House Calls Lift Spirits Of Depressed Moms

Sunday is Mother's Day, when many will celebrate their mothers and the joys of being a parent. But mothering isn't always sunshine and rainbows. In fact, research shows 10 to 20 percent of women with young children suffer from depression. For low-income women, those numbers more than double. So there's a new effort in Boston to help depressed moms — and ultimately their children.

BOSTON — Laura Starr rolls a small suitcase along a sidewalk in Brighton. She's a social worker who makes house calls, and this luggage is her office. On this day, she's visiting a depressed mother.

Fabiola, 31, moved here from Guatemala seven years ago and has clinical depression. She used to do home renovation work, but now she stays home with her two-year-old daughter, who's going off to spend the day with relatives.

After Fabiola kisses her daughter goodbye, the two women sit down to talk. Laura asks her how many days in the past week she's felt depressed. "Three or four," Fabiola replies. When Laura asks Fabiola how much she enjoys life, she answers quietly with just two words: "Un poco."

"This tells me that your depression is a little bit worse this past week," says Laura, who works for the Visiting Nurse Association of Boston.

Fabiola is part of a new program that sends social workers to the homes of low-income mothers. Fabiola says she really needs Laura's help.

Some studies show depression rates among low-income mothers range as high as 60 percent.She says she wishes her mother or sister lived nearby to help her with child care. Sometimes her daughter wants to do puzzles with her or have tea parties, but Fabiola says she feels so depressed she'd rather do nothing at all.

After her visit with Fabiola, Laura remarks how unsurprising it is that some mothers get depressed; she's a young mom herself, so she understands.

"After having my own daughter, I realized, 'Wow, this is really not a Betty Crocker commercial,'" Laura says. "This is really hard."

It's even harder for the women Laura visits because many of them are poor and struggle with English. That means they're less likely to get treatment for their depression because they can't afford it or they don't have transportation or they're afraid to leave the house. Others think they'll be stigmatized if they admit they want help.

Depression rates among low-income mothers can range as high as 60 percent, according to the National Center for Children in Poverty. That's because young mothers who are economically disadvantaged often struggle more with substance abuse, domestic violence, difficult relationships, a lack of social supports, and even an absence of hope than mothers who are financially better off.

"Depression is something that really has a pervasive effect on somebody's life," Laura adds. "It affects how they view themselves, it affects how they view the world. There's really nowhere that depression doesn't touch — and ultimately on the children."

That impact on children is what this program ultimately wants to reverse, because maternal depression doesn't just take a toll on the mom.

"When that mother isn't responding to the cries, isn't responding to the vocalizations and the cooing and the babbling and all those wonderful things that babies do, it's amazing the impact it has on the actual development of the brain," says Laurel Deacon, of the United Way of Massachusetts Bay and Merrimack Valley, which funds the program.

"Even neuroscientists would now say that the single most important factor in the development of the child's brain is the relationship with the primary caregiver," says Dr. Bill Beardslee, a child psychiatry professor at Harvard Medical School who has studied maternal depression for 30 years.

Dr. Beardlese says depression in mothers can lead to emotional and behavioral problems in their children, among other issues.

"These kids, when they're older, have higher rates of depression, they have higher rates of school difficulties when they're very young, they have more medical problems," he adds.

But depression is also highly treatable. Since the program started in March, it's identified 15 low-income women in Allston and Brighton as being depressed. Nine of them have signed up for treatment.

The appointments at their homes cost them nothing. But Fabiola says what she gets from Laura's visits is invaluable.

"I feel better when I talk about my feelings and my depression" Fabiola says.

She says she doesn't trust just anyone to talk about her feelings, but she does trust Laura to help her work through her depression — because not only will Fabiola benefit, but so will her daughter.