Helping The Depressed Mom: Can There Be A More Important Task?

Hello. I very much appreciate the important concerns you have expressed about your wife and the potential effect her mood disturbance may be having on your children. In my response to your concerns, I would like to strike a balance between soothing your worry and helping you address the actual problem.

First, it is important to understand the concept of "good enough" parenting; this is an idea discussed within post-freudian literature that makes clear the point that perfection in parenting is far from necessary but that "good enough" is sufficient if not superior. Every parent will stumble at times, exhibit empathic failures, lose their temper, and "leak" their own personal struggles with their children.

That said, a primary caregiver's depressive vulnerabilities are best not ignored. I am glad your wife is seeking and receiving both medicine and therapy. I think it is important for you and your wife to make your best determination as to the effectiveness of this treatment regimen, on both counts. Probably the best way to assess this is simply by talking openly and supportively with your wife about how helpful she believes this treatment is. If either the therapy or the medicine seems not to be working as well as she would like, there are definitely options to explore. For example, over 70% of the psychotropic medications in this country are prescribed by primary care physicians, who typically have very minimal training and expertise in addressing more complex mental health conditions. So, if she is not seeing a psychiatrist, that may be an option.

Further, all psychotherapies and psychotherapists are NOT created equally, as you may know. If your wife is not feeling strongly connected to her therapist, or is not receiving optimal benefit from treatment, then you may wish to talk with her about finding a new therapist. Bibliotherapy, or the reading of books to supplement therapy, can also be quite useful. Specifically, I strongly recommend books written from the cognitive behavioral therapy (CBT) perspective, such as "The Feeling Good Handbook" by David Burns. In any case, if the current therapy is not helping, and not providing her with tools and techniques with which she can help herself, then it may be time for a change of personnel.

I appreciate that your primary concern is the effect of your wife's depression on your children's development. Yes, young children do indeed have very sensitive "radar" to what their caregivers are thinking, feeling and doing, even if this is not discussed openly. One particularly negative impact can be that such children begin to try and "fix" or mitigate the parent's depressive symptoms, by tweaking their own behavior (this often results in a condition called "parentification"). This can have a significant impact on children, somewhat akin to that of growing up with an addicted, angry or anxious parent. One very good book to read in this realm is "The Drama of The Gifted Child" by Alice Miller (although, I must warn you, it is a bit psycho-babbly). I would strongly encourage you and your wife to deal with this challenge as collaboratively as possible. If she is amenable, I suggest that you accompany your wife to her therapy sessions every so often so as to particpate meaningfully in her recovery (this is NOT couples therapy, but more of a "guest appearance" on your part). Couples therapy may also be useful in helping you two discuss and address these concerns.

On a practical level, I do think that giving your wife as many breaks from her mothering role as you can, supporting her engagement in self-care activities (exercise, social involvements, time for herself or to visit family) will all be very important as well. Please do be sure and make an effort to fully understand her various concerns and symptoms, and to validate them genuinely and sensitively. For example, does she feel hopeless? Is she feeling particularly self critical? Is she dissatisfied with her life, with the marriage, or with herself? What specifically drives her depressive thoughts? After all, if your wife cannot value and improve her relationship with herself, then it will be difficult for her to be there effectively for your children. Needless to say, I strongly suggest that you get involved as fully as you can, despite your work demands. It is unlikely that you will ever look back with regret at the fact that you sacrificed work to attend to your wife and children. And it sure does seem as if they need you now.

By the way, I would not in any way minimize the very important role you play as the children's father, perhaps, at times, even in "compensating" for some of your wife's current limitations. Children who know that they have at least one parent to go to, lean on, and receive love from, will do a whole lot better than those who wonder why "Dad went off and left us with our depressed Mom."

I thank you very much for expressing your concerns and I hope that at least some of what I have said has been of use to you. The fact that you have taken the time to reflect upon this challenge and to write to me is clear evidence of your engagement and sensitivity. If you wish to elaborate further on your initial question, or to follow-up regarding specifics or respond to what I have written, I will be happy to provide additional response(s).

Sincerely,

Richard E. Schultz, Ph.D,

Practice: www.drschultz.org

Blog: www.mindset.mobi

Twitter: Mindsetdoc