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Understanding Parental Depression And Its Impact On Children · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello, this is Kim Lee, child and adolescent psychotherapist from the Children's Consultancy.
• 0:05
  SPEAKER_00: This is episode two in the podcast series which is concerned with the mind of the parent and parental mental health.
• 0:17
  SPEAKER_00: Now the motivation for this particular series comes from the understanding that the mental health of parents is something which is often overlooked, and of course, the connection between the mental health of the parent and children is one which we have to take seriously and treat with compassion and understanding.
• 0:47
  SPEAKER_00: So in this episode, we're going to talk about parental depression, not as a label, labels really aren't very helpful, but more from the point of view of understanding that any other kind of physical difficulty or disorder is something which, whilst very often visible, is something we take seriously.
• 1:11
  SPEAKER_00: The same is true with depression and other mental health states.
• 1:16
  SPEAKER_00: It's often misunderstood because it is sometimes just seen as sadness or a failure of some kind to actually manage.
• 1:29
  SPEAKER_00: Some of this is connected to stigma where mental health is concerned.
• 1:34
  SPEAKER_00: But I think a lot of it is due to the fact that people don't understand the mechanisms and the experience of depression.
• 1:48
  SPEAKER_00: The statistics show that one in four people will experience a mental health crisis during the course of their lives and perhaps more than once.
• 1:59
  SPEAKER_00: Depression is one of the most common in the range of difficulties.
• 2:05
  SPEAKER_00: And this is due to the fact that depressive states are often the result of cumulative stress that a person experiences events or a lifestyle which is stressful and demanding.
• 2:24
  SPEAKER_00: And whilst they are able to carry the load, so to speak, not without some difficulty, there comes a point when carrying that load is too much.
• 2:36
  SPEAKER_00: And so what we see is a kind of collapse.
• 2:40
  SPEAKER_00: People used to talk about breakdown.
• 2:42
  SPEAKER_00: You know, I had a nervous breakdown.
• 2:45
  SPEAKER_00: Very often what they're describing is that yes, they did break down because they simply couldn't carry the load any longer.
• 2:53
  SPEAKER_00: And when that happens, we see that the person's capacity to function and to remain connected with those things which were previously gratifying or that they were previously able to undertake really are no longer available to them.
• 3:15
  SPEAKER_00: So it's not just sadness and it's not weakness and it's not a failure.
• 3:23
  SPEAKER_00: It really is a state of emotional depletion, which is a kind of quiet dimming of energy and connection and internal vitality.
• 3:37
  SPEAKER_00: And when a parent feels this way, the child often feels like it too.
• 3:44
  SPEAKER_00: Parents feel of a depression in a variety of different ways, and some don't recognize it immediately.
• 3:54
  SPEAKER_00: But you might notice an emotional flatness or numbness, a sense of not being present, the experience of exhaustion that sleep doesn't repair, a loss of enjoyment or pleasure, wanting to or actively withdrawing from interactions with others.
• 4:17
  SPEAKER_00: You may experience reduced patience or tolerance.
• 4:22
  SPEAKER_00: You might find that you feel overwhelmed by ordinary demands, possibly guilt about not being the parent that you think you should be, difficulty being emotionally present when physically there.
• 4:41
  SPEAKER_00: One patient some years ago described that she felt as if she was looking down on herself but not actively occupying her body.
• 4:53
  SPEAKER_00: Some parents continue to function, they go to work, they care for children, they keep life going, yet inside they feel distant, muted, or disconnected.
• 5:05
  SPEAKER_00: This is sometimes called high-functioning depression, and it can be especially invisible to others.
• 5:12
  SPEAKER_00: And I remember someone saying to me a couple of years ago, this person says they're depressed.
• 5:21
  SPEAKER_00: What have they got to be depressed about?
• 5:24
  SPEAKER_00: Almost a state of disbelief.
• 5:28
  SPEAKER_00: And that kind of thinking, of course, really illustrates the sort of narrow lens through which some people understand emotional and psychological health.
• 5:41
  SPEAKER_00: But children are emotionally perceptive, they don't need words to sense a parent's emotional state.
• 5:50
  SPEAKER_00: Children experience parental depression in interesting ways.
• 5:54
  SPEAKER_00: They don't think to themselves, my parent is depressed.
• 5:58
  SPEAKER_00: Instead, they're more likely to experience a sense of something feels different.
• 6:04
  SPEAKER_00: Mum or dad isn't really here.
• 6:06
  SPEAKER_00: I can't reach them.
• 6:08
  SPEAKER_00: And sometimes, maybe it's me.
• 6:12
  SPEAKER_00: When a parent is emotionally withdrawn, children may respond by becoming quieter or more watchful, or trying harder to gain attention or connection, or becoming emotionally needy or anxious, withdrawing themselves, becoming overly responsible or good, and feeling confused by the emotional distance.
• 6:36
  SPEAKER_00: But what matters here isn't blame but awareness, because when we understand what's happening, we can begin to respond differently.
• 6:45
  SPEAKER_00: Even when a parent is struggling, small amounts of emotional connection, just a look, a touch, a moment of attunement, remain deeply meaningful to a child.
• 6:58
  SPEAKER_00: This is very important because there is something to be said for reassuring the child without overdoing it.
• 7:10
  SPEAKER_00: And by which I mean having those small bits of connection signals, yes, I've been struggling, but it's okay, I'm still here.
• 7:20
  SPEAKER_00: I think sometimes because children feel this sense of responsibility, it's a huge relief when the parent says, I've been struggling a bit, I'm not feeling so good, but it's okay because I am talking to a friend or other grown-ups, and it will be okay.
• 7:46
  SPEAKER_00: And this is important because it shows that the depressed parent has an awareness of the fact that the child is experiencing something, and that can be very hard when you're locked inside.
• 8:01
  SPEAKER_00: Sometimes depression tells parents to withdraw, to stay silent, to manage alone.
• 8:08
  SPEAKER_00: But recovery almost always begins with not being alone.
• 8:13
  SPEAKER_00: There are several forms of support that can make a real difference.
• 8:17
  SPEAKER_00: Speaking with a GP.
• 8:19
  SPEAKER_00: A GP can help assess the severity of the depression and explore the contributing factors, both emotional and physical, but also hormonal and situational.
• 8:33
  SPEAKER_00: And what they can do is they can guide you towards the next steps because depression is a legitimate health condition, and seeking medical support is an act of care, not failure.
• 8:45
  SPEAKER_00: Think about this.
• 8:47
  SPEAKER_00: If you had persistent pain, physical pain, you would very probably want to find out not just what was causing it, but how you could treat it.
• 9:00
  SPEAKER_00: Well, the same is true with your mental health, but it's a different kind of pain.
• 9:05
  SPEAKER_00: Now, as we know, there are a variety of psychological therapies which many parents benefit from.
• 9:12
  SPEAKER_00: And certainly in my clinical experience, when I see that the emotional state, the psychological state of the parent is compromised, then I am very likely to assess that and to guide the parent to the kinds of things that can help.
• 9:34
  SPEAKER_00: Now, we think about counseling, which can be very useful because it provides the opportunity to speak openly with someone whose feelings you don't have to worry about.
• 9:48
  SPEAKER_00: And the same, of course, is true with psychotherapy, although I think it's fair to say that psychotherapy is a deeper exploration, not just in terms of what it is you're experiencing now, but how you got there.
• 10:04
  SPEAKER_00: What are the things that cause this breakdown?
• 10:07
  SPEAKER_00: Because it's telling us something.
• 10:10
  SPEAKER_00: And that may take longer, depending upon the history, depending upon the severity of the symptoms, but also depending upon, or not depending upon perhaps, but certainly influenced by whether or not the patient is receptive to antidepressant medication, which isn't always required, but sometimes it is, partly because brain function is significantly compromised where in depression, and what we tend to see are comorbid difficulties like sleep disorder, which means that the brain's capacity to recharge is compromised.
• 10:52
  SPEAKER_00: Antidepressant medication levels the neurotransmitters in the brain and the production of dopamine, serotonin, and so on.
• 11:04
  SPEAKER_00: And that then makes it possible to access therapy more effectively.
• 11:10
  SPEAKER_00: It's not always required, but very often I find that it it helps a very great deal.
• 11:18
  SPEAKER_00: It also conforms to the NICE guidelines in terms of the two-pronged approach, as it were.
• 11:28
  SPEAKER_00: The use of medication alongside a therapeutic intervention of some kind.
• 11:37
  SPEAKER_00: One without the other can sometimes just just not not really work.
• 11:42
  SPEAKER_00: But you know, each case is different.
• 11:45
  SPEAKER_00: Some people choose cognitive behavioral therapy partly because it does help or can help in shifting patterns of negative thought, which maintain the psycho-emotional state.
• 12:04
  SPEAKER_00: And I I think it's not really something that I have very much experience of, it's certainly not something I provide.
• 12:13
  SPEAKER_00: But you know, I'm reminded of the phrase I used in a previous podcast, which is what works is what's best.
• 12:21
  SPEAKER_00: And of course, CBT is available on the NHS with very often with medication, sometimes without it.
• 12:31
  SPEAKER_00: But this is important because what we have to think about is that any therapeutic approach isn't about being fixed, it's about being understood and gradually reconnecting with oneself.
• 12:46
  SPEAKER_00: I also have to think about perinatal and postnatal mental health support, because for parents experiencing depression during pregnancy or after birth, it's important that the specialized perinatal services can be involved because they will provide a targeted emotional and psychological support system, both for parents and in the understanding of the neonatal period for the infant and how to help mothers and fathers through this time.
• 13:26
  SPEAKER_00: I want to just say a little more about medication.
• 13:33
  SPEAKER_00: The role of medication is to provide support and to stabilize mood.
• 13:38
  SPEAKER_00: It's not a replacement for the emotional work, but the relief that it can create for people is significant.
• 13:46
  SPEAKER_00: There's a lot of mythology about becoming addicted or feeling like a different person and not feeling like yourself and so therefore not wanting to take it.
• 13:59
  SPEAKER_00: And it's true that some people have reactions to certain medications and that deters them from trying anything.
• 14:08
  SPEAKER_00: I have been involved with many patients who have been prescribed different forms of medication and helped them to, alongside their GPs or the prescribing psychiatrist, get to a point where the right medication or combinations and the right dosage has finally been accomplished.
• 14:35
  SPEAKER_00: Sometimes people's because everybody obviously has a very different experience, sometimes it takes a little while, but it's worth it.
• 14:46
  SPEAKER_00: I think the other thing that's really important, because depression thrives in isolation, is the understanding of partners, family, friends, and support networks, because this can help reduce the emotional load and restore a sense of being with, being held rather than alone.
• 15:07
  SPEAKER_00: Remaining emotionally meaningful to your child when you're experiencing depression is sometimes very hard.
• 15:17
  SPEAKER_00: Some parents will think if I'm depressed, I'm harming my child.
• 15:22
  SPEAKER_00: That isn't the case.
• 15:24
  SPEAKER_00: If you're depressed and you are paying attention to that, you're helping your child because you're modeling the fact that we're fallible.
• 15:35
  SPEAKER_00: We don't have to go into lots of detail with the child about what we're experiencing.
• 15:42
  SPEAKER_00: We can say we're feeling sad, we can say we're struggling, we can say that we are needing some help at the moment, but not from the child.
• 15:54
  SPEAKER_00: And this is the kind of rupture and repair principle.
• 15:59
  SPEAKER_00: None of us get through life without experiencing something that affects us deeply, neither will the child.
• 16:07
  SPEAKER_00: So, in a way, what we're doing is we're arming the child with a sense of when difficult things happen, they are survivable.
• 16:17
  SPEAKER_00: But we need to demonstrate it, we need to say it, because the unsaid is always going to be felt but misinterpreted.
• 16:29
  SPEAKER_00: What matters most isn't perfection, but emotional honesty and repair.
• 16:36
  SPEAKER_00: And you know, even simple things can help.
• 16:38
  SPEAKER_00: Just sitting next to your child just quietly, and just small moments of eye contact or touch and a smile, and just saying, I feel I feel a bit low today, but it's okay, I'm here.
• 16:51
  SPEAKER_00: Now, sometimes we do that after disconnection, and we say, like, I'm I'm sorry, I was quiet earlier, or I was angry earlier, or I was grumpy, but I I'm I'm still here, I'm okay.
• 17:08
  SPEAKER_00: So children benefit from this because they don't need constant emotional brightness, they need emotional presence that returns.
• 17:19
  SPEAKER_00: And when a child experiences that, a parent can struggle and still remain emotionally connected.
• 17:26
  SPEAKER_00: Something very powerful develops, and it's resilience, security, and emotional understanding.
• 17:34
  SPEAKER_00: If any part of this episode feels familiar, you are not alone.
• 17:40
  SPEAKER_00: Many parents carry depression quietly.
• 17:44
  SPEAKER_00: Many feel guilt, shame, or fear, and the fear of being seen as inadequate.
• 17:51
  SPEAKER_00: But depression isn't the absence of love, it's the weight of something carried often for far too long and often alone.
• 18:02
  SPEAKER_00: Support exists, change is possible, and even in struggle, your relationship with your child still matters deeply.
• 18:14
  SPEAKER_00: In our next episode, we will explore parental anxiety when fear, worry, and uncertainty begin to shape the emotional world of both parent and child, and how support, understanding, and regulation can restore steadiness.
• 18:33
  SPEAKER_00: I'm going to be attaching a PDF for this episode on parental anxiety, because the words enough perhaps aren't alone.
• 18:47
  SPEAKER_00: Oh sorry, the words alone aren't enough.
• 18:50
  SPEAKER_00: So I didn't go to speech therapy this morning.
• 18:53
  SPEAKER_00: So what I want to do is I want to provide a resource.
• 19:26
  SPEAKER_00: And this idea came to me when I was looking at the series and thinking about anxiety and how to help people understand the mechanics of anxiety, the role of the vagus system, the vagal system rather, and what happens in terms of the internal brain chemistry and how we can practically regulate our anxiety.
• 19:51
  SPEAKER_00: I'm saying uh a resource document on this when it's worthy of a documentary, but you know, we'll have to have a think about that at another time.
• 20:00
  SPEAKER_00: Anyway, thank you for listening, and I will offer the next podcast as soon as I'm able.
• 20:08
  SPEAKER_00: Thank you.