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BYU study says depression is different for dads. But can athletes like Tanner Mangum help foster change?

When moms and dads get depressed, they express it differently: Moms internalize it and may become more withdrawn or seem indifferent or hostile to their children. Depressed dads are more likely to get angry and yell or punch a wall.

Both responses are bad for children, impacting relationships and children's well-being, according to a study by researchers at Brigham Young University that adds to a body of work suggesting parents who are depressed need to seek treatment — not just for themselves, but for their kids.

Brigham Young Cougars quarterback Tanner Mangum (12) talks with media after BYU football alumni day practice in Provo on Friday, March 31, 2017. He discussed the challenge depression has posed in his life during a recent #MentalHealthMatters campaign the university sponsored. | Jeffrey D. Allred, Deseret News

The new study is one of the first to focus largely on how depression impacts men when it comes to parenting. It found the children of depressed dads — both boys and girls, with no real difference — have two possible outcomes, labeled externalizing or internalizing, said Kevin Shafer, associate professor of social work and lead author of the study, published in the academic journal Social Work Research.

"We see internalized problem behaviors, things like kids having low self-esteem, being anxious, feeling depressed, withdrawing from others, those sorts of issues," he said. Externalizing behaviors include things like aggression, hyperactivity and noncompliance, such as lying, cheating, stealing and bullying.

The impact of depression on families is a big deal because childhoods are formed largely on parent-child relationships. Depression is the most common mental health challenge in America, impacting nearly 1 in 5 people at some point in their lives. Each year, about 7 percent of Americans have a major depressive episode.

Mom versus depression

More studies have looked at maternal depression than paternal depression, but those studies typically focused on the effect on very young children, up to age 5, because that's such an important developmental period. The BYU study focused on parental major depression and what it does to adolescent children.

Shafer and BYU graduate students and study co-authors Brandon Fielding and Doug Wendt looked at the sixth-grade and age-15 waves of the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development.

The complex data set was collected at 10 different sites nationwide and includes different types of data, from videotaped interactions between parent and child to in-depth interviews. The depression data was based on questions used to uncover the symptoms of depression included in the "Diagnostic and Statistical Manual of Mental Disorders."

Previous studies of women with major depression have shown that the kids do worse on a variety of measures over the course of years as a result of the way the women behave as parents. Shafer said they're typically less warm and engaged, less likely to hug their kids or monitor their behaviors and actions. When their kids are older, depressed mothers often seem more hostile, such as assigning ill intent when a child does something wrong.

For a depressed dad, it isn't his behavior as a parent, but his overall behavior that provides direct negative effect on his children. "We believe this is because depressed dads are more likely to act out in anger — think hitting walls or yelling — than to express low-self esteem or feel worthless as a person," Shafer said. "So while depression works through parenting behaviors to affect children for moms, dads' depression directly affects their kids."

If both parents are depressed, it's "super-bad," said Shafer, probably in part because with one depressed parent, there is the hope that the other takes up slack. If both are depressed, that doesn't happen.

For the future

United States' Allison Schmitt watches the swimming competitions at the 2016 Summer Olympics, Thursday, Aug. 11, 2016, in Rio de Janeiro, Brazil. Last week, Olympic swimmers Michael Phelps and Allison Schmitt both discussed their personal battles with depression. | Lee Jin-man, Associated Press

Depression is a topic that's increasingly being "owned" by high-profile people that it affects. Last week, Olympic swimmers Michael Phelps and Allison Schmitt both discussed their personal battles with depression. At BYU, noted quarterback Tanner Mangum discussed the challenge depression has posed in his life during a recent #MentalHealthMatters campaign the university sponsored. A post he made on Instagram was widely shared for a national audience.

Among other things, he wrote: "Mental illness is one of my personal battles and I want to offer my love and support to all those who suffer in one way or another. You are not alone. There is help. Let's focus on accepting and loving one another for who we are and celebrate our humanity. It's a beautiful thing. Let's erase the stigma surrounding mental health."

The study's authors and researchers have high hopes for what their work may prompt.

"The biggest thing for me is not only could it change the way I see men's help-seeking behaviors, but it also changes the way I seek help as a man. Society has taught us that our role is to take care of others and that if we take care of ourselves, we're being weak," said Fielding, a study co-author who recently graduated with a master's in social work. "That's so backwards. How are we supposed to take care of others if we are not doing that for ourselves?"

The researchers hope their findings will encourage men to seek professional help for mental health issues, something Shafer said they do at half the rate that women do. "Our hope is fathers will see that if they are depressed, they can be affecting their kids in important ways … that are predictive of all kinds of things like how the kids will do in school, whether they will graduate and go to college. It could really impact their life chances if the fathers don't get help. And depression is a really treatable issue."

He noted that some men who are depressed may not recognize it; they think that's just how life is.

Olympic swimmer Michael Phelps testifies on Capitol Hill in Washington, Tuesday, Feb. 28, 2017, before the House Commerce Energy and Commerce subcommittee hearing on the international anti-doping system. Last week, Olympic swimmers Michael Phelps and Allison Schmitt both discussed their personal battles with depression. | Susan Walsh, Associated Press

They also hope that social workers and clinicians will consider parental depression as they try to understand an adolescent's behavior and that clinicians and others should talk to both parents and adolescents about the impact that parental depression can have on how the family functions.

The researchers note limitations of the study, including that the sampling is not nationally representative and over-represents individuals from advantaged backgrounds. They said they would have liked to hear from the adolescents themselves on their behaviors, but the study was only able to consider mothers' reports of the adolescent behaviors.