Public Release: 

Depression in mothers caring for chronically ill children can make problems worse

University of Georgia

Children with chronically painful illnesses are frequently depressed, as anyone might expect. The problems for young people facing such diseases as cancer or rheumatoid arthritis are complex, but how their mothers feel about themselves may play an important role in their children's well being.

That's one finding in a new study of 59 chronically ill children, led by psychologist Dr. Gail Williams of the University of Georgia, and just published in the journal Health Psychology.

"This is one of the first studies that brings many of the pieces together to see how children who experience chronic pain deal with their illness," said Williamson, "and it points toward new ways for helping both mothers and children cope."

Past studies have shown that the protracted burden of care and ambiguity about the future take a tremendous toll on sick children and their parents. The severity of children's illness, however, is only modestly related to how well the children cope, and other researchers have suggested that how children adapt to their pain may depend, in large part, on how their caregivers adjust.

The new study, by Williamson and Dr. David Shaffer of UGA and Dr. Andrew Walters of Hobart and William Smith Colleges, shows that children of well-adjusted and supportive parents are less depressed by the pain they experience. This finding could point the way toward showing mothers prone to depression that, by helping themselves, they are helping their children.

Walters, who earned his doctoral degree at the University of Georgia, interviewed chronically ill children and their mothers at the Medical College of Georgia in Augusta. The participants were part of a larger study, and the children were 18 years of age or younger, in outpatient therapy for a painful chronic disorder, willing to provide verbal or written comments and not under the influence of narcotics.

The mean age of patients was 11.6 years and most were boys (64 percent) and African American (56 percent). The children suffered from diseases such as sickle cell anemia, hemophilia, cancer and juvenile rheumatoid arthritis. The sample of caregivers included 55 biological mothers and four grandmothers with legal guardianship.

"Our data reaffirmed earlier studies that show those care-givers with insecure attachment styles don't deal with stress as well as others," said Williamson.

To say the issue is complex is perhaps not strong enough. In years past, it has seemed intractable, because most character traits are developed early in life, and changing stable character traits such as life-long depressive tendencies is extremely difficult. Still, the study suggests that children may benefit if social or medical workers can determine early on which care-givers are likely to adjust poorly to their children's chronic pain and target these individuals for appropriate interventions.

It is becoming clearer through many studies that mothers of sick children often need better coping skills and ways to relieve depression. Crucial aspects, according to this new study, are the ways mothers view themselves and others. Giving mothers ways to achieve stable dispositions and positive outlooks could manifestly help their children, it appears. (Very few studies have been done to see how the emotional health of fathers or male caregivers affect the well being of chronically ill children, because the sample available is so small.)

One thing is clear from the present study and others: stable social support-a network of family and friends-makes caring for a chronically ill child far easier for mothers. Those who try to "handle it on their own" may be missing a tremendous help if they don't use family and friends to share the burden.

The problem is that less secure mothers or caregivers may not feel that other people will respond to their requests for help.

While the new study points the way toward further research, the best advice mothers should remember is that children-especially those in pain-are tremendously affected by their mothers' emotions and the ways that they attempt to cope with a difficult, upsetting situation.

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