Maternal depression may have deleterious effects on a young child’s emotional well-being and increase the risk that the child will develop depression in childhood. The more continuous and prolonged the mother’s depression, the more at risk a child will be for behavioral disturbances. Evidence is beginning to emerge that suggests that the period from six to eighteen months, the time for stabilization of attachment behavior and emotional regulation, is one of increased vulnerability for enduring effects of maternal depression on children’s emotional development.

Depressed mothers typically have difficulty providing contingent responses and optimal levels of stimulation and display less positive and more negative affect when interacting with their infants. During mother and infant interactions, there is reduced sharing of positive emotional states and increased matching of negative emotional states.

Depressed mothers and their infants spend more time engaged in mutual negative states, such as mother "anger-poke" and infant "protest", or mother "disengage" and infant "look away." These infants joined their mothers in inattentive or negative states, resonating with their mother’s depressed behavior.

Thus, the infant may develop depressive symptoms as a result of mimicking the mother’s depressed behavior. Infants may also fail to develop adequate means for regulating arousal and emotion because of the mother’s failure to provide optimal levels of stimulation and arousal modulation.

While the infant continues to be aroused and possibly overly stressed, he or she learns that reaching out behaviorally or affectively does not consistently elicit emotional sensitivity or comforting by the mother. Chronic ‘psychological unavailability," or emotional unresponsiveness, leaves the infant with fewer chances to feel secure in novel or stressful situations or to be effective in drawing upon others as a source of support for emotional regulation. This leads to the infant’s turning inward for self-directed strategies of arousal regulation such as self-soothing and self-stimulation behavior.

Infants of depressed mothers are behaviorally less active, vocalize less frequently, and display increased gaze aversion and fussiness. At the same time, they show higher heart rates and lower vagal tone. Additionally, children whose mothers are depressed typically have problems in self- control, poor peer relationships, behavioral problems, academic difficulties, and attention problems and are at higher risk for affective disorder.

It is also important to note that the mother who is depressed during pregnancy possibly exposes the fetus to an imbalanced physiological and hormonal environment and perhaps to other risk factors operating during pregnancy, such as malnutrition. Neonates born to depressed mothers tend to be less active, socially unresponsive and fussier than those born to nondepressed mothers.

It has been found that maternal depression occurring when the infant was fourteen months of age was predictive of behavioral problems during the preschool years, even when the depression was absent by the time the child was in preschool. Similarly, it has been found that maternal depression during the infant’s first year of life was predictive of lower cognitive ability at four years of age, regardless of mother’s depression status when the child was four.

Infants are particularly vulnerable to long-term effects of material depression if mothers remained depressed after the infant is six months of age. Infants whose mothers’ depression remitted by six months of age were not found to have cognitive delays and emotional symptoms at one year of age.

Young children of mothers with depressive symptoms at eighteen months but not at five years appear to be at increased risk for anxiety symptoms at age five.

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