Treating Mothers’ Depression May Help Children Manage Their Own
When both mother and child suffer from depression, treating the mother’s symptoms may do more than help the mother.
October 26, 2016
Like most mental disorders, depression is highly genetic; experts estimate that about 40 percent of people with depression can trace it to a genetic link. That link is often between parent and child, and living with a depressed parent can trigger depression in a child who is predisposed.
The good news? According to two related studies, helping depressed parents (specifically, depressed mothers) manage their depression reduces the risk that a child will develop a depressive episode — and might even help them recover from one, with no additional treatment.
The studies, presented together at the 63rd Annual Meeting of the American Academy of Child and Adolescent Psychiatry, were both led by Myrna Weissman, Ph.D., of Columbia University. The first study, using data from the National Institute of Mental Health’s Sequenced Treatment Alternatives to Relieve Depression (STAR-D), identified 151 mother-child pairs in which the mother was currently living with major depression. Researchers interviewed the subjects in a blind manner, meaning that the researcher interviewing the child was unaware of the mother’s status, and vice versa.
The results showed that, if the mother experienced remission of her depression, children who had themselves been diagnosed with depression were nearly three times more likely to go into remission: 33 percent of children who had been diagnosed with depression went into remission if their mother did, compared to just 12 percent of children whose mother didn’t experience remission. Children who didn’t already have a diagnosis of depression experienced similar results: If their mother remitted, they were significantly less likely to develop depressive symptoms or later receive their own diagnosis.
Dr. Weissman and her team were impressed with the results, but they realized that the study had limitations. “The studies were observational,” said Weissman, which made it impossible to prove that the children experienced improved symptoms due to their mother’s treatment. A number of other factors could’ve influenced the mother-child interaction in a positive way. “It could’ve been that she won the lottery,” Weissman joked.
To further explore the results, she joined a second study — a double-blind, placebo-controlled trial focusing on the efficacy of two different SSRIs (bupropion and citalopram) for people with major depression. This study included 76 mothers, all diagnosed with depression, and 135 of their children — approximately 47 percent of whom had psychiatric diagnoses of their own.
The original hypothesis of the study was that the combination of bupropion and citalopram would treat depression more effectively than either of the two drugs on their own. This hypothesis wasn’t ultimately supported by the data — each drug produced similar positive results when used n its own or combined with the other. But when it came to the child’s improvement, the medication taken by the mother mattered significantly.
Children whose mothers took citalopram experienced either full remission or a marked decrease in their own symptoms, and reported that their mothers were more “loving and caring.” Children of mothers who took bupropion, on the other hand, reported that their mothers were more irritable, and ultimately saw less improvement in their own symptoms.
“The message [of the first study] is: Get the mother better as fast as possible,” said Weissman. The second study supported that conclusion, she said, but made it clear that “it’s not just the overall reduction of symptoms that matters.” Medications like bupropion, which come with side effects like irritability, might put the mother into remission, but they’ll do little to help her child, who often feels the brunt of those negative side effects.
“A depressed parent is a stressful event for a vulnerable child,” she concluded. To treat these children, “it’s imperative to find out the clinical state of the parents” and treat them accordingly — always keeping the child’s interests in mind.
