According to the World Health Organization, depressive disorders are among the top 15 leading causes of disability adjusted life years (DALYs). DALYs are used to measure the burden of disease. Even though depressive disorders impact a large number of people, these disorders are not well understood. While there are numerous depressive disorders, this project will focus on major depressive order.
Major depressive disorder (also known as clinical depression) is defined as a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.
Van Gogh, Vincent. Sorrowing Old Man. 1890, Oil on canvas, Kröller-Müller Museum, Otterlo.
A variety of factors influence whether or not a person experiences clinical depression; these factors include socioeconomic factors, loss, abuse, neglect, and more, including genetic factors. Clinical depression is not caused by one specific gene. Instead, current research suggests that clinical depression is the result of a combination of genes along which increase the risk of experiencing depression. If someone has a parent with clinical depression, that person has approximately a 2 or 3 times greater risk of developing depression compared to the average person.
Each person experiences clinical depression differently. The pathophysiology of clinical depression is not fully understood, so diagnosing the disorder is based on the individual's personal account of symptoms. Because of the importance of personal accounts, an extensive amount of research on clinical depression is focused on documenting experiences of this disorder.
This memoir will work to present the common experiences of parents and children with clinical depression, and then, I will share the experience of my family in order to illuminate the impact of both a mother and a child having clinical depression.
"Drowning that’s when I, when I get lower than I’ve ever been. I don’t know if I can get any lower but the risk is that I won’t be able to do anything anymore, that’s how it feels. When I feel like I’m drowning then I go lie down and pull the covers over my head and don’t give a damn about anything."
The above quote is from a participant in Ahlström, Britt Hedman, et al.'s study titled "The Meaning of Major Depression in Family Life: The Viewpoint of the Ill Parent.”
Parents with clinical depression frequently report feeling hopeless as though they would never feel happiness again.
Having a parent with clinical depression greatly impacts the family as a whole. Both partners and children discussed shifting roles and instability in the familial environment. At times, children feel like they had to grow up too fast and experience increased stress and depressive moods as a result of needing to step into a parental role.
"i knew the pain and bad feelings were coming from an Invisible, INVADING monster, which was bigger, and no match for me."
The above quote is from Boston Children's Hospital's Depression Experience Journal.
Children with clinical depression often feel the need to internalize their experience.
As the child internalizes their feelings, they tend to feel isolated. Some children sought to counteract this isolation by seeking acceptance or assurance from other children or adults.
Children with clinical depression often experience physical symptoms like headaches and stomaches while also having a lack of confidence and low self esteem.
Illustration by James Kay from Patrick Ness' A Monster Calls
Having a child with clinical depression impacts the parents' mental health. Parents, especially mothers, report feeling helpless and try to find a reason for their child's depression. It is also common for mothers to neglect their own feelings and health when their child is having depressive episodes. Along with neglecting their own well-being, mothers report that it can be difficult to connect to their child and find that clear communication skills are necessary.
It is clear that having one family member with clinical depression impacts the entire family, but what happens when both a mother and child are suffering from clinical depression?
Here's our story.
I have always felt the need to internalize my emotions. The idea of communicating my emotions invokes a panic in me as though I am opening Pandora's box. As I am writing this, I feel a certain level of anxiety, and I am not sure how to say what I experience and dwell on every day.
For the past 20 years, I have had a front row seat to the saga that is my family's unspoken mental health journey, specifically my mother and older sister's mental health. As my sister, Kayley, and I have grown up and gone to college, we have become more open in terms of discussing our childhood and how we have struggled with mental health. During these discussions, we find that we often felt similar things, but we chose to suffer in silence. It is finally time to break that silence.
"My family has never had an honest conversation about mental health. It is so easy to assume that the people who you spend every day with, the people that raised you, loved you must know you the best. But in my experience that is often the furthest thing from the truth. When my sister asked me to write about my experiences with mental health, I was unsure how much to include. Even now there is a vulnerability that makes me nervous. How do you tell the people who love you that they failed you?"
Throughout our childhood, talking about your emotions was not an option. It was simply understood that you were fine, or if you were not fine, it was because you were choosing to be upset. Everything was a choice. You chose to be happy. You chose to be sad.
Even when I was young, I knew Kayley wasn't choosing to be sad. I would watch her slip in and out of the lonely prison that was her own mind, but I said nothing and did nothing.
"I couldn’t sleep, eat, or function constantly plagued by a revolving door of upsetting and intrusive thoughts that just wouldn’t leave me alone. My mom used to tell me to use a remote, press a mental stop button, rewind, and change my thought. I kept trying to hit the stop button, kept trying to change it, make myself less afraid. But I couldn’t. I lived trapped in my own mind."
Looking back, I attribute my lack of action to two things.
First, I felt helpless. As a child, Kayley was my idol; she was my big sister. If she was struggling, how was I going to be okay?
Second, I also thought my mother would help her. My mother is a psychologist. It is her job to know how to help her.
Why wasn't she able to help her?
"Looking back, I always wonder how could this have happened? It’s not uncommon, but I was supposed to be different. I was lucky. I had a mom who was supposed to know all this stuff, who was supposed to see, who was supposed to help me when I asked for it. She didn’t help me. No one did."
As a child, I could not understand why my mother wasn't helping Kayley. She was the hero; she was my hero. How could she not save Kayley?
"As a person with a mental health background with knowledge and experience, it has always been a fine line between over analyzing situations with my daughters and simply being their mother. As I look back at how I showed up for my oldest daughter, I wish I could go back and do things differently. This is one of my biggest regrets. I often wonder if I had done this, if I had been able to hold the space for her and not been caught up in it not being a failure on my part, that perhaps she would not have experienced ongoing anxiety without tools that were helpful to her. As I write this, I have no good reason for why I did not access help sooner."
"It is an area of extreme discomfort for me to watch my daughter be in emotional pain. As my daughter was growing up this discomfort was so extreme that I would lash out and tell her to get over it, to step feeling this way, etc. all because I could not stand to feel the pain of my daughter experiencing her pain. It became all about me."
I think, in the moment, I blamed my mother for not being able to help Kayley. It was not until recently that I realized it was no one's fault. All of us were trying to navigate our own internal turmoil without ever admitting that the turmoil existed.
"I want to be very clear that I don’t blame my mother for what happened to me. I don’t blame anyone in my family. You can’t know a person who doesn’t want to be known."
Kayley has always been different, but it was obvious that she did not want to share her identity because she was afraid of how our family would react. When I was a freshman in high school, she came out on our drive home from school. I could tell she was scared to tell me, and I was scared to say the wrong thing. Suddenly, I started to understand why Kayley was struggling. It was not her choice. Our upbringing told her that who she is is wrong, and none of us were telling her that she was right.
"I always knew I was gay and by the time I was six or seven I had come to the realization that was horrible. I don’t remember when I first realized that or how, but I remember being terrified of hell from a young age. I grieve for the little girl who cried and shook with fear that she wouldn’t see her family in heaven, and I mourn the fact that sometimes even now she reappears."
I was not there for Kayley. I was not there for my mother. We were all struggling, but we were all unable to communicate our internal implosions, our fears, our anxieties, and our love for each other. This inability to communicate led to a sense of isolation as though each of us was being abandoned by those who were supposed to love us the most, so we all suffered in a silence alone with no way out.
"Everything I felt became so overwhelming. I felt like I was exploding on the inside, like my feelings were spilling out and I had no way of controlling them. They told me it was overwhelming, annoying, a rollercoaster. Even now I still feel scared to share how I feel for fear that it overwhelms everyone around me. And if I do share, I struggle with how much to. What I shared with my family those years and now is still only a fraction. If they couldn’t handle my surface level depression, how could they handle the fact that life was unbearable to me."
Every day, I strive to support my sister and my mother. I am so incredibly lucky to have two strong, independent females as my role models and support system. While we each have our own struggles, I know, now more than ever, that the struggle is not silent.
"I’m aware that I am nothing like the daughter my parents imagined. My relationship with them and my family suffered tremendously because of it. But at the end of the day, I am myself. I advocated for myself. I got the help I needed, and I am here today successful because I never gave up on myself. I am proud of myself. I am comfortable as myself."