Sorrow's Web: Hope, Help, and Understanding for Depressed Mothers and Their Children

Martha Manning author of Undercurrents With equal compassion for mothers and children, Sheffield integrates research with riveting interviews, which makes for a compelling read....A hopeful book and a rallying cry for early intervention.

William Beardslee, M.D. Gardner Monks Professor of Child Psychiatry, Harvard Medical School Offers important help to depressed mothers....She has beautifully and eloquently captured recent advances in the study of depression and provides vital practical advice for both sufferers and those around them.

Peter S. Jensen, M.D. Ruane Professor of Child Psychiatry and Director, Center for the Advancement of Children's Mental Health, Columbia University A remarkable book based on careful research. Going beyond simple "feel good" solutions, Sorrow's Web's message is skillfully couched in elegant prose and poignant personal history. Highly recommended for depressed parents, child "survivors," and professionals alike.

"With equal compassion for mothers and children, Sheffield integrates research with riveting interviews, which makes for a compelling read . . . A hopeful book with a rallying cry for early intervention."--Martha Manning, author of Undercurrents

"Offers important help to depressed mothers . . . She has beautifully and eloquently captured recent advances in the study of depression and provides vital practical advice for both sufferers and those around them."--William Beardslee, M.D., Garnder Monks Professor of Child Psychiatry, Harvard Medical School

"A remarkable book based on careful research. Going beyond simple 'feel good' solutions, Sorrow's Web message is skillfully couched in elegant prose and poignant personal history. Highly recommended for depressed parents, child 'survivors,' and professionals alike."--Peter S. Jensen, M.D., director Center for the Advancement of Children's Mental Health, Columbia University

Anne Sheffield, formerly director of development for the Planned Parenthood Federation of America and the International Planned Parenthood Federation, is also author of the award-winning book How You Can Survive When They're Depressed. She lives in New York City.

Chapter 1

Shedding New Light on an Old Problem

An eminent child psychologist once observed that all children need at least one adult who is irrationally enthusiastic about them. I lacked such a parent because my mother suffered from a chronic depression that prevented her from feeling enthusiastic about anything, including me. Neither she nor I is alone in the brand of lasting grief her depression caused us both. One in every four women will suffer from this illness at some time during her life, often during her childbearing years. Although depression is not contagious in the sense that measles and tuberculosis are, its presence virtually ensures that those closest to the depressed person will in their turn suffer from the depression's fallout. Even the most selfless, caring moms cannot, when they are depressed, avoid causing pain and problems for those they love.

Searching my childhood memories for images of my mother, I find I am a poor navigator, unable to hold a true course. I am buffeted by the ill winds of our later relationship, which was an unhappy one. Those recollections are clear, unlike the few remaining from a more distant past. I thought that I had a happy childhood. But the only psychotherapist I ever consulted insisted this was not so, that in fact I was an unhappy child, not on the basis of my memories but because of my lack of them. "You're screening them out," she told me, shaking her head at my stubbornness as though I were being deliberately uncooperative. I would dutifully sift once again through the handful of early recollections about my mother; finding nothing new, I would tell her more about my grandmother, my teachers, my friends, my games and achievements at school. If my therapist was correct in her assertion, I can only congratulate myself on the effective barrier to the truth that I appear to have erected. It served me well for many years, obliterating earlier memories and softening the impact of later ones. When I was twenty-three, that protection crumbled abruptly with my mother's attempted suicide, the only spectacularly overt evidence of her depression. The sympathy this should have engendered in me was dissipated by her statement, issued on recovering from the effects of stomach pumping, that she had done it because I didn't love her.

Before that event, I had spent my life engaged in the business of growing up as the only child of a divorced mother. Perhaps her depression was in those years less enveloping than it subsequently became, or perhaps the bright pleasures of school and the friends and rewards it afforded me were sufficient nourishment for my psyche. My father had left when I was an infant; during my childhood I saw him only once, when at the age of seven my mother allowed me to visit him in Florida where he lived with his second wife and my two young half-sisters. When I returned home, my tales of delighted discovery were ill-received, and I understood that my father did not belong in my thoughts.

When I was nine, my first stepfather arrived and stayed for several years, bringing me two stepsisters and a stepbrother, and the semblance of a normal houseful of parents and kids. My mother's growing negativity and critical outlook now had multiple targets, and I had in my stepsiblings sympathetic allies, but by early high school I was once again the reigning bull's-eye for her dissatisfaction. Nothing I did was right; nothing I did was enough; and everything wrong in her life was, she inferred, my fault. She eschewed the big guns of outright warfare, preferring instead furtive guerilla sallies, disguised as the urgings of a concerned mother: "Why can't you...How is it possible that...You could at least have...But you always..." I became more than ever a striver for excellence, propelled by the rewards I believed it would win me, among them her love and support. My mother wanted the same from me, but not in return for hers. The unspoken pact was to be one-sided.

Once again, a new stepfather arrived, a kind and patient man with whom I shared a deep affection. In public my mother displayed pride and pleasure in us, but in our absence she confided to friends the hurt our failings as husband and daughter caused her. Occasionally one of her intimates would pull me aside and urge me to be more supportive and demonstrative, hinting that Tony was already a heavy cross for her to bear. Behind the closed doors of our apartment and fortified with alcohol, she complained to each of us about the other, welding us into an unspoken conspiracy of protection. Not long after my mother's suicide attempt, Tony abruptly decamped during one of my mother's hospital stays for the cancer that eventually killed her. Friends heaped abuse upon him for this abandonment in a time of such need, but, although I missed him terribly, I understood and condoned his departure. Had I been able, I would gladly have escaped.

By then I had my own apartment. Finding the distance it afforded me an insufficient shield, I elected to marry an Englishman and moved a comfortable three thousand miles away. But in my haste to escape I chose badly, and I returned shortly with an infant daughter. This steep and sudden fall from excellence seemed persuasive evidence that I was indeed the inadequate and undeserving person my mother had long perceived. Dorian Gray-like, the portrait she had so long been painting became my self-image. Overlaying it with broad brushstrokes -- impressive jobs, an enchanting child, and a constant supply of suitors and friends -- I kept its existence well hidden, but it bound me to my mother, the artist. Longing for the love and approval she continued to withhold, I sought them with a resentment and anger that matched hers. At her death, my relief at the freedom it portended caused me to add shame and guilt to the toxic mix. Despite the staged appearance of confidence, I felt like the consummate loser.

My memories of my mother after her suicide attempt are clear and unpleasant, colored with a resentment and anger that spread beyond their immediate target. Decades later, these emotions still lie just beneath the surface, waiting for any opportunity to cause dissatisfaction with who and what I am. When I feel brave enough to travel down that road, I find them connected to everything I most dislike about myself: an inability to sustain intimacy; the belief, against ample evidence, that I am a failure and a fraud with its concomitant burden of perfectionism; and a bottomless longing for approval and recognition that I try to hide.

The pathways in my brain that lead to these deficits, I assume, did not spring into being at the moment of her postsuicidal pronouncement. They must have been long in the making, the product of innumerable exchanges between us, each infinitesimally deepening the grooves of feelings, thoughts, and behavior until they settled into a pattern that holds me hostage. Together with that part of me of which I am the sole creator, what I think of as the good part, they constitute the essential me. I have come to accept and to live with the flawed whole, but I remain stubbornly angry at my mother.

What brought me a measure of tolerance and understanding was, paradoxically, my own depression that fully blossomed fifteen years ago. You have to live through this illness to have an inkling of what it does to the human psyche, of how much it distorts and mangles not only the interior but the exterior landscape as well. That a tiny fault in the production of this or that neurochemical can cause such havoc is a testimony to the intricate miracle that is the human brain. While many gifted artists and writers have created lasting beauty from their experience of this illness, for most who suffer from it the principal product is negativity and unhappiness, both for ourselves and for those who live with and love us. It's as though our internal compass has gone dead, leaving us to flounder about in a sea of solitary misery. At a time when we most need love and support, we are least able to ask for and receive it. When depression lifts, either through treatment or because it has run its course for the time being, we suspect that someone has flicked a magic switch. We are dazzled by the light that suddenly comes streaming in, and the world seems inviting; once again it is good to be alive.

Emerging from my own darkness, I caught my first glimpse of my mother as depressed rather than mean-spirited, as unable to love rather than unloving, as the victim of her illness rather than a free agent who chose to be hurtful. The professional help I received was unavailable to her: Antidepressants were rarely prescribed in the mid-1950s, and she viewed psychotherapy as strictly for crazy people. After her suicide attempt, the hospital psychiatrist came to offer his services, but she refused to discuss anything other than where he had gone to college and how he and his family spent their summer vacations. Neither Tony, her sister, nor I had any more success in coaxing forth an explanation. We never discussed it among ourselves or in depth with her, and life traipsed on as before.

The only thing that makes my story unusual is that I am fortunate in understanding that it is not just a sad tale about my mother and myself; it is about her depression and how it dominated our entire relationship. Had she been depression-free, both her life and mine, and our respective views of ourselves and each other, might have been quite different. That insight, so many years in coming, has lightened some of the burdens I have needlessly dragged throughout my life, burdens that also weigh on the many others with a similar background. Many mothers suffer from depression and most feel and behave in a manner akin to that of my mother, not because they are bad, aberrant people but because their illness distorts thinking and feeling.

Why I Focus on Mothers, Not Fathers

I focus on maternal depression for several reasons. First, mothers play a unique, intimate, and defining role in a child's development in ways that even the most devoted fathers do not. Second, a huge body of research, amassed over more than two decades, supports the conclusion that a mother's depression is a handicap for her kids, pushing the learning process off track and disturbing their emotional, social, and, many experts believe, cognitive growth. Maternal depression sets in motion a vicious circle that helps explain why kids of a depressed parent are two to three times more likely to develop depression later in life than are those of a non-depressed parent. Dr. T. Berry Brazelton, parenting maven to millions, rates maternal depression as critically germane to today's major issue, the future of our children. "A depressed mother," he told me, "gives kids a difficult start in life. Because of it, they miss out on what they most need -- a sense of security, a positive self-image, and the motivation to learn in school and to succeed."

Experts in the domains of psychiatry, psychology, and child development who study the problem are painstakingly cautious and rely on direct observation rather than anecdotal evidence for their conclusions. Some of the effects they note are seen immediately: Infants with depressed mothers are less likely to thrive physically and are less responsive and secure in their attachment to them. Other consequences show up as behavioral and learning problems among preschool and school-age kids. In adolescents, they play out as poor grades and in such social shortcomings as low self-esteem, trouble making friends and handling authority, lack of emotional equilibrium, and drug and alcohol abuse.

The adult children of depressed mothers remain beyond current research parameters, perhaps because the task of linking later psychosocial problems to earlier life experiences of necessity must depend on personal recollections rather than on observation. But surely the origin of our problems, for example, with intimacy and commitment, is rooted in our experience of growing up with a depressed mother. Because we have not been "studied," we are left to puzzle over our emotional handicap, and to unknowingly pass it along to our own vulnerable offspring. The full roster of issues bearing on generational depression is far from complete.

Recently, research attention has turned to depression during pregnancy, far more prevalent than had been suspected. New technology yields a three-dimensional image of the fetus in utero, allowing researchers to observe and measure fetal reactions to maternal stress and anxiety. Within just twenty-four hours of birth, babies born to depressed women show signs of differences in central nervous system development. They have less motor activity and endurance and are more irritable, fussier, and harder to soothe than newborns of non-depressed mothers. These new discoveries represent a welcome contribution to the knowledge and understanding of scientists and mothers alike.

The causal relationship between these emotional and behavioral deficits and maternal depression is a complex one because so many factors, including genes and temperament, are involved, all playing out within the larger family context. Depressed mothers feel inadequate and incompetent; their spouses feel shut out and underloved, setting the scene for disagreement and friction. Children, short on reason and long on radar, pick up on all of these vibes. While no one can predict precisely any given child's reaction, few will escape unscathed.

Kids are remarkably resilient, and the potentially toxic effects of a mother's depression won't occur overnight. But prolonged exposure to the neglectful or erratic parenting it engenders does damage over time. Self-awareness on the part of the mother and treatment for her depression can substantially mitigate these destructive effects. Unfortunately, depression is a stealthy opponent. Unlike other illnesses, it causes few serious physical symptoms that might send one running to the doctor and so usually goes undetected, causing trouble before a perceptive relative, teacher, or coach realizes what's the matter. And while depression can, in extreme cases, lead to psychosis and profound despair, requiring hospitalization, it usually just digs in and hides out for a long time under the guise of exhaustion, the sense of being overwhelmed and helpless, plus the sinking conviction that life will never be good again. It's this garden variety of depression that sneakily lays low so many mothers.

Knowing that a mother's depression is a harbinger of problems for kids should be viewed as a previously unavailable luxury, not as a reason for maternal guilt. Researching and writing this book has led me to the conviction that depression, with its hateful ability to propagate itself in successive generations, is a foe worthy of national attention and action, a widespread affliction that needs airing and solving. Despite growing public recognition and understanding, countless mothers endure it, few doctors are capable diagnosticians, and innumerable kids and their parents suffer needlessly as a result. The real issue lies in the stubborn silence surrounding it.

The single greatest shaper of my sense of self, then and now, is the experience of growing up in the sphere of my mother's undiagnosed illness. In addition, as so often happens, I inherited a vulnerability to depression through her genes and subsequently passed it along to my own daughter, who also suffers from depression. But while our family vulnerability to depression may continue to thrive, its potential destructive impact will not. In the light of what is known today both parents and kids can beat depression's odds, or at the least ensure less harsh outcomes.

Widespread dissemination of information about maternal depression is the key. While the professional journals are chockablock with articles about the newest research, their findings rarely if ever escape the confines of academia. Not only do they fail to reach mothers, but most health professionals who minister to women are also unaware of their implications, or are perhaps unwilling to tackle depression's ripple effect. And although depression is no longer automatically stigmatized, delinquent parenting is.

Of all the human roles, motherhood remains a sanctum of supposed perfection and "bad mother" the most damning of accusations. Although mother bashing is in vogue in some quarters, in most it is the epitome of political incorrectness. This may help explain why all those professional journal articles have never made it into the popular press. A number of psychologists have told me that young depressed mothers, in particular, need to be handled with kid gloves lest they feel accused and guilty. But depressed moms of all ages would give anything for an early diagnosis, and for the opportunity to spare both themselves and their kids pain.

When knowing and willful damage is inflicted on children, the accusation of neglect or abuse is justified. Depressed mothers, however, are reacting to the pain, distress, and emotional distortions of an often-unrecognized condition that narrows their perceptions and demands a focus on self rather than others. They are just as devoted to their children as their non-depressed counterparts, just as aware of their pivotal role in the parenting process, and usually desirous of fulfilling it, facts borne out by all the studies. If they are flawed parents it is through no unnatural fault of their own. Pointing out the facts about maternal depression may be disturbing, but it has nothing to do with blaming or demonizing mothers. The demon is depression. Blame is restricted to those who, once made aware of the problem, choose to ignore it.

Simply stated, it's hard to be a good mother when this illness is in the picture. The following chapter looks at what can happen when a mother's depression arrives early and stays late. It offers insights and solutions both for adult children and for depressed mothers of younger offspring. Many of the people whom you will meet in it were brought up during a time when this medical illness went unrecognized, and when treatment for it was largely unavailable. The legacy they received stands as stark testimony to the consequences of turning a blind eye toward this problem.

Copyright © 2000 by Anne Sheffield