Blog Post 39-Parental Anxiety, Depression, and Cognitive Biases (1 of 4)

Healthy Sleep Habits, Happy Child
by Marc Weissbluth, M.D.

A Healthy Child Needs a Healthy Brain,
A Healthy Brain Needs Healthy Sleep.

If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.

Parental Anxiety, Depression, and Cognitive Biases

When children are not sleeping well, the cause might be the father, the mother, the baby or any combination.  Even if the root cause or trigger might occur within the father, or the mother, or the baby, as time passes, interactive effects develop between all three.  In order to help solve sleep problems, without judgement, it is important to consider all possible causes (Blog Posts 17 and 18).

Parents may have symptoms of anxiety or depression or habitual thoughts and beliefs that might, or might not, contribute to or cause sleep difficulties in their child.  This topic is confusing because some studies look only at the father’s role and others look only at the mother’s role.  Some research suggests that a colicky baby might trigger these symptoms in the parents.  Interactions between each parent and the baby are important.  Therefore, it is difficult to make firm conclusions about the direction of effect.  Blog Posts 39-42 share studies that describe how parents’ issues might contribute to or cause sleep difficulties in their child.

FATHERS

About 10% of men experience prenatal and postpartum depression, and this is often associated with maternal depression.  But an Australian study followed over 1,000 young men over 21 years showed that “expectant and new fathers are not at greater risk of depression or anxiety” compared to a matched group of men who did not become fathers.  However, a separate study showed that men with a tendency to interpret events negatively (a cognitive bias) may respond to a fussy baby with greater negative affect; also, these “cognitive biases are associated with symptoms of depression and anxiety among fathers during the transition to parenthood.”

In Australia, publicly funded Early Parenting Centers (EPC), also known as Sleep Schools, provide a residential program offering parenting support and education, commonly for sleep and settling issues with their children (Blog Post 17). One study observed that the majority (84%) of fathers attending EPCs complained of “moderate to high fatigue” and concluded that “distress among fathers may be experienced as psychological and physiological tension, agitation, and frustration rather than depressed mood.  It is also possible that it is more socially acceptable for fathers to report symptoms of stress than depression.” 

Another Australian study found that while 10% of fathers experience mental health difficulties, there were attitudinal barriers to seeking help:

  1. The need for control and self-reliance (“I like to be in charge of everything in my life.”).
  2. A tendency to downplay or minimize problems (“Problems like this are part of life; they’re just something you have to deal with.”).
  3. A sense of resignation that nothing will help (“I’d rather just suck it up than dwell on my problems.”).

Fathers with the first attitudinal barrier regarding the need for control and self-reliance were more likely to have high levels of depression, anxiety, and stress symptoms. In a separate study, fathers of 4-month-old infants with sleep problems had increased depressive symptoms, anger toward their child, poor personal sleep quantity and quality, and at 6 months, increased depressive symptoms.  Finally, another study concluded that when postpartum depression occurs, “mothers are more likely to report sadness, and fathers are more likely to present with increased irritability and alcohol and substance use.” 

Also, in Australia, many fathers whose wives sought care in EPCs exhibited “risky alcohol use (episodic excessive drinking or daily alcohol use).”  For example, among these fathers, 20% had mental health problems and risky alcohol use occurred in 82%.  Even among the 80% without mental health problems, risky alcohol use occurred in 50%. 

Some fathers, perhaps those with certain cognitive biases, experience parenthood with symptoms of agitation, frustration, irritability, tension,  anxiety, depression, or risky alcohol use.  Other fathers are abusive, angry, absent, alcoholic, or addicted.  However, in studies that focus on mothers’ mental health around pregnancy and parenthood, fathers are often not studied, thus producing an incomplete picture of mothers’ mental health.  Mothers’ mental health status might, or might not, be strongly influenced by fathers’ mental health status.

(To be continued.)

DO I HARM MY CHILD IF I LET HIM CRY AT NIGHT TO LEARN SELF-SOOTHING?           

• Studies show that children are not harmed (Blog Post 24) when extinction or graduated extinction is used. Blog Post 25.

IT IS NOT NECESSARY TO MAKE YOUR CHILD CRY TO HAVE A GOOD NIGHT’S SLEEP

WHAT A PARENT CAN DO

• Accept the fact that your friends and relatives may not be aware of why a healthy brain depends on healthy sleep. Blog Post 38.

• Ignore myths such as sleep regressions or that teething or growth spurts disrupt sleep or that late bedtimes are fine because your young child is an “owl”. Blog Posts 36 and 37

• Focus on timing: The time when drowsy signs (Blog Post 9) begin to appear is the time when you start your soothing to sleep. Blog Posts 2835.

• It may be difficult to begin or choose a sleep solution. Blog Posts 23 and 26.  A Community Sleep Consultant may be helpful. Blog Post 27.

• No television or digital electronic devices in child’s bedroom (Blog Post 21), if possible. Blog Post 22.

• Some babies sleep better than other babies. Develop coping strategies to reduce stress if your baby has extreme fussiness or crying.  Plan to encourage self-soothing skills at 2 to 4 months of age. Blog Post 20.

•  ‘No Cry’ sleep solutions (‘Fading’ and ‘Check and Console’) may solve sleep problems. Blog Post 19

•  Communicate with each other and coordinate nighttime parenting practices.  Consider delaying your response to nondistress sounds your baby makes at night by 5-10 seconds, especially after 3 months of age.  Blog Post 18.

•  Encourage partner to help care for baby daytime and nighttime.  Be emotionally available at bedtime.  Seek help if your child is not sleeping well and there are symptoms of anxiety or depression for yourself or partner.  Blog Post17.

•  Encourage self-soothing; the earlier the better.  Consider leaving the room after putting your child down to sleep. Provide opportunity for naps based on drowsy signs.  Encourage partner to help care for the baby daytime and nighttime. Blog Post 16.

•  Plan for healthy sleep by focusing on sleep quality, not just sleep quantity. Provide opportunities for naps. Blog Post 15

•  Make a sleep plan that you are comfortable with; be flexible and tolerant.  Blog Post 14.

·  Become more aware of the difference between how you feel when well-rested versus mildly sleepy. Blog Post 13.

·  Try to maintain a regular sleep schedule.  Blog Post 12.

· Try to not respond immediately to every quiet sound your baby makes at night.  Blog Post 11.  

· Practice soothing to sleep and bedtime routines, every night, if possible. Blog Post 10.

· Watch for drowsy signs. Blog Post 9.

· Respect your child’s natural sleep rhythms.  Blog Post 8.

· Encourage an early or earlier bedtime (even a slightly earlier bedtime may produce better sleep.  Blog Post 6) especially at 6 weeks.  Blog Post 7.

∙ Recognize that a healthy brain requires healthy sleep. Blog Posts 1, 2, 3, 4, 5, and 38.

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