Life is hard for the children of a parent suffering from depression. Children take on an enormous amount of responsibility for the ill parent and for other family members. It is therefore important for the health services to be aware of this and have support functions in place for the whole family, and not just for the person who is ill. This is the conclusion of a thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden.

Registered Nurse Britt Hedman Ahlström has examined the way in which family life is affected when a parent is suffering from depression. Nine families, including ten children and young adults between the ages of 5 and 26, and eleven parents were included in the study.

The results show how the family's daily life changes and becomes more complicated when a parent is suffering from depression. Uncertainty about what is happening has an effect on the daily life of the entire family. Depression also means that the parent becomes tired and exhausted, which then affects and weighs heavily on the children's daily life. Depression changes the relationship between a parent and his/her children, since they no longer communicate with each other as they used to. Family interplay and reciprocity decrease. The depressed parent withdraws from the family, and the children feel that they have been left to themselves.

Daily family life becomes unfamiliar to the children

The family members try their utmost, both as individuals and together, to cope with the situation, so that daily life can be restored to a more manageable level. The children take responsibility for both the depressed parent, siblings and themselves, when they notice that the parent cannot cope.

"The toughest burden of responsibility that children take on is ensuring that the depressed parent doesn't commit suicide. So children take on an extremely heavy responsibility by monitoring and keeping an eye on the depressed parent," says Britt Hedman Ahlström.

For children, the parent's depression means both a sense of responsibility and a feeling of loneliness The feelings of responsibility and loneliness include a striving and yearning for reciprocity with the parent, and for things to return to a state of normality.

"Even if the depression goes away for a time, the family is never entirely free from anxiety over it coming back. This means that there is a prolonged period of suffering associated with depression," says Britt Hedman Ahlström.

Health services must help the whole family

Involving the entire family when a parent becomes ill is important, both for the children and the parents. It is essential to have a well-defined level of guaranteed care on how, when and from whom the families will get support. Psychiatric healthcare personnel meet people suffering from depression at an early stage, and therefore have the opportunity to focus the care on the family, in order to together identify ways of helping the family get through the depression.

"We need a new approach within the health services, in which the focus is on the family's own perspective when a parent is suffering from depression. It's vital to be aware of the whole family's needs in terms of help and support, and not just those of the person who is ill. It's particularly important to be aware of the children's situation. Research can therefore focus on how to develop various ways of providing families with care and support, and introduce them into the existing organisation, as well as evaluating the consequences for the whole family, the parents and the children," says Britt Hedman Ahlström