Maternal depression and family health context: tracking depression trajectories of rural, low-income mothers

ABSTRACT This study examined depression trajectories of rural, low-income mothers over 3 years in the co-occurring family health context. Specifically, within a Family Systems Theory framework, we compared 11 mothers who showed ongoing signs of major depression (“constantly depressed”) with 12 mothers who exhibited signs of major depression at baseline but whose condition improved over time (“continuously improved”). The constantly depressed mothers experienced more physical health problems, distrust toward health-care professionals, and a more negative outlook on their lives. While both groups of mothers reported similar struggles of dealing with children’s health, struggle to deal with children’s emotional and behavioral issues tended to be more profound issues among the constantly depressed mothers. These issues were accompanied by a set of challenges in the mothers’ lives, including limited childcare options, loss of employment, day-to-day behavioral management, and concerns for delinquent behaviors. The findings highlight the importance of family context in understanding maternal depression, particularly, among vulnerable rural populations.