There is nothing more joyful for parents than to bring home an adorable new baby. Couples look forward to the exciting role of parenting as they watch their child take first steps, say their first word and fill their lives with pride during school recitals, sport activities and graduations.

With that said, parenting can also be exhausting.

The weight and responsibility of parenting children at any age can be stressful for parents emotionally, physically and financially, even when a child is healthy. 

But what if a child is not? 

What does stress look like for parents who are raising a child with a chronic illness? Can the additional stress of a child’s medical and developmental needs cause silent depression? 

In a word, “Yes.” 

Parents raising children with special needs have additional fears and worries that weigh heavily on every aspect of their lives.

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Seven reasons silent depression often remains unnamed and unaddressed

1. They often fear their child will struggle and experience deep feelings of rejection by those who exclude them.

This happens when others are unable to look beyond the challenge of getting to know the person with the disability. Unfortunately, this is a far too common occurrence that most parents of special needs kids face more often than you might imagine. 

In addition to dealing with worry and fear, parents also have additional tasks that go above and beyond what is typically expected of most parents. Parents of children with special needs may have to feed, bathe, communicate and/or transport their child everywhere, regardless of how old the child (or adult) is.

2. They may spend hours on the phone with insurance companies or at doctor's and therapy appointments supporting and advocating for their child’s care. 

Parents in this situation tend to experience prolonged chronic stress for years, especially if they care for their child throughout adulthood. Exposure to this type of stress can cause a silent depression that is ignored for a very long time.

Robbing parents of their joy and vitality. With all of their awareness about the medical help and support that’s available, the question remains why do parents who experience this kind of depression choose to not get help for themselves?

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3. They put a lot of effort into appearing happy, content, productive, and in control.

Parents spend an enormous amount of energy trying to stay positive. In time, they habitually learn to hide the feelings of depression, even from themselves. Parents who believe it is their responsibility to keep everyone positive and upbeat learn to hide feelings of sadness, helplessness, and exhaustion. 

In time, hiding vulnerabilities becomes a habit and feelings of depression are often pushed aside and not addressed.

4. They attribute symptoms of depression to irregular schedules and lack of sleep. 

Caring for a child with special needs often requires one’s schedule to become irregular and spontaneous. Parents often stay up all night and skip meals. The overwhelming schedule prevents one from fully attending to exercise, nutrition and self-care needs.

The continuous cycle of fatigue, poor nutrition and anxiety can exacerbate or even cause symptoms of depression. In this case, depression remains silent because they don’t see the symptoms as related to their mental health, but instead attribute them to schedule and sleep irregularities. 

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5. They may attribute symptoms of depression to worry related to their child’s illness. 

Parents who understandably feel sad, worried and anxious may relate those feelings to how they feel about their child’s illness or developmental delay. Parents also worry about the stigma of their child’s illness and how that stigma may contribute to their child being rejected. Worry and anxiety often overshadow the realization that they too may be feeling down and depressed.  

6. They may not recognize “not so obvious” symptoms. 

Silent depression is not always obvious. Symptoms can emerge in the form of negative thinking, irritability, pessimism, loss of concentration, health complaints, using mood altering substances and disinterest in activities that were once joyful. 

Parents often link “not so obvious” symptoms to the non-stop routines of everyday caregiving and not to silent depression. They hide behind typical measurements of depression such as, “Have these symptoms persisted longer than two weeks?” This question is included on the list of diagnostic criteria used to measure the duration of depressive symptoms.

For parents who have been caring for a child with a chronic condition such as epilepsy, leukemia, autism or other mental illness, the answer to this question is almost always “yes.” For these parents, a two-week measurement is not reflective of the pattern of symptoms experienced or the coping skills learned along the way. 

Silent depression is often hidden behind clinical measurements used for individuals who are not caring for a chronically ill child. Without looking beyond two weeks and into the chronic patterns of social, emotional and behavioral changes, silent depression is often missed from both the parent and even a mental health practitioner or doctor.

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7. They worry about their child’s future in terms of acceptance and ability to live independently. 

Parents often worry about the future, although they cannot control aspects of what is next for their child. They also worry about how their child will cope in the future.

How will their child experience having a chronic illness?  Will they stay positive and resilient? Will they be happy and connected with family and friends, or be isolated?

Worrying about what you cannot control can often exacerbate symptoms of anxiety and silent depression. 

If you or someone you love is struggling with the balance between life and caregiving responsibilities for someone else, please reach out to a group or someone. Get support. Learn from other parents who understand your journey.

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Nancy Musarra is a clinical psychologist and author of the book, the New Normal: 7 Things to Know as You Care for & Love a Child with Special Needs. She shares her clinical expertise in the area of developmental disabilities and mental health challenges through her workshops, books, and consultations.