COVID-19: Depression symptoms between parents can be mutually reinforcing and activating

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Depression is a common mental health disorder that affects millions of people worldwide. It can have far-reaching consequences for the individual’s health and well-being, as well as their relationships with others.

One such relationship that may be affected by depression is the parent-child relationship. In some cases, depression symptoms between parents can be mutually reinforcing and activating, leading to a cycle of negative interactions that can further exacerbate depressive symptoms.

Research studies have found that depression symptoms between parents can be interdependent and mutually reinforcing. For example, a study published in the Journal of Family Psychology found that maternal depressive symptoms were associated with increased paternal depressive symptoms, and vice versa.

The study also found that this interdependence was stronger in couples who reported higher levels of negative interactions, such as criticism and hostility, in their relationship.

Another study published in the Journal of Affective Disorders found that parental depression symptoms were associated with poorer parent-child relationship quality, which in turn was associated with increased child depressive symptoms. The study suggested that depression symptoms may interfere with parents’ ability to engage in positive interactions with their children, leading to a cycle of negative interactions that can further exacerbate depressive symptoms.

Depression symptoms between parents can also be activating, meaning that one parent’s depressive symptoms can trigger depressive symptoms in the other parent. For example, a study published in the Journal of Abnormal Psychology found that when one partner in a romantic relationship experienced depressive symptoms, it was more likely to trigger depressive symptoms in the other partner.

The study suggested that this may be due to negative interactions between partners, such as criticism and blame, which can lead to feelings of hopelessness and helplessness.

There are several possible mechanisms by which depression symptoms between parents can be mutually reinforcing and activating. One possibility is that depression symptoms may interfere with parents’ ability to engage in positive interactions with each other and their children, leading to a cycle of negative interactions that can further exacerbate depressive symptoms.

Another possibility is that depression symptoms may lead to changes in brain structure and function that contribute to a more negative view of the world and others, making it more difficult to engage in positive interactions.

Overall, depression symptoms between parents can be interdependent and mutually reinforcing, leading to a cycle of negative interactions that can further exacerbate depressive symptoms. Understanding the complex interplay between depression symptoms, negative interactions, and family relationships is an important area of research that may lead to new interventions for families experiencing depression.

It is important for parents to seek help for their depression symptoms, both for their own well-being and for the well-being of their children and family as a whole.

Anhedonia is a common symptom of depression that is characterized by a loss of pleasure or interest in activities that an individual used to enjoy. It can have far-reaching consequences for an individual’s mental health and well-being, as well as their relationships with others.

One such relationship that may be affected by anhedonia is the parent-child relationship. In some cases, anhedonia may be mutually reinforcing and activating, leading to a cycle of negative interactions that can further exacerbate depressive symptoms between parents.

Anhedonia is a term used to describe a condition in which an individual loses interest or pleasure in activities they once enjoyed. While it can be a symptom of various mental health conditions, it has also been observed in individuals who have recovered from COVID-19. In this article, we will explore the link between anhedonia and COVID-19, including its possible causes and treatment options.

What is Anhedonia?

Anhedonia is a symptom that is commonly associated with depression. It refers to the loss of interest or pleasure in activities that were previously enjoyable. Individuals experiencing anhedonia may feel like they are unable to enjoy things they once found pleasurable, such as hobbies, social interactions, or sex. They may also feel like they are emotionally numb, experiencing a lack of positive emotions.

While anhedonia can be a symptom of various mental health conditions, it has also been observed in individuals who have recovered from COVID-19.

COVID-19 and Anhedonia

Recent studies have suggested that individuals who have recovered from COVID-19 may experience anhedonia. According to a study published in the Journal of Affective Disorders, 52% of individuals who had recovered from COVID-19 reported experiencing anhedonia. The study also found that individuals who experienced anhedonia were more likely to have symptoms of depression and anxiety.

Another study published in the Journal of Psychiatric Research found that anhedonia was one of the most common symptoms reported by individuals who had recovered from COVID-19. The study surveyed individuals who had recovered from COVID-19 and found that 45% of respondents reported experiencing anhedonia.

Possible Causes of Anhedonia in COVID-19 Patients

The exact cause of anhedonia in COVID-19 patients is not yet fully understood. However, there are several possible factors that may contribute to the development of anhedonia in these individuals.

  1. Inflammation: COVID-19 is known to cause inflammation in the body. This inflammation can affect the brain and may contribute to the development of anhedonia.
  2. Isolation: Individuals who have recovered from COVID-19 may have been isolated from their friends and family members during their illness. This isolation may contribute to the development of anhedonia.
  3. Neurological Effects: COVID-19 can affect the central nervous system, which may also contribute to the development of anhedonia.
  4. Medications: Some medications used to treat COVID-19 may also contribute to the development of anhedonia.

Treatment Options for Anhedonia in COVID-19 Patients

The treatment options for anhedonia in COVID-19 patients are similar to those used to treat anhedonia in individuals with depression.

  1. Psychotherapy: Psychotherapy, or talk therapy, can be effective in treating anhedonia. Cognitive-behavioral therapy (CBT) is one type of psychotherapy that is often used to treat anhedonia. CBT focuses on identifying negative thought patterns and replacing them with more positive ones.
  2. Medications: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be used to treat anhedonia. These medications work by increasing the levels of serotonin in the brain, which can help to improve mood.
  3. Lifestyle Changes: Making lifestyle changes, such as engaging in regular exercise and practicing relaxation techniques, may also help to alleviate symptoms of anhedonia.

Research studies have found that anhedonia between parents can be interdependent and mutually reinforcing. For example, a study published in the Journal of Family Psychology found that maternal anhedonia was associated with increased paternal anhedonia, and vice versa. The study also found that this interdependence was stronger in couples who reported higher levels of negative interactions, such as criticism and hostility, in their relationship.

Another study published in the Journal of Affective Disorders found that parental anhedonia was associated with poorer parent-child relationship quality, which in turn was associated with increased child depressive symptoms. The study suggested that anhedonia may interfere with parents’ ability to engage in positive interactions with their children, leading to a cycle of negative interactions that can further exacerbate depressive symptoms.

Anhedonia between parents can also be activating, meaning that one parent’s anhedonia can trigger anhedonia in the other parent. For example, a study published in the Journal of Abnormal Psychology found that when one partner in a romantic relationship experienced anhedonia, it was more likely to trigger anhedonia in the other partner.

The study suggested that this may be due to negative interactions between partners, such as criticism and blame, which can lead to feelings of hopelessness and helplessness.

There are several possible mechanisms by which anhedonia between parents can be mutually reinforcing and activating. One possibility is that anhedonia may interfere with parents’ ability to engage in positive interactions with each other and their children, leading to a cycle of negative interactions that can further exacerbate depressive symptoms. Another possibility is that anhedonia may lead to changes in brain structure and function that contribute to a more negative view of the world and others, making it more difficult to engage in positive interactions.

Using network analysis to investigate depression within families

Most studies investigating the co-occurrence of depression in parents use summed symptoms or ‘clinical cut-off’ scores. Reference Fried and Cramer 9

This approach assumes that all symptoms are equally important, but this may not be the case. Network analysis provides a framework to investigate symptom-level associations, where symptom patterns or clusters of cognitions and behaviours, can influence each other. Reference Borsboom and Cramer 10

These symptom clusters can be conceptualised as feedback loops driving depressive processes, for example, insomnia can cause fatigue, which can cause psychomotor-related symptoms, which in turn can disrupt sleep. Reference Borsboom and Cramer 10 – Fried, Epskamp, Nesse, Tuerlinckx and Borsboom 11

The network approach can also inform the understanding of symptom-level mechanisms underlying the co-occurrence of depression in parents. Reference Paulson and Bazemore 2 – Goodman 4

There is good reason to pursue this research aim: one study found associations between mothers and fathers for only some depression symptoms, specifically insomnia, feeling guilty and self-harm ideation. Reference Matthey, Barnett, Kavanagh and Howie. 12

These symptoms may act as ‘bridges’, providing connections and activating symptoms, between parents. Reference Jones, Ma and McNally 13 – Levinson, Brosof, Vanzhula, Christian, Jones and Rodebaugh 14

Network models can also be used to examine depression-related risk pathways between parents and children. Reference Brown, Waite and Freeman 15

Findings from an intervention study in this area suggest that the parental symptoms of anhedonia (the inability to feel pleasure) and impaired attention may be important in the intergenerational transmission of psychopathology, Reference Potharst, Zeegers and Bögels 16, in part because they may be associated with more withdrawn and less nurturing parenting, both of which are associated with emotional symptoms in children. Reference Elgar, Mills, McGrath, Waschbusch and Brownridge. 17

Main findings, comparison with other studies and interpretation
Overall network structure of mother and father symptoms

Our first aim was to examine the overall network structure of mother and father symptoms. By using network analysis, we found that symptoms intercorrelated with very similar clustering patterns in both parents. As expected, we found that panic, worry and feeling guilty clustered in mothers and fathers, supporting previous findings suggesting that these symptoms constitute an anxiety-related depression factor of the EPDS. Reference Matthey 19

Previous studies have found differences between mothers and fathers, positing a stronger role for anxiety-related depression symptoms for fathers, Reference Massoudi, Hwang and Wickberg 39, whereas, we found that the strength of the associations of the anxiety symptoms within the network were very similar for both parents. This may be because we measured symptoms when the infant was 21 months old.

For fathers, anxiety symptoms have been found to increase prenatally, peak at birth and then rapidly reduce postnatally, Reference Philpott, Savage, FitzGerald and Leahy-Warren40, suggesting that anxiety-related depression symptoms may be most salient for fathers early in the postnatal period.

As well as finding symmetry in symptom clusters between parents, we also found that the same symptoms in mothers and fathers had the greatest influence on the total network. For example, sadness and feeling overwhelmed were the most highly connected symptoms with the rest of the network for both parents.

Of interest, we found that the same symptoms associated between mothers and fathers, suggesting that when specific symptoms are high in one parent, they are also high in the other parent, potentially contributing to the concordance of depression between parents. Reference Goodman 4

Symptoms bridging mother and father depression symptoms

Our second aim was to identify symptoms bridging mother and father depression symptoms, to provide insight into symptom-level mechanisms underlying the high rates of co-occurrence of parental depression.Reference Goodman 4

Our hypothesis was partially supported as we found that feeling guilty and self-harm ideation were bridge symptoms in both parents.

This indicates that these symptoms act as a gateway, mutually activating and reinforcing the wider network of symptoms in the other parent. Reference Jones, Ma and McNally13,Reference Cramer, Waldorp, van der Maas and Borsboom 41

However, despite previous research finding that insomnia associated between mothers and fathers, Reference Matthey, Barnett, Kavanagh and Howie 12, we did not find that insomnia acted as a bridge symptom.

The most likely explanation for this is because networks model conditional associations between groups of symptoms, highlighting the value of network modelling of complex relationships between individuals.

Importantly, these activating symptoms (feeling guilty and self-harm ideation) could be targeted for therapeutic deactivation. For example, one study examined whether reduction in the activation of influential symptoms would reduce overall activation of the grief symptom network.

They found that reduced activation of influential symptoms more strongly associated with a greater reduction in overall network activation, compared with symptoms that were low in influence. Reference Robinaugh, Millner and McNally 18

The bridge symptoms identified in this study may therefore provide clinical targets when depression co-occurs between parents, by deactivating influential symptoms, thereby reducing co-activation of the wider network of symptoms between parents.

Role of bridge and other symptoms in the parent network associated with later emotional difficulties in the child

Our third aim was to examine whether the bridge and other symptoms within the parent network associated with later emotional difficulties in the child. In mothers, the bridge symptom feeling guilty directly associated with child emotional difficulties, as did panic, anhedonia and sadness. These results support previous findings that suggested anhedonia and impaired attention as potential mechanisms in the intergenerational transmission of depression. Reference Potharst, Zeegers and Bögels 16

This may be explained in part by the impact of depression symptoms on mothers’ parenting, Reference Elgar, Mills, McGrath, Waschbusch and Brownridge 17, and the transmission of depressogenic cognitive styles from mothers to their children. Reference Pearson, Fernyhough, Bentall, Evans, Heron and Joinson 42

For fathers, only the symptom feeling overwhelmed directly associated with child emotional symptoms. This is consistent with previous findings that indicators of being overwhelmed in fathers, such as ‘feeling trapped by my responsibilities as a parent’ was the strongest predictor of paternal depression severity. Reference Bronte-Tinkew, Moore, Matthews and Carrano 43

Indeed, our findings for aim one found feeling overwhelmed to be one of the most influential symptoms in the depression network for fathers.

Therefore, it is plausible that this symptom is particularly important for overall depression severity in fathers, which in turn increases risk for emotional difficulties in children.

We also found evidence of mediated pathways from father symptoms to child emotional difficulties through the same symptom in mothers. This finding is reflected in existing literature where the effect of father depression is often mediated through other processes. Reference Gutierrez-Galve, Stein, Hanington, Heron and Ramchandani 44

One explanation may be that father depression can increase the negative impact of mother depression symptoms on children. Reference Brennan, Hammen, Katz and Le Brocque 45

Our finding that specific symptoms, when higher in one parent are also higher in the other parent, may provide new insight here.

Of note, the symptom feeling guilty seems to play a particularly important role in familial transmission of depression, acting as a reinforcing bridge between parents, and providing a pathway from father to mother to child. These cascades of symptoms may present important targets for therapeutic deactivation, to reduce the transmission of depressive symptoms within families.

reference link : https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/mother-and-father-depression-symptoms-and-child-emotional-difficulties-a-network-model/5D2001D06C87325151760C7152CE20DB

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