Families in Psychiatry

When Your Patient With Depression Has a Family


Julie Totten was 24 years old when her brother Mark took his life. Shortly after, she helped her father, who had been suffering from undiagnosed depression all his life, get treated for the illness. In dealing with the depression that afflicted her father and brother, she felt alone, lost, and responsible. She thought there must be a lot of other families like hers.

So, 10 years after Mark’s death, Julie founded Families for Depression Awareness, a nonprofit organization to help families, including family caregivers like her, recognize and cope with depressive disorders to get people well and prevent suicides. The organization’s website, helps families recognize and cope with depression, and focuses on getting people into treatment to prevent suicide.

Dr. Bill Beardslee, chairman of psychiatry at Children’s Hospital Boston, lost an older sister to suicide when he was in medical school. "The depression took her over and after a valiant struggle against it, she took her own life some years later.

"It has taken me many years to deal with that and many conversations with my father, my mother and my wife, my friends, and, more recently, my children. Above all, it has given me a sense of how awful this illness can be for families," he wrote on the Hachette Book Group website. In his book, Out of the Darkened Room (New York: Little, Brown & Co., 2002), he describes the experiences of families with depression and strategies that families find helpful. It is highly recommended to psychiatrists to share with their patients and families.

Parents with depression worry that their children are suffering. Dr. Beardslee, who also is the Gardner-Monks Professor of Child Psychiatry at Harvard Medical School, Boston, has developed interventions with his colleagues aimed at helping these families. A major goal is "breaking the silence and helping the family talk together about depression." He conceptualizes depression as a chronic medical illness but also a family calamity and has developed an intervention to help families talk together and make meaning together.

His website, Families Preventing and Overcoming Depression provides details on the Family Talk Preventive Intervention. This is a public health, strength-based, and family-centered intervention designed to support families in which one or both parents have depression. This evidence-based practice partners with families to improve relationships and functioning by educating families on depression risk factors and understanding the benefits of applying protective factors to promote resilience.

Dr. Beardslee has many international collaborators in many different countries: Australia, Finland, the Netherlands, Norway, Sweden, Columbia, Costa Rica, and Iceland. Family interventions in these countries are supported by government, and in the public health, and medical and mental health systems. Interventions in these countries are more widespread and systematically available than they are in the United States.

A symposium on this topic will be held at the American Psychiatric Association’s annual meeting in Philadelphia, moderated by Dr. Ellen Berman. It is called "When Your Patient Is a Parent: Supporting the Family and Addressing the Needs of Children." As part of that symposium, Dr. Beardslee will present "Clinical Implications of Evidence-Based Preventive Interventions for Families With Parental Depression." Finally, Ms. Totten will present "A Family Perspective," and I will present "Overview of Needs of the Children of Parents With Mental Illness." See you there!

Dr. Heru is an associate professor of psychiatry at the University of Colorado at Denver, Aurora. She has been a member of the Association of Family Psychiatrists since 2002 and currently serves as the organization’s treasurer. In addition, she is the coauthor of two books on working with families and is the author of numerous articles on this topic

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