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NAMI Book Shelf: The Ghost in the House

October 2006

In The Ghost in the House, Tracy Thompson opens new perspectives on depression, exploring the dimensions in the book’s subtitle: Motherhood, Raising Children and Struggling with Depression.

Beyond post-partum depression, there is maternal depression. To some degree, perspectives in the book may even apply to fathers, but Thompson’s work is informed by her own experience as a mother who lives with depression. It also draws extensively from a survey of almost 400 mothers.

More than 60 percent of Americans living with depression are women. Its incidence peaks between the ages of 24 and 44, which “not coincidentally” are women’s major child-bearing years. Approximately one-third of women with depression have children, translating to 4 million mothers “who get out of bed each morning to face the daunting job of parenting while suffering with an illness that is at best debilitating, and at worst life-threatening.”

Held in the balance are an estimated 6 million children. If one parent has a mood disorder, a child is three times more likely to develop one too.

Depression can be transmitted to children through genes, environment, learned behavior “or any combination of the three.” From the survey of mothers, Thompson identifies three patterns of response to depression that inevitably affect child development: withdrawal, chronic hyperirritability, and an inability to impose limits, usually through conflict avoidance. Depression includes exhaustion. “Making rules takes self-confidence; enforcement takes energy. Mothers with depression find both qualities in short supply,” Thompson writes.

But Thompson also reminds parents that having a child “is like playing dice with the cosmos anyway. Healthy children die in swimming pools; cerebral palsy strikes.”

One of the strengths of the book is its pragmatism. It identifies issues and patterns. It offers frank, balanced perspectives and coping skills.

Some observations are startling -- but not necessarily surprising. In the survey of mothers, 55 percent of those who experienced post-partum depression said their obstetrician was “no help” to them. When it comes to motherhood and depression, there appears to be “a blind spot” in the medical profession. If ever there is an area that requires self-awareness and full partnership in managing care, it is here.

One of the most remarkable chapters is entitled “Rats, Monkeys and Mothers,” which explores the nature of depression, the physiology of the brain, stress, and genetic vulnerability. “Depression is a lot more than genes,” Thompson writes. “In fact, the more complex the picture becomes, the more encouraging it becomes.” Even in the coping with depression, it turns out, one finds that there are choices.

The last three chapters also offer encouragement. “Don’t Look Now, but Your Kids are Stealing Your Coping Skills,” reminds parents that children learn from weaknesses as well as strengths. “Coping” discusses several strategies and tools, while dispelling the guilt that mothers often feel about their illness. “How the Struggle with Depression Can Make You a Better Mother” similarly emphasizes the wisdom that comes from such pain and its practical consequences.

Many mothers said the “greatest single benefit” of their illness was that it taught their children “to recognize the symptoms of mental illness, to not feel ashamed of it, and to seek help when they needed it.”

Thompson is an award-winning journalist and it shows. Ten years ago, as a reporter for the Washington Post, she shared her personal story in The Beast: A Journey Through Depression, striking an early blow against stigma both in the journalism profession and in the nation’s capital. This time, she has broadened how we look at the journey along a life course.

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