June 10, 2009 — Parental depression can take a serious toll on children, and the whole family should be involved in depression care, according to a new report.

That report, issued today by the National Research Council and the Institute of Medicine, estimates that in any given year, 7.5 million U.S. parents are depressed and at least 15 million U.S. children live with a parent who has major or severe depression.

Those are conservative estimates, notes Mary Jane England, MD, who chaired the committee that wrote the report. England is president of Regis College in Weston, Mass., and a past president of the American Psychiatric Association.

Depression is a “major problem that affects a significant number of people” but is “very treatable,” England tells WebMD.

The new report is about how parental depression affects children — and what to do about it.

Parental Depression Affects Kids

The new report traces the impact that parental depression may have on children — starting even before birth.

Here are some of the findings cited in the report:

• Depressed pregnant women may be less likely to get prenatal care.
• Depressed moms may be less attentive or less able to respond in a healthy way to their babies’ needs.
• Parental depression has been linked to children’s early signs of, or vulnerability to, having a more “difficult” temperament, including more negativity, less happiness, poorer social skills, more vulnerability to depression, more self blame, less self-worth, and a less effective response system to stress.
• Older children and teens may experience stress from a depressed parent.

The risks to children differ depending on the child’s age, notes committee member William Beardslee, MD, of the psychiatry department at Children’s Hospital in Boston.

“Early in life, we worry most that somehow the fundamental bond between the mother and father and the infant may be weakened because of depression,” Beardslee says.

“A little later on, when children are older, parents are vitally important in providing structure, order, encouragement, support, helping with school, helping with friendships, and those processes tend to be disrupted when a parent is depressed,” Beardslee says.

Most of the research done on parental depression has focused on mothers, especially during pregnancy or when their babies are very young. But parents can become depressed at any age, and depression in dads is also important.

“Fathers are a really critical part of families, and depression in fathers also has an impact on their children,” committee member Mareasa Isaacs, PhD, executive director of the nonprofit National Alliance of Multi-Ethnic Behavioral Health Associations, tells WebMD.

Depression saps energy, which can make it harder for patients to seek help.

But “parents care most about their kids and they want to do the right things for their children, so that’s a major motivating factor,” Isaacs says.

Big Picture Approach

The new report calls for a family focus in treating parental depression that includes parenting skills and attention to children’s well-being.

Tiffany Field, PhD, a pediatrics professor at the University of Miami Miller School of Medicine, agrees with that approach, though she wasn’t on the IOM committee.

“It’s critical to look at the whole family,” says Field, who studies parental depression. She notes that when a parent is depressed, the children will often become depressed, and then the parent gets even more depressed. “It’s like a vicious loop,” Field says.

The committee members want parental depression care to be available in several different settings — not just at mental health clinics or in specialists’ offices.

“There are childcare settings, school-based settings … other community settings where parents may feel more comfortable getting services,” Isaacs says. “We feel very strongly that we want to mainstream depression treatment,” England says.

The new report also recommends making policy changes and prioritizing research on parental depression.

“We have a major systems problem,” England says. “The system is truly broken, in the sense that we do not focus on families. We focus only on the individual, and if you happen to walk in the right door, then you will get care, but only as an individual.”

She and her colleagues recommend that state task forces be formed to make it easier to find parental depression resources. That way, England says, families dealing with depression won’t have to spend their scarce energy looking for help.

Read more about parental depression on WebMD’s news blog.