When a Mother’s Worry Is Something More

Mrs M brought in her daughter for her 12-month visit. I had known the family since her daughter was a newborn, and so her usual double-sided sheets of questions were an expected component of her visits, many of which were sick visits. Except today, something was different. Perhaps they had always been there: the furrowed brow, the tense lips, the repeated attempts to tuck a wayward swath of hair behind her ear, and the way she managed to avert eye contact. As she moved from question to question hurriedly, her voice quivered at times, and finally she broke into tears. It was then that I became keenly aware for the first time that Mrs M was struggling with depression.

There has been a plethora of research done on maternal depression and how it can adversely impact mother- child bonding and child development. For pediatricians, this can manifest as missed well-visits or—in Mrs M’s case—frequent medical visits and phone calls, a possible manifestation of anxiety which is very often a comorbid condition of depression. Depressed mothers may have difficulty meeting even basic needs of their children such as preparing meals, ensuring they have clean clothes, or adequately child-proofing the home. Depressed mothers are less likely to read to their children, limit screen time, and take safety measures. Children of a depressed parent are more likely to suffer from depression themselves.

As pediatric healthcare providers, we are on the front lines for detecting maternal depression and for initiating the process of healing. An estimated up to 25% of mothers may struggle with depression. The risk is even greater for women of low income. That means potentially 1 out of every 4 mothers you see may be depressed. Since depression is highly treatable, asking just a few screening questions (multiple screening tools are available) and having just a few resources in your pocket can make a huge and lasting positive impact for both mother and child.

After asking Mrs M a few probing questions, I learned that Mrs M’s husband had lost his job and the family was struggling financially. She had been feeling depressed since her daughter’s birth, but since the family had no insurance following the job loss, she felt she had to struggle with her depression alone. I was able to help Mrs M obtain treatment for her depression, and at every visit, I check in with her to see how she is feeling. In my medical career, I’ve learned that sometimes, when you treat the parent, you also the treat the child. Mrs M and her daughter are certainly one of those instances.