depression may intensify if his mother’s depression prevents her from
fully meeting his needs and makes their interactions unpredictable and
disorganizing. One study showed that maternal depression adversely affects
preterm newborns’ health status during the initial hospitalization. Other
researchers found that depression interferes with preventive care. Depressed
mothers were less likely to use an infant car seat or cover electrical outlets.
Infants as young as three months old can detect depression in their mothers.
They respond in kind. If the mother withdraws and becomes silent or easily
upset; so does the baby.
Goodman and Gotlib (1999)
suggest four pathways by which maternal depression might be passed on to
babies:
♦ Depression or predisposition may be inherited ♦ Dysfunctional regulation, possibly due to a neurological
deficiency or mother's stress-related
hormones
♦ Exposure to mother's negative thoughts, behaviors, and affect ♦ Stressful life
Factors that might moderate
the effects of maternal depression on the infant are:
♦ Father's health and involvement. Dads, grandparents and other
caregivers can provide the very resilient and may bounce back quickly with
timely ordinary care and attention the mother is temporarily unable to offer
♦ Course and timing of mothers' depression Child characteristics. ♦ Children are very resilient and may bounce back quickly with
timely ordinary care and attention. Latest Research
Although infant depression
has been studied for decades, we still do not really know when infant
depression begins or what its outcome is. Some scientists see depression in
every kind of suffering in infancy. Some say it does not exist until much
later. It could be an outcome of attachment disorganization in infancy, since
depression and disorganization seem to share the same learned helplessness.
New research from France
suggests that infant depression needs a certain amount of emotional and
cognitive development to unfold, and that it might not exist before 18-20
months when major cognitive and emotional abilities emerge and the child is
able to think of himself as responsible for loss within a relationship, and to
feel hopeless, without a safe base. This may happen if the mother is depressed
or with incoherent parenting in general. Infants’ reactions follow a path
delineated by Bowlby in 1951: surprise, protest, withdrawal and despair. Before
18-20 months, Guedeney suggests that the concept of “relational withdrawal”
maybe more applicable and useful than “depression”. It is difficult to find a
clear definition of “withdrawal”, although it is recognized as an important part
of normal parent-infant interaction and regulation. Withdrawal seems to be a
key symptom of infant depression, but is seen with attachment disorders, pain,
autism, PTSD, and anxiety. Sustained withdrawal is seen as a warning sign of
relationship problems and depression. Infant depression is difficult to
differentiate from attachment disorders and non-organic failure to thrive. Implications for Practice
The literature shows that a
mother's depression may be transferred biochemically to her baby in the womb or
later through compromised bonding and care giving. Knowledge of the devastating
effects of mothers' depression on babies presents an urgent need to incorporate
into prenatal care and public health programs methods to identify women at risk
for depression and intervene early. Beck's (1998) Postpartum Depression
Predictors Inventory is a checklist to help maternity care providers identify
women whose depression may interfere with mothering.
Healthy fathers and
siblings can nurture the baby and support the mother emotionally. However, if a
mother's depression is lasting or severe, the entire family may need support.
Experts recommend music and massage therapy for both parents and children.
These stress-relieving measures may enable mothers to be more receptive
to parenting coaching and
help babies respond to improved interactions. Drug therapies must consider
effects on the breastfeeding infant. A trial of parent-toddler psychotherapy
found that the intervention prevented an IQ decline exhibited by depressed 3
year olds who received no therapy. More research is needed to identify
effective prevention, screening and treatment of depression in mothers and
young babies. For more
information on infant mental health, visit www.zerotothree.org Beginnings
Parent's Guide offers practical advice for
dealing with infant and toddler anxiety and stress including, baby massage, night terrors, separation anxiety and more. To view the Table of
Contents for the Beginnings Parent's Guide, click here. You can preview the Beginnings
Pregnancy and the Beginnings Parent's Guides online - click here to learn more. References Armstrong, K.L.,
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association with prenatal factors and maternal distress/depression . J
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