Family and mental health

By Nathalie Vallerand

Approximately one in five people will suffer from a mental illness in their lifetime. Depression and anxiety disorders (generalized anxiety, panic disorder, phobia, obsessive compulsive disorder, post-traumatic stress disorder) are the most common. Some people suffer from chronic mental disorders such as schizophrenia, bipolar disorder and borderline personality disorder. As for eating disorders, these affect mainly girls and women between the ages of 13 and 30.

I have a healthy baby and a life partner I love, but I’m sad and I see only the dark side of life. What’s wrong with me?

About 13% of new moms suffer from postpartum depression in the first month following delivery. Possible symptoms include great sadness, irritability, a loss of interest or enjoyment in usual activities, trouble sleeping, fatigue, a feeling of emptiness, suicidal thoughts, etc. “Postpartum depression requires immediate medical attention,” insists psychiatrist Marie-Josée Poulin, head of the Perinatal Psychiatry Program at the Institut universitaire en santé mentale de Québec. “A new mother doesn’t always dare ask for help because she’s ashamed of feeling unhappy.” If a partner or other loved ones see that mom isn’t doing well, it’s important that they get her to seek help.

Postpartum depression is not the same as baby blues, which is a passing minor depression that affects up to 80% of women and often appears on the third day after delivery. “The new mom is in a bad mood and cries without really knowing why. But she doesn’t experience negative thoughts and is able to care for her baby,” explains psychologist Nancy Verreault.

There is also a rare and extremely serious illness called postpartum psychosis. It manifests itself in the days following the birth, and symptoms include confusion, hallucinations, delirium and aggressiveness. The mother must be quickly taken to hospital since her safety and the safety of her child are compromised.

How can I help my partner if she’s suffering from depression? Can her mental health harm our child?

Above all, it’s important to recognize your partner’s suffering. “If you minimize the importance of her feelings, she’ll feel even more guilty and incompetent,” says Dr. Marie-Josée Poulin. “Her depression may then worsen.” The best is to listen without judging her, to encourage her to seek help and to ask her how you can help her.

“A depressed mom is not as present for her child,” says Dr. Andrée-Anne Marcoux, child psychiatrist at the Albert-Prévost Pavilion in Montreal’s Hôpital du Sacré-Cœur. “For example, she may have a hard time comforting her child, giving affection, helping her manage her emotions or offering her the necessary stimulation for healthy brain development. Depression can also affect the attachment bond between mother and child.” It’s therefore important to provide your child with a lot of love and attention while mom gets better.

I’m a new dad and I’m finding it harder than I thought. Should I see someone?

Don’t hesitate to seek help! An unhealthy mental state can affect your relationship and your baby’s development. Studies show that depressed dads have less positive interactions with their babies, which may lead to future emotional and behavioural issues in the child, and can also affect the attachment bond between father and child.

Depression affects nearly 10% of dads before or after the birth. “Men tend to express their distress with anger, impatience and irritation rather than sadness and tears like women,” notes psychologist Nancy Verreault. “This difference explains why the men themselves, as well as their entourage, don’t always recognize the symptoms as depression.”

My partner suffers from a mental illness. Is our child at risk of this too?

Your child is more at risk of developing a mental health problem, but that doesn’t mean she will have one. Most mental illnesses involve a genetic factor. The child doesn’t inherit the illness, but she’ll be more at risk for developing it. “However, if the parent’s illness is not treated or stabilized, this adds another risk factor. Because of the symptoms, the parent may find it hard to offer the child the attention and secure environment she needs,” says child psychiatrist Andrée-Anne Marcoux. Since this situation increases the child’s stress, it makes her even more vulnerable to mental illness.

I worry constantly about my child. Am I suffering from anxiety?

“It’s normal to be worried from time to time about your child. However, anxiety becomes a problem when you’re unable to control it, when it takes up too much space, and when it stops you from functioning in your daily life,” explains psychiatrist Marie-Josée Poulin. This is then considered generalized or pathological anxiety.

Generalized anxiety often comes with other symptoms such as fatigue, irritability, trouble sleeping or concentrating, restlessness, heart palpitations, trembling and nausea. If you think you’re suffering from anxiety, don’t hesitate to seek help.

I’m a mother of two young children and I’m at the end of my rope. Am I at risk for burnout?

“Juggling work and family life is exhausting enough. But some women tire themselves out even more trying to be perfect mothers,” says psychologist Nancy Verreault. “They idealize their maternal role. This can lead to disappointment, since parenting is not always easy.” Mothers end up feeling an intense physical or mental fatigue along with stress. This is mommy burnout. The key to preventing it is to take time to relax and to try not to have such high expectations. You’ll benefit from respecting your limits and sharing parental tasks and responsibilities with your partner as much as possible. If you’re a single mom, don’t hesitate to ask for help from family and friends.

My sister has borderline personality disorder and I’m worried about her. How can I help her?

Whether it’s a borderline personality disorder (also called BPD) or another mental health issue, you can encourage her to seek help or follow her treatment, and offer her respite by taking care of her child or helping her with errands and household chores. “However, it’s better to avoid taking care of everything, since this may prevent the ill person from taking responsibility and helping herself to get better,” advises Julie Desrosiers, social worker with Cercle Polaire, an organization offering support to the loved ones of people living with mental illness. It’s also important to set your own limits and to take care of yourself. If you’re exhausted, you won’t be much help to anyone else.

Do I need to explain to my child that I have a mental health issue?

Your illness is part of your child’s life and she therefore needs to know what’s happening. For example, as soon as she’s three or four years old, you can explain to her that you have an illness that sometimes makes you feel like your head and heart are full of dark clouds. An organization specialized in mental health can help you find the right words based on your child’s age. “It’s very important to tell your child that it’s not her fault you’re sick,” says Angélina André, social worker with Cercle Polaire. “Give your child the chance to express her emotions, thoughts and questions about the illness. You should also give her the opportunity to be in contact with other adults who are important to her, like a grandmother or uncle.”

Do I risk losing custody of my child because I have a mental disorder?

“A mental disorder is not reason enough for you to lose custody of your young child,” says Isabelle Laviolette, psychologist with the Centre jeunesse de Montréal — Institut universitaire youth centre. “The youth protection authorities only get involved when a child’s safety or development is compromised,” she specifies. If this is the case, you have everything to gain from collaborating with the authorities and accepting the help they offer you.

To avoid getting to that point, you can take care of your mental health by following your treatment and paying attention to the signs of a possible relapse. It’s also recommended to make up an emergency plan indicating who can help you and who can take care of your child in case of need.

How do you explain to a toddler that her mom or dad is in the hospital for mental health reasons?

Talk to her in simple terms, as you would about any other illness: “Daddy is sick in his head and he’s at the hospital so that the doctors can take care of him.” The important thing is to reassure the child by telling her that her parent is getting help, and also that this parent is thinking about her a lot. “The child will probably worry about the consequences of the hospitalization on her everyday life,” says Angélina André, social worker with Cercle Polaire. “That’s why you must let her know what will be done to make sure her routine stays the same as much as possible.” It’s also important to allow her to keep playing and enjoying herself. Even if one of her parents is sick, she is still just a child.

Can I be a good parent despite my mental health disorder?

Of course, as long as you do what needs to be done to heal or to control your illness. “One of the essential steps is accepting the diagnosis and recognizing that some aspects of the illness may also affect your parenting abilities,” explains Isabelle Laviolette, psychologist with the Centre jeunesse de Montréal — Institut universitaire youth centre. “With the intent to better yourself, you can seek the help you need to work on your difficulties and develop better parenting skills.”

I just found out that my child has a developmental delay. How do I accept the situation?

Denial, anger, sadness, guilt—all of these are normal emotions following such news, and it’s natural to feel overwhelmed. “The parents must grieve the loss of the perfect child,” says psychologist Nancy Verreault. “This process is difficult and takes time.” During this period, try to avoid cutting yourself off. Confiding in people who can offer support and comfort can perhaps help you. Even if it may seem difficult in the beginning, you should also try to continue doing activities you enjoy. This will help prevent you from sliding into depression and you will be more present to help your young child through what she is experiencing. Gradually, you will get over the shock and adapt to your child’s health issue.

Young children and mental health

Can young children have mental health problems?

Can parental separation affect a child’s mental health?

Scientific studies show that the separation or divorce of parents increases the symptoms of anxiety and depression in a child. Even if this increase is only slight, it indicates that separation is a source of stress and sadness for young children. “The more intense the conflict, the more harm it causes the child, who feels torn between his parents,” explains psychologist Nancy Verreault. To make the transition easier, it’s important to think about your child, to remain respectful towards the other parent and to work together. Even if you’re angry with your ex, remember your child still needs his other parent.

How do I explain to a child that his father or mother committed suicide?

It’s best not to hide the fact that it was a suicide from the child. “You can explain to the child that his father had a sickness in his head that made him very unhappy which meant he took a bad decision,” suggests Josée Lake, social worker with the suicide support network Ressource régionale suicide de Laval. In some cases, the child may believe that if he’d been nicer or put his toys away, his mom or dad wouldn’t have died. It’s important to make the child understand that he’s not responsible. The child may also not react much to the news of the death. “This is typical since the news is too much to take in,” says the social worker. “In the weeks that follow, it’s important to pay attention to the child and help him express what he’s feeling in his heart through words or drawings.”

How do I promote my child’s mental health?

“First and foremost, you need to take care of your own mental health, since it impacts that of your child,” says child psychiatrist Andrée-Anne Marcoux. “Next, you should focus on your child’s needs according to his age.” For example, during your baby’s first few months of life, he forms his attachment to you and builds his trust in you. It’s therefore important to quickly respond to his needs (to be comforted, fed, changed, etc.). It’s also essential, for healthy brain development, to give him affection, exchange smiles and play with him.

As he grows, you can teach him to recognize his emotions, to talk about what he’s feeling, to develop relationships with others and to ask for help. In order to help him develop healthy self-esteem, encourage his efforts, praise him on his achievements and show interest in what he does. And to make him feel safe, it’s important to set limits. But beware: this is not a magic recipe. Mental illnesses are complex and can appear regardless of how you raise and guide your child.

Pregnancy and mental health

Does pregnancy increase the risk of depression?

When a mother suffers from anorexia or bulimia, is she or her child at risk?

Eating disorders increases the risk of pregnancy-induced hypertension, miscarriage, premature delivery and birth defects. Furthermore, babies born to anorexic or bulimic mothers risk suffering from malnutrition and low birth weights, which expose them to various health issues, developmental delays and behavioural problems.

“Children of anorexic or bulimic moms often have a lower threshold for stress tolerance,” says psychologist Howard Steiger, head of the Eating Disorders Program at the Douglas Mental Health University Institute. “They are also at risk for suffering from an eating disorder later on, or other mental health issues such as depression or anxiety.”

Can I take antidepressants during pregnancy and when breastfeeding?

“Since the symptoms of anxiety and depression and their severity vary from person to person, every case is unique,” says Dr. Marie-Josée Poulin. Some women feel better with psychotherapy and exercise, but others need antidepressants to feel better. Generally speaking, antidepressants do not pose a threat to the foetus. However, your doctor may change your medication towards the end of your pregnancy, since some antidepressants can cause temporary problems for the baby at birth. Babies also absorb small quantities of the antidepressant when breastfeeding. This is usually safe, but your doctor may wish to prescribe an antidepressant that the body eliminates more quickly.

I’m bipolar. Why do I need to consult my doctor before getting pregnant?

You should consult because your medication needs to be checked. This is because some drugs used to treat bipolar disorder (manic depression) can lead to birth defects in the baby. Psychiatric follow-up is also recommended throughout the pregnancy and for a few weeks after delivery. “Pregnancy increases the risk of a bipolar relapse,” explains perinatal psychiatrist Marie-Josée Poulin. “Moreover, bipolar women are at a much higher risk for postpartum depression and even postpartum psychosis, which is a very serious condition.”

Source: Naître et grandir Magazine, May-June 2016 Research and copywriting: Nathalie Vallerand Scientific review: Dr. Lorraine Boucher, Consultant Psychiatrist, CIUSSS du Centre-Sud-de-l’Île-de-Montréal

Photos : iStock.com/Yulkapopkova, iStock.com/PeopleImages, iStock.com/Johannes Norpoth