Depression can be passed on from one generation to the next

The hypothesis that there is adolescent and childhood depression was one of the first to be put forward by Dr. Myrna Weissman from Columbia University, head of the Department of Translational Epidemiology at the New York State Institute of Psychiatry, and the research she has begun has also led to the conclusion that depression can be inherited from one generation to the next. generation.

Recent evidence for this was provided, among others, by data from the Adolescent Brain Cognitive Development study published this year in the journal JAMA. The researchers analyzed retrospective, cross-sectional reports on psychiatric functions in 11.2 thousand children, as well as interviews with parents about their parents ‘and grandparents’ history of depression, collected over 40 years. In addition to extensive interviews, the researchers searched for various markers of depressive disorders, collecting data including from EEG or genotyping.

It turned out that the presence of depression in earlier generations is associated with an increased risk of developing the disease for the next generation. Moreover, it even happens in childhood. Due to common genetic and environmental risk factors, the offspring of depressed mothers have a two to five times greater risk of developing the disease than offspring from healthy parents.

Tendencies hidden in genes

Scientists have also identified genetic factors that may influence the occurrence of depression, although they are not determinative – they are more or less prone to depressive reactions, which does not mean that a person will eventually develop depression. It depends on the type and configuration of various genes, but also on psychological factors (e.g. stressful situations, pattern of relationships with other people) and socio-cultural factors (e.g. availability of support, loneliness, professional or material problems).

Quite obviously, depression is more likely to occur in homes where conflict and violence occur. It is also known that people who come from an environment where there have been a lot of emotional conflict suffer from more severe forms of depression and are less likely to respond positively to currently available medications and treatments. This knowledge has been systematically developed over the years.

By treating the mother, you are treating the baby

“The question arose: what can we do to break the generational transmission of depression, and can we do it through treatment?” – says Dr. Anna Nowak from the Mental Health Clinic in Pregnancy and Puerperium NZOZ Dialog Therapy Center.

The study by Dr. Myrna Weissman, Dr. Maurizio Fava and Dr. John Rash, in which it was determined whether effective pharmacological treatment of women with severe depression was associated with a reduction in symptoms and diagnosis in their children, came to the rescue.

– says the specialist.

The best results were achieved by children of mothers who achieved remission at the beginning of treatment (between the third and sixth months). At that time, the improvement in children was maintained at least one year after the mother’s recovery, regardless of how it was obtained – through pharmacotherapy or psychotherapy. Improvement in the mother always helped the baby.

“The results of this study are very important to us, because we know the clinical inclination of this disease. The findings in a family at high risk of developing depression emphasize the importance of prevention and early intervention. While it seems obvious, the facts are that in everyday practice it is not we pay as much attention to it as the research results would suggestif we have a child with depressive symptoms, we should also check the mother. And if she shows symptoms of depression, she should be treated, because perhaps the improvement in the child will occur in the very process of mother’s treatment “- explained Dr. Nowak.

The study did not include situations where the father is depressed, and this also seems to be an area that needs further investigation.

Can you prevent depression?

Given these results, the physician believes that the need to screen high-risk women and start treatment before symptoms appear is obvious. Psychological protocols come to the rescue, especially those in Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT).

In 2016, a large meta-analysis was published showing the effectiveness of interpersonal therapy in the prevention of depression in high-risk women. This type of therapy is a form of “speech therapy”. It focuses on the patient’s relationships, difficulties in communicating with family, relatives, friends, employer, etc. Its purpose is to improve communication and raise self-esteem.

The sensitive period of fetal life

It is also worth paying attention to the topic of the influence of fetal life on later life analyzed by psychologists.

The fetal programming hypothesis is that the environment in the uterus can alter fetal development, especially during sensitive periods, causing a permanent effect in the phenotype (a set of organism traits resulting from genetic and environmental conditions – editor’s note). This is why we are afraid of using drugs during pregnancy.

However, it must be clearly stated that untreated depression also produces fetal damaging effects, and there are studies that show that when the mother is anxious at a certain time during pregnancy, children may develop behavioral, emotional and ADHD disorders. These children are predisposed to mental disorders and should be monitored by us, the psychiatrist believes.

In addition, depression in pregnancy can result in premature birth or low birth weight, with very serious implications for the metabolic health of these adults in adulthood, as well as long-term emotional, behavioral and cognitive effects.

“That is why it is so important to take therapeutic measures in pregnancy if there are symptoms that require treatment” – emphasizes the doctor.

Postnatal depression can affect your baby’s development

The period immediately after birth is also extremely important for the development of the child, because the mother’s depression may lead to a disturbed relationship with the child, attachment disorders, and sometimes even mental disorders.

This is clearly shown by Edward Tronic’s “Still face experiment” experiment, which very vividly shows what happens to a child who has contact with a depressive mother.

During the experiment, the mother initially behaves “normally”: she smiles, talks to the baby, and the baby reacts to these taunts. After a while, the woman adopts a stony expression on her face. A baby looking at his mother, who does not express any emotions, does everything to “bring back” her mother, gets nervous, encourages her to react in any way. The experiment shows that for infants, the expression on the face of the closest caregiver is of great importance and says a lot about the psychological importance of building emotional contact between mother and child.

– points out Dr. Nowak, adding: – From January 2019, the standards of perinatal care even recommended screening these women between the 11th and 13th week of the child’s life and later, between the 33rd and 37th week, as well as during the patronage visit after childbirth.

Can I take antidepressants while pregnant?

Many women are afraid of starting pharmacological treatment. Wrong. Currently, the use of SSRIs (selective serotonin reuptake inhibitors) during pregnancy is relatively safe. In the multi-center study STAR * D (Sequenced Treatment Alternatives to Relieve Depression) conducted between December 2001 and April 2004, 18,000 patients were examined. Children whose mothers with depression have been treated with medication.

Remission of maternal depression after three months of treatment was significantly associated with a reduction in diagnosis and symptoms in children. There was an overall 11 percent. a decrease in the frequency of diagnoses in children of mothers in whom depression subsided, compared with about 8%. an increase in the frequency of diagnoses in children of mothers in whom depression did not resolve.

“We are doctors, and if a patient has depressive symptoms, plus knowledge of epigenetics and the importance of treating depression in pregnancy, it seems obvious that treatment should be started. Although, of course, it is always worth checking whether or not it would be possible to achieve positive effects by ordering the patient to receive psychotherapy. It is a very effective influence, still insufficiently used “- believes the psychiatrist.

Breaking the generational transmission of depression in the family is possible, but it requires collecting an appropriate, reliable interview, generational observation, looking at patients through the prism of the family and its environment, and taking action as early as possible. However, it is worth getting involved in helping such a family to save the next generations from this destructive disease.

About Peter Wilson

In love with technology, with an eye towards smartphones, he does not disdain any activity linked to the Nerd world. TV series, movies, manga, anime, and comics (Marvel addicted) are the order of the day.

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