Mental Health

When Treating Depression, Entire Family Called On

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Genetics researchers have yet to pinpoint a specific gene or genes for depression. But researchers do know that people with depression in their family are more vulnerable to the condition. This is most likely due to both genetic factors — and the struggle of having a depressed family member. As scientists work to figure out the genetics of the illness, families and therapists are figuring out ways to cope.

Untreated depression can be "a family calamity," says Dr. William Beardslee, a professor of psychiatry at Harvard Medical School and longstanding researcher of the effects of severe parental mental illness on children. Nearly 16 million children under the age of 18 are living with an adult who had a bout of major depression in the last year, according to a recent report from the National Academy of Sciences.

Parents may function reasonably well for a time, but when a bout of depression hits, parenting can becomes rocky, says Beardslee. Then the child may experience "a change in parent's attention, a change in parent's praise, and a change in parent's focus," he says. That can make children angry, sad or wary.

Depression In Families

All scientists can say for sure is that depression in the family increases the risk of any one individual member. According to the National Academy of Sciences report, 2 to 4 percent of young children with a parent who has depression will have depression themselves. As many as four in 10 adolescent children of depressed parents will have depression. And, children of depressed parents are more likely to be substance abusers.

So genes do matter, and having a depressed parent also matters, and that's why researchers are developing new strategies for families.

Genetics can be an indication of vulnerability, says Beardslee. It may take an environmental problem like a divorce or an experience of violence or poverty to spark depression. And sometimes, parents' problems can make their children more likely to develop depression.

Getting Support Is Key

Parents with depression can reduce the risk to their children by getting treatment. Families can go in for family therapy, an approach pioneered by Beardslee and supported by the National Academy of Sciences report. If there's a full awareness of the depression, the family can figure out ways to make sure the child is able to get emotional support from the other parent, a friend or relative when the other parent is going through a bad spell.

"What we've found works well is participant support groups," says Peter Ashenden, head of Depression and Bipolar Support Alliance. "People get to meet other individuals with the same or similar experiences," he says, and families can see how other families have coped.

Challenges To Healing

Getting the right kind of professional help can be challenging, though money isn't always the obstacle you might think. Most health insurance policies that cover mental illness include family therapy, says Julie Totten, head of Families for Depression Awareness.

But a problem she does see is that doctors often only treat the patient, not the family.

"It's not something that medical professionals often talk about as an option," she says. "That's how our medical system is set up, to treat the patient and not the family."

She says it can be a big problem convincing family members with depression to get help.

"Expect them to say 'no,' " she says."Then keep working at it, get other people involved, because if someone is depressed their first answer is going to be no, they don't want to do anything because they're feeling so down."

Totten's own brother had depression. She tried to convince him to get help, but he wouldn't. He eventually committed suicide, which prompted her to found Families for Depression Awareness.

The big stumbling block to getting help is stigma. "People don't really talk about it enough," says Totten. "You don't say to your neighbor, 'my brother is really depressed.' "

Groups like Depression and Bipolar Support Alliance guarantee anonymity for people who use their Web site because they understand the importance of this, says Ashenden, the head of the organization.

"We know it from our people that are reaching out to us. There's a fear in people's voice when they're calling us."



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