Women are about twice as likely as men to develop major depression, according to a study by US-based Harvard Medical School. But what kind of impact does it have on the children, who watch their mothers battle the illness every day? Gulf News spoke with mothers and a teenager, and checked in with an expert on how best families can cope.
Every day, seven-year-old Ali plays hide and seek with his mother’s blanket.
He buries the offensive piece of cloth in nooks and crannies of the house, and refuses to reveal its hiding place. It’s because the blanket makes his mother weep, he says.
But his mum Sara, 34, always finds it. She needs it to smother her sobs every night, as she fights for another day.
The mother of one suffers from clinical depression. And she isn’t alone.
As many as one in every eight women can expect to develop clinical depression during their lifetime, according to US-based National Institute of Mental Health. But fewer than half of the women who experience depression will ever seek care, the British Journal of Psychiatry reports.
For Sara, an Indian homemaker based in Dubai, the illness struck when her son was just over a year old.
She said: “I would cry constantly, I would not be able to feed my baby, and often couldn’t even get out of bed. I would have heart palpitations. I would keep panicking and tell my husband not to leave me.”
When Sara couldn’t cook for her family or see off her son to school in the morning, it got her in-laws and neighbours talking. Was she fit to be a mother, or a wife? And the one person who should have had her back, failed to stand up for her - her husband.
She had to return to her parents’ house in Hyderabad, for treatment. She took Ali along.
Sara said: “There is a huge taboo about this topic, especially in India. I was treated like an outcast. People said there was something inside me, which had to be removed through magic. I was taken to hack doctors and was considered unfit to raise my child. It was horrible. I had no support. Only my mother, who would take me to any doctor she could find.”
Eventually, she met a psychiatrist who encouraged her to share her thoughts without judgment. She took anti-depressants, and had counselling sessions every 15 days.
A year after she arrived in India, Sara began teaching at a school.
It took her three years to feel healthy enough to return to Dubai, medications in tow. And all the while, as she battled her demons, her son watched.
Even today, Sara’s blanket will sometimes go missing. But she is working on making sure Ali knows she is there for him, and that it is going to be okay.
According to US-based National Academy of Sciences, at least 15 million children – one in five – in the US live in households with parents who have major or severe depression.
Dr Sonia Singhal, a psychologist at Family First Medical Centre in Dubai, said: “A parent’s depression can have a significant negative impact on a child’s emotional, behavioural, academic and social development. The child’s level of resilience and the strength of their overall support system are important factors. Some children may require higher levels of attention and care. They may struggle tremendously, even with the mild symptoms of their parent’s depression. Other children may be more emotionally resilient or have a wider support system in place, which can help them cope with the negative impact of their parent’s depression.”
Susan, a British national, has suffered from depression for most of her adult life.
She told Gulf News: “My children acknowledge that sometimes I’ll not be able to function and other times, I’ll be fine. My sons know that the love and attachment is always there, regardless of my mood dipping, and they accept and support me. For that, I’m grateful.”
But a mother’s depression can also have a cyclical effect.
At any given time, five per cent of children aged 9 to 17 meet the criteria for major depression, according to the American Academy of Child and Adolescent Psychiatry.
Dr Singhal said: “A child whose parent is depressed, is at high risk for depression, anxiety, low self-esteem and behavioural difficulties. They may either internalise their feelings or act out in extreme and unhealthy ways. If a parent is emotionally absent, the child may believe that he/she is unlovable, and develop a sense of self-hatred and withdraw from others. Alternatively, a child may express his/her feelings by seeking out ways to get into trouble and ‘be noticed’ by the parent.”
Megna Rajagopal, a 17-year-old student in Dubai, knows what it is like to walk on tenterhooks around a depressed parent.
She said: “When depression affects your mother, the roles flip, and you have to become the responsible one. As a child, I never knew what was happening around me. My mother used to get furious, scream, shout and burst into tears for no apparent reason, and there were so many fights at home. With all this going on, my heart used to beat so fast, and I would be clueless as to why it was happening. I never had the courage to question what was going on around me.”
She learned in grade eight, that her mother had been diagnosed with severe chronic depression.
It changed her life.
Rajagopal said: “Subconsciously, I think I always knew something wasn’t right. My mum has had depression for as long as I can remember, and I never knew how to support her, especially as a child. I am still not able to cope with this reality sometimes, and feel that her illness is shaping my life. She is the one who was diagnosed with chronic depression… but I live with her depression, too.”
It has already shaped the way she thinks and behaves.
She said: “I learned pretty early if I wanted to be loved, I had to be good. Always good, always giving the right response, staying perfectly in line. The fear and anxiety I attached to disappointing my parents — my mother — was so intense, I rarely got in trouble as a child, and when I did, it was the end of all things, in my mind.”
According to Dr Singhal, it’s vital that families with a depressed parent have conversations.
She said: “As much as possible, family members need to constantly check in with each other and be emotionally available. Parents need to create an environment that allows for open and honest dialogue so that children feel comfortable to approach them. This will also encourage a parent struggling with depression to reach out for support and accept help.”
Fighting her own feelings of resentment and regret, Rajagopal said she has learned to adapt, especially for the sake of her younger sibling, who looks up to her.
For little boys hiding their mum’s blankets, and teens struggling to deal with maternal depression, she had some advice: “Try to forgive your mum and accept that she may be in a different frame of mind. Your mum may be too sick to fill in the role of a parent, so search for other adults who can be mentors to you. Find activities that relax you or help you feel great. This could include sports or playing with the family pet. Remember that it’s okay to cry. Having a depressed parent is difficult. Your feelings are natural and valid.”
— Some names in this report have been changed to protect the readers’ identity.
Medication for people suffering from depression can be difficult to acquire in the UAE.
A list of controlled drugs, released by the General Authority for Health Services for the Emirate of Abu Dhabi (GAHS) in 2007, includes Prozac and Seroxat – two of the most common antidepressant medications, which are known as selective serotonin re-uptake inhibitors (SSRIs).
Susan told Gulf News: “People who suffer from depression are no longer able to simply get a repeat prescription for anti-depressants from their doctor in Dubai. They now have to go to a psychiatrist every month and incur further expenses. This is discriminatory against people with mental health problems and further compounds their anxiety and depression due to the stigma involved. It is cheaper for me to fly back to the UK every three months and bring in three month’s supply of anti-depressants with a covering letter from my general practitioner there.”
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