Ellie Zuehlke and her husband had expected the birth of their long-awaited first child to be one of the happiest moments of their lives—until, somehow, it wasn't. Instead, Ellie experienced severe postpartum depression that left her unable to care for their newborn son. To thousands of mothers, Ellie Zuehlke's story will sound sadly familiar. Ellie, a health care industry professional, was ultimately lucky. Though some mothers lose health care coverage shortly after giving birth, Ellie had health insurance and access to a qualified mental health provider and was able to get help quickly. As she explains, "Because I received prompt, appropriate treatment after the birth of my first son, we were able to greatly reduce the negative impact of my depression on my son. In addition, I was able to get the care I needed to prevent depression after the birth of my second child."
Today, Ellie is enjoying her family life and two sons, now seven and two years old, who are healthy and happy. Ellie shared her story with the Children's Defense Fund-Minnesota (CDF-MN) staff, who were studying the effects of depression in families like hers for their new report "Maternal Depression in Early Childhood." CDF-MN found that undiagnosed and untreated maternal depression is not only dangerous for a mother but can have long-term harmful effects on her children.
As the report explains, "Infants and toddlers are very vulnerable to the effects of parental depression because of their total reliance on their caregivers. A growing body of research is documenting that the foundation for future brain development is laid down during the earliest years of life. Adverse childhood experiences can disrupt that process with lifelong consequences if untreated. 'Unaddressed depression can seriously impair a parent's ability to respond to her newborn in a nurturing way,' says Terrie Rose, founder and Executive Director of Baby's Space, an early learning center in Minneapolis. This can harm a child's cognitive, physical, social, and emotional development, beginning early in his or her life. 'As a result, lower responsiveness, sleep problems, and more negative emotions can be seen in infants as young as six months.'"
These risks continue to accumulate. By toddlerhood, children are at elevated risk of behavior and emotional problems and delayed language development; by early childhood they are at elevated risk of learning difficulties and conduct disorders and are already more vulnerable to depression themselves. By adolescence they are at higher risk of depression, learning and anxiety disorders, and substance abuse. CDF-MN cites a finding by the National Center for Children in Poverty that "maternal depression and anxiety is a stronger risk factor for child behavior problems than smoking, binge drinking, and emotional or physical domestic violence." CDF-MN estimates that in Minnesota one in 10 babies is born to a mother experiencing serious depression during his or her first year of life—nearly 14,000 Minnesota mothers and infants in 2009—and every untreated case of maternal depression in the state costs a minimum of $23,000 a year primarily from lost productivity and higher health care costs for mother and child.
The good news, as Ellie Zuehlke knows first-hand, is that maternal depression is treatable. "Fortunately, we know a great deal about how to help mothers and families struggling with depression before or after a baby's birth," Helen Kim, a psychiatrist and director of a women's mental health program at a Minnesota medical center, told CDF-MN. "We can also identify mothers who are at higher risk of experiencing depression than others and offer assistance before they get pregnant or give birth." CDF-MN found that Minnesota has some good policies, effective programs and practices, and innovative providers that help prevent or reduce the incidence of depression and its negative effects. But many of the policies are not fully implemented and several programs operate on a small scale. Too often the mothers most at risk—poor mothers, young mothers, and mothers of color—are the ones least likely to receive help. Much more must be done to raise awareness about maternal depression and the importance of addressing it.
In Minnesota, as in many other states, the difficult economic times are making maternal depression and depression in other caregivers worse. "Unfortunately, some of the state's budget cutting actions have increased the risk factors associated with depression, especially for low-income parents," says Marcie Jefferys, CDF-MN's Policy Development Director. Reduced access to postnatal health care, public assistance policies that push families with newborns deeper into poverty, lack of child care assistance for low income working parents, and cuts in county mental health programs are all among recent budget cuts that increase family stress, which is tied to higher rates of depression. I hope this important new report will sound the alarm for policymakers across the nation that cutting crucial programs and services has devastating impacts on our most vulnerable mothers and children and causes lifelong harm. States should be investing today in effective programs that identify at-risk mothers and help them get the treatment they need. Everyone—mothers, children, and the state's bottom line—will benefit tomorrow.