Parenting Through Tough Times Coping with Depression

It is circles within circles, a sadness out of

control,” says one mother struggling to

raise her three children. Life can be hard

and it is normal to feel sad sometimes. Some

people experience depression as “nerves”

or “too much stress.” Others may have body

aches and pains or experience that they are

being visited by “unhappy spirits or ancestors.”

Whatever the words, if you are unable to

shake your sadness, you may be suffering

from depression. What’s most important is to

recognize that you are not alone and to find

others to talk to, others who can help you.

Depression is an illness that can range from

mild to severe. It can be very painful to live

with depression. It causes people to withdraw

from social contacts, from their children and

families, and even from the help that could

save them from years of suffering. Many

people do not know how to recognize or talk

about depression — yet it is one of the most

common mental illnesses that caregivers,

including parents, experience.

Yet there is every reason to be hopeful. In the

last 30 years, a great deal has been learned

about the causes of depression, its effects, and

what can be done about it. The encouraging

news is that depression is the most treatable

of the major mental illnesses. Depressed

parents can in fact be effective parents despite

depression. The challenge is that depression

goes largely unrecognized, is misunderstood,

and often goes untreated.

The hopeful news is that much can be done to

cope with depression. Simply talking it through

with a trusted friend or caregiver may help.

Keeping track of your moods can help, and so

can trying to do things that improve your mood

— exercise, spiritual practices, familiar routines

and rituals, even humor can all be helpful. More

formal treatments, whether delivered in health

centers or mental health centers, also work for

those who need it. Studies show that more than

60-70 percent of those who get treatment for

depression will get better.

Frequently Asked Questions

How Can I Help Myself?

• Learn more about the signs of

depression to figure out if they apply to

you and what you are feeling.

• Find out who you can talk to. Don’t feel

like you have to deal with your feelings

alone; talk to others about them. Share

this paper with someone you trust and

start a conversation. In some cultures, this

can be the hardest part, if you feel that

you are breaking a taboo or norm against

talking about your feelings.

• Reach out. Talk to a counselor, therapist,

doctor, minister, or other professional you

trust about getting help. Learn how to

see depression as an illness and talk to

someone about it.

• Get help. Reach out to your friends and

family to find community resources that

will work for you. For many, the primary

care doctor will be an important resource.

There are many types of treatment that

can be effective, such as talk therapy,

medication, changes in diet, or even

paying attention to other medical

problems (such as diabetes) that can put

you at risk for depression.

• Know that change takes time. In

exploring treatment options, choose

a mental health professional and an

approach to treatment that feels right

to you, and give it time to work. Monitor

what’s going on if you’re getting treatment

with a mental health professional. Talk

about what’s working and what’s not

working.

• Continue to try to be a good parent.

Remember that it’s possible, even with

feelings of sadness, to be a good parent.

Continue the routines that help your child.

We’ve described these in the short paper

The Ability to Cope: Building Resilience for

Yourself and Your Child.

How Do I Know If What I Feel Is

Depression?

Depression often occurs after difficult events

such as the loss of a loved one, moving to a

new community without supports, witnessing

community violence, or losing a job. Perinatal

depression may occur during pregnancy, right

after the birth of a child, or during the following

twelve months. Depression may look and feel

different for every person. Different cultures may

have different ways of describing depression,

and different words for it. Here are some signs

that may occur when someone is depressed:

• Unpleasant mood such as sadness,

anger, and tearfulness. Perhaps things

that normally would be minor annoyances

are very upsetting, such as a child spilling

food.

• Feelings: exhausted, forgetful,

disorganized, sad, full of rage, irritable,

hopeless, maybe empty or numb. You

may feel like you are “losing it” or feel

“overwhelmed.”

• Different physical sensations: Some

people describe a “heaviness” or pain in

their body or their heart. People who are

very depressed might hear voices or see

shadows that are not there.

• Thoughts: always seeing the bad side of

things, glass half empty, forgetting positive

qualities, not feeling good about one’s

self, or “getting stuck.” Other symptoms

include harsh self-criticism, feelings of

worthlessness, and thoughts like “No

one likes me. They may think I am a bad

person/mother/father.”

Depression may affect the ways we commonly

behave or do things in daily life

• Forgetting appointments, details, or

follow-up tasks.

• Difficulty making decisions, even about

simple things like what to have for dinner.

• Sleeping more or less than usual, having

a hard time getting out of bed, having

trouble falling asleep, waking up early in

the morning and not being able to get

back to sleep.

• Eating more or less than usual with

noticeable weight gain or loss.

• Self-medicating behaviors, including

drug or alcohol use, as a way to numb out

sorrow or pain.

• Isolating behaviors such as withdrawing

from friends and family; wanting to be

alone; thinking people do not want your

company; having a harder time using the

supports that are available, such as your

child’s early care program.

• Emotional outbursts, like yelling or crying,

then feeling guilty about “taking things out”

on the children or others.Not being able

to get things done like shopping, cleaning,

getting meals on the table or the kids ready

for their day. Not having energy to take a

shower, wear clean clothes, or do your hair.

• Not being able to get things done like

shopping, cleaning, getting meals on the

table or the kids ready for their day. Not

having energy to take a shower, wear clean

clothes, or do your hair.

• Not enjoying things that used to make

you feel good like a hobby, time with the

kids, family get-togethers, or sexual intimacy

with your partner.

Some people with severe depression

might have thoughts about ending their

lives. If you or someone you know is

having these thoughts, call 911 or go

or take them to an emergency room

immediately.

Can My Depression Affect My

Children?

While it’s true that you can be a good parent

while struggling with depression, it is also true

that children are sensitive to their parents’

moods and behaviors. Many children are able

to grow up healthy and strong even when living

with a parent who suffers from depression.

Some infants of depressed parents may show

high levels of distress and may avoid eye

contact with their caregivers. Some toddlers and

preschool children of depressed parents may

cry easily, act aggressively, have more tantrums,

get easily frustrated, or have problems sleeping

and eating. Some older children may have

a hard time controlling themselves, become

withdrawn, or find it hard to make friends.

Depression may affect your child in these ways,

but it’s important to know that there are things

that you can do to counteract the effects, and

with help you and your children can do well

despite parental depression. There is every

reason to be hopeful.

How Can I Help My Family?

The following suggestions can help parents

recovering from depression to help their

children as well as themselves. Many parents

begin with one of the following suggestions. By

making even a simple change, you are helping

the people you love.

• Take care of yourself as an important part

of taking care of your family.

• Talk to your family about your depression

and make sure they know the illness is not

their fault. Use words that make sense in

your culture. Be ready to talk about it more

than once in words that young children

can understand. It often takes time for

families and children to understand this

sensitive subject.

• Provide a safe, consistent and secure

environment for your child. Routines and

guidance help children feel safe. Make

sure your child attends school every day

and enroll him or her in quality after-

school activities. Predictable routines

about meals, bedtime and other times of

the day are important and reassuring.

• Help your child with the appropriate

challenges he or she faces in their early

care program or school.

• Read to your child, talk to your child, sing

with your child, and encourage activities

where your child enjoys learning.

• Encourage your child’s relationships with

his or her friends and other caring adults.

• Use your resources. Ask a partner,

friend, or relative for help in watching

your child or with transportation to school

or activities. Find out more about the

resources available to you through your

child’s early care program.

Mental Health: Health Tips for Families

Mental Health: Health Tips for Families

Things You Can Do and Say to Help Your Child

For Your Infant
• Hold your baby during feedings.
“I love cuddling when I feed you.”
• Look at your baby and smile, smile, smile!
“Hey, when I smile, you smile back.”
• Talk about what you are doing.
“I’m going to change your diaper now.”
• Try to relax and have fun.
“When I am happy, you are less fussy.”
• Read and sing to your baby every day.
“It is bedtime. Time for a story and favorite song.”
• Take care of yourself.
“When I am rested, I take better care of you.”
• For Your Toddler/Preschooler
• Make sure they always feel safe.
“I know loud noises can be scary, but it’s OK.”
• Offer choices.
“Do you want the blue shirt or the red shirt?”
• Practice patience.
“Let’s wait until the song is over and then we’ll
go outside.”
Show understanding.
“You REALLY want another cookie! It is hard
when you can only have one.”
• Leave extra time.
“I see you don’t want to leave the playground.
One more time on the slide, then we need to
leave.”
• Play together at least 15 minutes a day.
“There is so much to do but it is important for us
to play together.”
• Follow her interest.
“I see you want to play with the blocks. What
are you going to build?”
• Praise your child when she keeps trying.
“I love the way you keep trying to find the right
piece for the puzzle.”
• Practice following directions.
“First pick up the blocks,
then take out the cars.”

Encourage Healthy Eating Habits

Healthy eating is essential to a child's well-being. Children who are overweight are at risk for chronic health problems. The Weight-control Information Network (WIN), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), offers guidance to parents and caregivers on how to encourage healthy eating habits in children.

Tips for Families to Help Children Eat Healthy

  • Eat breakfast every day. Skipping breakfast can leave your child hungry, tired, and looking for less healthy foods later in the day.

  • Plan healthy meals and eat together as a family. Eating together at meal times helps children learn to enjoy a variety of foods.

  • Buy and serve more fruits and vegetables (fresh, frozen, or canned). Let your child choose them at the store.

  • Buy fewer soft drinks and high fat/high calorie snack foods like chips, cookies, and candy. These snacks are OK once in a while, but keep healthy snack foods on hand too and offer them to your child more often.

  • Start with small servings and let your child ask for more if he or she is still hungry. It is up to you to provide your child with healthy meals and snacks, but your child should be allowed to choose how much food he or she will eat. One tablespoon per year of age for each component of the meal is a great place to start when considering serving sizes for young children.

  • Offer your child water or low-fat milk more often than fruit juice. Fruit juice is a healthy choice but is high in calories.

  • Eat fast food less often. When you visit a fast food restaurant, try the healthful options offered.

  • Do not get discouraged if your child will not eat a new food the first time it is served. Some kids will need to have a new food served to them 10 times or more before they will eat it.

  • Try not to use food as a reward when encouraging kids to eat. Promising dessert to a child for eating vegetables, for example, sends the message that vegetables are less valuable than dessert.

  • Make healthy choices easy by putting nutritious foods where they are easy to see and keep high-calorie foods out of sight.

Healthy Snack Ideas

  • Fresh or frozen fruit, or fruit canned in juice or light syrup

  • Small amounts of dried fruits such as raisins, apple rings, or apricots

  • Fresh vegetables such as baby carrots, cucumber, squash, zucchini, or tomatoes

  • Reduced fat cheese or a small amount of peanut butter on whole-wheat crackers

  • Low-fat yogurt with fruit

  • Graham crackers, animal crackers, baked pretzels, or low-fat vanilla wafers

The 5-2-1-0 Message Provides Suggestions for Building Healthy, Active Lives

  • Eat at least 5 fruits and vegetables a day.

  • Keep screen time (like TV, video games, computer) down to 2 hours or less per day.

  • Get 1 hour or more of physical activity every day.

  • Drink 0 sugar-sweetened drinks. Replace soda pop, sports drinks, and even 100 percent fruit juice with milk or water.

Be Supportive

Throughout any process or program that you undertake to address your child's eating habits, be supportive. Help your child set specific goals and track his or her progress. Reward successes with praise and hugs. Be positive.

Tell your child that he or she is loved, special, and important. Children's feelings about themselves are often based on how they think their parents and other caregivers feel about them. Children need compassion, understanding, and encouragement from caring adults.

Note: Foods that are small, round, sticky, or hard to chew, such as raisins, whole grapes, hard vegetables, hard chunks of cheese, nuts, seeds, and popcorn can cause choking in children under age 4. You can still prepare some of these foods for young children, for example, by cutting grapes into small pieces and cooking and cutting up vegetables. Children should always be supervised during meals and snacks.

SMART CHOICES FOR FEEDING PRESCHOOLERS

• Many parents worry they are not feeding their preschooler enough. But serving sizes for preschoolers are

smaller than serving sizes for adults and each child is different. Your role is to provide healthy choices for your

preschooler and let them decide how much they want to eat. The information on the front is provided as a

guide to help you gauge how much average preschoolers consume.

Nutritional Information

• At this age, children can begin to serve themselves. Family-style dining encourages appropriate serving sizes and

trying new foods.

• Did you know that it’s normal for a growing preschooler to have 1 to 2 snacks every day? Make snack time healthy to

help your child get all the nutrients he needs.

• Serving sizes for preschoolers are much smaller than serving sizes for adults. A serving of fruits or veggies is about ½

cup. A ½ cup for milk is a serving size for a preschooler.

Common Challenges

• Picky eating frustrates and discourages many parents. It’s normal for toddlers to go through a picky eating phase. As

toddlers grow into preschoolers, however, this phase can turn into a habit. It can be frustrating, but with time, hard

work, and patience these habits can be changed.

• Be patient. Your child is learning what he likes and what he doesn’t—and his tastes can (and will!) change very quickly.

• When you are dealing with a picky eater:

• Stay calm when your child won’t eat what you prepared. Don’t try to force him to eat.

• Offer new foods with familiar foods that you know your child likes.

• Let your child choose between two healthy options. He’s more likely to eat something if he chooses it himself.

• Try not to use your child’s favorite food as a reward for good behavior.

Helpful tips

• Preschoolers are often very curious about learning new things and fun facts. You can use this to help him learn about

new foods. For example, you can:

• Let your child help with food shopping, preparation, and serving. The more you involve him in the process, the more

likely he’ll be to try the foods.

• Preschoolers are at the perfect age to learn about how food grows. Plant vegetables and herbs with your child—he

will love to try the foods he grows!

• Talk to your child about what other kids like to eat. If a friend really likes a food that your child has not tried, use this as

an opportunity to try a new food.

Mealtime with Preschoolers

• Encourage your preschooler to try small amounts of food at mealtimes.

• Try using child-sized dishes and utensils for accurate portions.

• Allow your preschooler to tell you when he is full. Don’t worry if it seems he didn’t eat enough this time. He will eat

when he is hungry.

• Try to keep a routine with meals and snacks. This helps to limit all-day grazing and makes it easier to say ‘no’ when

your preschooler asks for food outside of meal and snack time.

Beverage Choices

• Milk and water are still the healthiest choices for your preschooler.

• Eat whole fruits instead of drinking juice. Offer cut up bananas, strawberries, grapes, or other fun finger foods.

• Healthy choices away from home

• Teach your child to ask other adults for milk or water when she’s not at home.

• If you are out together and only juice, soda pop, or sports drinks are available, give her tap water.

• If you decide to allow some juice or punch at a party, mix in some water so that it’s less sugary.

SMART CHOICES FOR FEEDING TODDLERS

Why Is This Important?
• Many parents worry they are not feeding their toddler enough. But serving sizes for toddlers are
smaller than serving sizes for adults and each child is different. Your role is to provide healthy
choices for your toddler and let them decide how much they want to eat.
• Establishing healthy meal routines is an important step in healthy toddler development. Ideally,
mealtimes should take place at regular times, at a table with limited distraction, and children should
be encouraged to feed themselves with adult support as needed.

Nutritional Information
• Serving sizes for toddlers are much smaller than serving sizes for adults. A serving of veggies is about
¼ cup.
• A typical serving size for a toddler drink is 4-6 ounces.
• Your toddler (and you too!) needs food from all five of the food groups—grains, protein, vegetables, fruit,
and dairy. Try offering a variety of foods from these groups at meal and snacks.
Mealtimes
• Your toddler may eat more some days and less on others. Don’t worry, this is normal! Keep offering
regularly scheduled meals and snacks.
• Allow your toddler to tell you when she is full. This teaches them to listen to their body for signs of
hunger or fullness.
• Try using child-size plates, bowls, and utensils for “right-size” portions for your toddler. Using child-size
utensils also makes it easier for your toddler to eat.
• Limit distractions during meal and snack times to allow your toddler to enjoy the food. Turn off the TV
and sit at a table.
Snacking
• Toddlers get hungry between meals. Snack time is a great chance to feed your toddler healthy foods
(like fruits and veggies).
• Remember to have a start and end time for snack time. Toddlers should not be snacking (or grazing) all day.
• Remember snack time does not have to mean junk food time. Snacks can be healthy and easy to prepare.
Beverage Choices
• What your toddler drinks is very important too! Water and milk are the best choices for toddlers.
Children 1-2 years old should drink whole milk unless otherwise directed by their doctor and children
over two should drink low-fat milk (Skim, 1% or 2%).
• Limit 100% juice to 1 time a day if at all and try to avoid other sugar sweetened beverages.
• Encourage toddlers to drink from cups and avoid use of bottles or sippy cups.