formula for depression

November 15, 2009

Here’s a nifty little formula about depression, which is derived from some great research done in 1978 (Brown & colleagues – no reference sorry!)

This research just confirms something we know instinctively, that people develop depression when their ability to cope with life is overwhelmed. This is not always the case, with some of the more severe (melancholic) forms of depression, it may just occur without any provoking event.

But for the majority of people, we become depressed when our coping resources are overwhelmed. So adversity can trigger depression, but interestingly the researchers found that adversity did not always invariably cause depression. In a study of women they managed to isolate another factor that influenced people’s response to adversity, which was social support.

So in looking at a group of women who had experienced one or more stressful life events, those who did not have social support were more likely to become depressed. Seems obvious right? Those with good social support were more able to survive adversity without developing depression. This just goes along with the theory that humans are really herd animals.

adversity minus social support = depression

adversity plus social support = resilience

I would say that this formula does not always work for everyone; some people still get depressed with all the social support in the world (I’m sure we all know those people) and some just cope heroically on their own with all kinds of misfortunes.

And the same goes for postnatal depression. I am a huge advocate of how wonderful babies and parenting are, don’t get me wrong I believe it is the most positive life experience there is. But nevertheless it is a stressful event requiring a lot of physical and emotional resources. So the same formula can apply to postnatal depression, with the baby as the “adversity”.

What that means is we all need to support new mothers, as well as Dads who do often also develop postnatal depression from some new research. That’s something that we seem to know instinctively, from the traditions of baby showers and dinner deliveries that hopefully occur when someone has a baby.

But it also means thinking outside your own family or social group to others who may not be so well connected and maybe just dropping in on them to see how they are going. Pass on your baby clothes to someone new or deliver them a meal.

And more generally don’t be afraid to go visit people you know when they are having a hard time, especially when they are isolated.

 

As someone who had kids fairly late in life, I have had the advantage of more stability in many ways (social, mental and financial!) which hopefully has given my kids some benefit as I’m more mature as a mother than I would have been 10 years earlier. I observe this trend of later motherhood and for many people like me it turns out fine in the end, but not for all. However, there is a part of me that believes this is not the natural or most ideal state of affairs, that maybe humans as a species are actually designed in many different ways to reproduce earlier. Here’s why.

The biological side is obvious, there is the obvious problem with declining fertility in males and females. All the infertility experts urge us to start earlier. There is a greater risk of pregnancy complications, birth defects, miscarriage, just about any problem. Older mothers have less energy to stay up all night and run around after the little ones.

What about the psychological or emotional side? I’m really only referring to Western society here, and I am still considering this theory so it’s a work in progress, bear with me. Younger adults or adolescents have different brains, which become “adult” in structure only at around 25. Young people are highly social and connected, concerned with forming their identity. Sometimes they  are more impulsive, flexible, risk-takers with a lack of empathy and a sense of invincibility. They are also highly social. All this is now confirmed with brain research that shows our brain connections are not fully established until the mid-20s.

If child-rearing was to occur in the teens or early 20’s , psychologically parents would be more flexible, able to cope with chaotic baby behaviour without too much need to impose an artificial routine. The highly social nature of teenagers is also adaptive because a social environment is necessary or extremely preferable for children. The effect of having a baby is (for most people) to increase empathy or the ability to put another’s needs before your own. So I think the benefit of early parenting (for the parent) would be actually to help emotional development, at a critical time of development, onto a more productive and cooperative path. We know from psychology that cooperativeness is a great character strength which leads to positive health outcomes (There are other parts of this theory that don’t work like impulsivity & invincibility, so I am working on those)

Socially, having children earlier would have benefits for the extended family. Grandparents would be younger, and could therefore support parents more, rather than having children when one’s own parents are very old and may require care themselves. Having children earlier would mean that they were able to help the parents to care for their own grandparents in old age.

I would see all this as having a benefit for babies in terms of attachment. A more highly supported social network for the mother may lead to a secure baby. Of course a theory like this can’t be universal and I guess there are down sides to this as well.

Why is parenting delayed? These days, largely because of financial expectations we expect to establish careers and do a lot of intellectual work (at least in the West) in our teens and 20s – to get into a reasonable financial position before we have the children. However this kind of career focus requires the maturity of a more adult brain, and in some ways it would be better to wait until over 25 when we may have more capacity for self-knowledge to choose an appropriate career path, wisdom to make responsible decisions for society and the persistence or discipline required for a complex workplace.

The other reason is relationships. People in their 20s now have the cultural expectation of transient relationships, often based on pleasure and self gratification, multiple relationships in order to find the best fit “try before you buy” without expectation of commitment or care of the other. We also expect to have “fun” and leisure before settling down to the “hard slog” of parenting, but I’ll get to that later. I think there is some evidence that this approach to relationships might be damaging. We know that broken relationships can be a grief event, and some of the most traumatic experiences from a psychological, mental health point of view – leading to depression, suicide and insecurity. By practicing serial monogomy or low-commitment and low-care relationships we are actually un-learning the art of real relationship by practising uncaring behaviours. This is actually bad for us in the long run, and sometimes it takes a long time to catch up and heal from the wounds of multiple relationship losses.

Anyway, that’s about all for this theory for today – as I said it’s a work in progress and so it could probably use some references, but this blog is just about ideas, not necessarily references!

Adios for today.

As a regular and quite recent facebook user I soon discovered “Farmville”. You may know it, the game application where you get a little patch of virtual land. You can then plow the earth, buy seeds, plant them and wait for them to grow. Plants grow, you harvest them and get money, which can be used for exciting things like buildings, lemon trees, cows, pigs or chickens – great fun.

Well, this application had me interested for a few weeks. It was quite nice to plant the seeds then come back in 1-2 days and find fully grown plants. It gave me something to look forward to in the day. After I expanded the farm a bit, got a few animals and nearly towards generating some kind of balanced diet, well it did get a bit boring. I’m quite glad to say.

What happened next though, was quite amazing. I actually went out and bought some real seeds and a seed tray, shoved them in and did the same thing – waited. Surely enough after a few days, things did begin to grow out of the earth. It was incredible. I have to admit to never doing this before in my life. My previous experience of plants was to buy and kill them. Unlike children or animals, plants were just never loud enough or made enough demands for me to pay attention.

So I took the next step and dug out a bit of the garden, mixed in a bit of compost from the neighbours and inserted seedlings in. Watered, even fertilised. Waited… and amazingly enough those little plants continued to grow.

My husband kindly cut logs to delineate a space and now we have it – a real vege garden. With live things, that actually grow. I’m pleased to say I’ve even been remembering to water it. Checking it for new leaves. Could it be that I’ve become a gardener after all.

We’ll see how long it lasts – after all I have had new projects before (joining the gym, mosaics, guitar, saxophone, novel writing) none of which are still happening.

This is all supposed to be leading to the main point, which is my gardening theory of parenthood. Like plants, children naturally grow and flourish and learn and develop when they are given the right conditions. We don’t always know in what direction they will grow, or even what kind of plant they are sometimes. But our job is to wait, watch – provide the earth and the water and the sunshine. Love, food, shelter, protection, nourishment. Allow them to grow. Don’t get in their way and they will bloom in amazing ways.

The gardening approach to parenting is in contrast to the baking / cookie cutter approach. Baker knows what kind of cookie she wants, prepares dough according to recipe, cuts dough to shape and puts in the oven. Gets exactly the cookie she prepared from the recipe.

But a cookie is not alive.

I want to be a gardener parent.

Evolutionary psychology is a field of science that looks at human behaviour in terms of evolution. Some of our habitual or instinctive behaviours have developed that way and are encoded in our brains because these behaviours lead to the survival of the species.

These types of behaviours include attraction to the opposite sex  (for reproduction) protection of offspring, seeking food or shelter (nesting) and general response-to-threat behaviours.

I remember a particularly interesting trip with my 3 children to the “Crocodile Farm” in Cairns. On arrival I became nervy and irritable, I wanted to make our trip as short as possible and I got very prepared to fight irrationally and seriously with my husband when he tried to take the children somewhere. Basically I was quite prepared to do whatever it took to remove the threat. But it took a while for me to realise that what i was actually afraid of was the Crocodiles! Because a lot of the time, evolutionary behaviours occur on an unconscious level – they are instant reactions that occur in the “anxiety centre” or brainstem, and bypass the logical thought centres (cortex) of the brain.

So in mental health anxiety is often seen as an evolutionary behaviour. Our nervous systems have evolved a “fight or flight” response to any kind of perceived threat. This involves certain body sensations (increased heart rate, muscle tension etc) which prepare us to literally fight or run – and other responses here might include a “freeze” response which happens in some kinds of anxiety.

Looking at mothers with new babies, all our evolutionary responses are maxed out because we are programmed to protect this new little life. This leads to the “mother bear” syndrome when some of us will go for anyone’s jugular if they seem to be threatening our baby. This includes fathers, when they seem to be putting the baby in danger.

So how does this work for postnatal disorders. We all know about postnatal depression and how common it is. Anxiety symptoms are very common and is intimately connected to depression, so much that some even say they are the same thing.

We have all seen worrying mothers and anxious mothers and fiercely protective mothers. When does this cross the line and become a disorder? Maybe some of our behaviours and body responses were adaptive when we used to live in the savannah surrounded by possible predators. We had to find shelter and food, avoid threats and stay with the group to survive. These responses can work against us in the society in which we now live.

Some common anxiety disorders are:

– panic disorder and agoraphobia (fear of open spaces) people become anxious when out in the open – a primal fear of exposure to predators, and this is associated with panic attacks.

– social anxiety – people are afraid when around their friends or community and fear rejection by the group, sometimes worrying about their own appearance – this dates back to a time when rejection by the group could mean death, and perhaps those who looked different were rejected because it might mean disability and threaten the survival of the group. But the result of this kind of anxiety can be that people actually avoid the group and inadvertently create what they fear – isolation.

– obsessive-compulsive disorder – a classic feature is fear of germs and compulsive hand washing – related to fears of disease and death. Again this becomes worse with a small baby as a protective mechanism gone wrong and can sometimes cause harm to the baby through excessive cleaning or lack of affection. I have met women who fought bitterly with their husbands about hygiene, not realising they were literally fighting for their lives.

So that’s how anxiety disorders in pregnancy and postnatally are related to evolution. It kind of makes sense when viewed in the context.

The solution is to encourage people to see their thoughts more rationally and logically, and evaluate the reality of the situation. Is there any threat and what is the outcome of their conditioned behaviour. Is the anxiety harming or helping, and how to come up with more logical thinking or helpful behaviour. We need to activate our higher thought centres (cortex) and integrate it with the anxiety centre (brainstem) to calm it down. The good news is those pathways do exist and can be developed, as neuroscience research shows.

 

 

 

 

1. Get to watch a lot of good TV
2. Read books
3. Write a novel
4. Do research / complete a PhD
5. Invite friends over for drinks / dinner
6. Save money on taxi fares
7. Save money on overpriced / fattening restaurant food
8. Become an artist, catch up on unfinished knitting projects
9. Instant excuse for unwanted invitations
10. Write a blog!

poo and happiness

April 12, 2007

I had long suspected a connection between poo and happiness. This realisation gradually dawned on me over more than a year of changing nappies for two in addition to (and preceded by) caring for Ellie the Funt.

My suspicions were first confirmed by the sensational recent Australian movie, Kenny in which our protagonist is a Porta-Loo manager, happy as a pig in mud. He is really doing the world an essential service, and has a sense of purpose and importance. And so he should. After all human waste is ubiquitous and someone really needs to maintain those systems for dealing with it.

My natural reaction to poo is, like anyone’s, a normal “eww, yucky” feeling on first encountering the poo. God forbid, you don’t want to get it on your fingers. But the encounter is also strangely grounding. To come face to face (or face to bottom) with the waste products of one’s children does something to one’s sense of connectedness, somehow.

And last night on the SBS program, Insight, with my hero Jenny Brockie my suspicions were confirmed. It’s a fantastic talkback TV program that deals with interesting topics superbly and last night’s topic was, would you believe it “Happiness“. And the champion case example of happiness, was, would you believe a sewerage worker. I have forgotten the guy’s name. But he exhibited all the core features of happiness: a sense of purpose, a sense of connection to others, involvement in one’s work etc…

And for me, a penny dropped, another link in the chain. I’m starting to think I’m onto something, the association of poo and happiness.

the good-enough parent

March 5, 2007

We have always aspired to “good-enough” parenting, never remotely tempted by the perfectionism and high achievement that characterises a lot of our peers. Thank you to Ms Melancholy over at the psychotherapist blog for articulating so nicely the reasons why we do this. I would create a trackback or a pingback at this point, except I have forgotten how this is done.

Today I left the boys (15 months each) at Occasional day care so I could clean the house and do some writing. There was screaming as I left, and as this is the first time I’ve done anything so awful there were 3 sets of tears. I came home and wrote a story about a woman who leaves her children alone, eating out of a cat feeder – that was about as low as I felt.

But reading Ms Melancholy does make me feel better. I’m lifting the Winnicott quote.

“The good-enough mother…starts off with an almost complete adaptation to her infant’s needs, and as time proceeds she adapts less and less completely, gradually, according to the infant’s growing ability to deal with her failure…

D.W.Winnicot (1951) Transitional Objects and Transitional Phenomena

And her post does explain, so very nicely why it is so natural for parents to be imperfect and how our imperfection actually provides a learning ground for the children and prepares them for the world to come.

Other People’s Kids

February 19, 2007

You can’t shoot ’em…

I’m entering a whole new zone of behaviour and ethics. The playground interaction. The delicate interplay of boundaries, civility and protection of our most precious ones. My twins are now almost 15 months. Old enough to run around in a toddler-friendly playground and have a go on some of the equipment. It’s fun! It’s new, it’s exciting.

When you are one year old, you believe the world is a happy place and everyone is your friend. Of course, when you are a twin you are also used to another little rival who likes to steal your rusk, pull your hair and sometimes even push you over. But once you enter the playground the dangers multiply. There are Big Kids. Physically stronger and capable of more calculating attacks.

My son was taunted with a lollipop today! My first instinct was to grab the lollipop and hiss “You’re not a very nice little boy” loudly and throw said confectionery in the rubbish. A three year old boy persisted in holding the lollipop in front of my very innocent and trusting one, who would of course reach for it – and then snatch it away. Meanwhile the mother stood around with her very skinny designer-clad friends holding their “bugaboos” and bitching about someone or other in their school mothers’ group.

No wonder the kid had issues, I could see already that antisocial behaviour was his only path to being noticed at all. This still did not engender any sympathy in me.

No, I didn’t abuse the 3 year old, relax. I simply walked over, stood behind my son and said “hello” pointedly. Luckily that was all it took.

Earlier on at the same playground, the other twin was pushed over by a snotty nosed little girl. Luckily he was totally unfazed by this.

However it does raise some questions. What do you do? Is it acceptable to discipline someone else’s child? Do you raise it with the parents first? When is snatching lollipops or verbal abuse appropriate?

To what lengths will you go to protect your precious ones? At what point is it better to let them fight their own battles? Obviously not at 15 months. I think I’ll continue the close supervision for now.

The fact is, other people’s kids are sometimes horrid. And although it has been a surprise to me, it’s to be expected. People in general aren’t always nice, the children just follow suit.

It’s harder to post every day than I thought. And the posts are coming out a bit unformed, but never mind, I’m going to persist anyway…

How best to describe the motion of a toddler around the room? I would say, milling. But one cannot mill alone, milling really requires multiple millers. That’s why having twins is so great, they can mill around the room. And going visiting is even better, we can get all our babies together for milling.

There is a really charming randomness about the activities of a toddler. Mine are particularly good at playing on their own, and as I sometimes get caught up with the computer I feel guilty about neglecting them. However, I’m sure they don’t actually feel neglected and they are quick to let me know if they do. They’re quite happy just doing the random thing.

The thought process goes something like this: ‘Oh, here’s this toy again so I might stand up and walk over here, carrying it… I’m pretty good at this. Oh, here’s this other toy, I can bang them together, that’s a nice noise. Now I’ll throw the first one away, haha a really loud noise. OK, here’s my brother, hi bro, maybe I can pull him over if I grab his hair hard enough…’

And on it goes. Perhaps if you had enough toddlers in a room you might get Brownian motion? It’s fun to watch.

A-da! baby language

November 3, 2006

This may be a post-in-progress…

My 11 month twins are already inventing a language, but it has very few words so far.

The most important word is “A-da!” (emphasis on the second syllable) sometimes also prnounced “Hadda”. This word is basically a pronouncement, it has several meanings including “Here it is”, “Look at this”, “Gee mum, why does that funny thing do that?”, “I’m here” “You’re here” etc.

Other words of secondary importance include:
– “Mamamamama” (loud) It’s not what you might think! It actually means “Give me that food right away” – an alternative version is “Nanananana”
– “Nim nim” means “this food looks nice”
– “Bwee” this is a controversial one, it’s hard to pinpoint the exact meaning, and may in fact have many different meanings. It can be thoughtful “I wonder what’s going on here” or jocular “this is fun”
– “Aaaaa” in a semi-whisper of awe means “This is really amazing” as in “that cup fits inside the other one!”
– “Ha” (loud, multiple while crawling) means “Wow, look at all this new stuff, I’m finding lots of things here”