Sheila Marcus, MD
“What’s exciting to me is the possibility of understanding potential risk factors for depression as early as the first days or weeks of life.”
When asked about her career in child and adolescent psychiatry, Sheila Marcus modestly underplays her rather extraordinary accomplishments in the field, which include decades devoted to helping children thrive, supporting women through childbearing, parenting, and periods of anxiety throughout the lifespan, and offering strength to families under stress.
Marcus calls her path to the field of child psychiatry “circuitous,” arriving there through a strong interest in promoting child welfare and in finding ways to boost children’s resilience in the face of challenge and adversity. A key part of her research focuses on prenatal development and the genetic factors and environmental influences of the womb that may be involved in a baby’s earliest emotional development.
“I began working with pregnant women pretty early in my career and began screening pregnant women for depression, and then became interested in the neuroendocrine impacts of depression on developing babies. So I first began studying pregnant women and infants very early in course of their development, namely in utero, and then began looking at infants within the first three years of life, and at things that we could do to protect babies both from the genetic and neuroendocrine influences of depression during pregnancy,” Marcus says. This includes looking infant cord blood levels to determine the effect of a mother’s depression on her baby’s stress hormones.
This part of her research has evolved to focus on improving the understanding of how maternal stress affects infant development, and finding ways to minimize the impact of stress on mothers and their developing fetuses. This work aims to develop improved mental health treatment strategies for women during their childbearing years with the ultimate goal of preventing intergenerational transmission of risk.
For many years, Marcus and her team have been working to enhance interventions that can improve the connections between underserved, high-risk children and their caregivers. Mothers who have a history of trauma and/or depressive illness “have different kinds of challenges in developing secure attachments to their babies,” Marcus says. “We’re in the process of developing a number of interventions to try to support mothers in developing secure, comfortable relationships with their kids.” They have found that mothers who participate in their interventions come away with more solid bonds to their children, and they also report that their children’s behavior improves as a result of their participation.
“We know that in many ways, the [parent/child] relationship really helps shape the human brain within the first several years of life,” she says. “So we’re teaching parents the skills they need to create secure relationships, which really forms a child’s capacity for intimacy throughout their lifespan.”
Marcus is also developing similar strategies for military families struggling to maintain stability through the precariousness of the deployment cycle. Through an educational intervention under the M-SPAN (Military Support Programs and Networks) initiative , Marcus has found that distressed military families have greatly benefitted from supportive activities aimed at strengthening both marital and parental bonds in relationships that have been placed under the strain of separation and reunion.
Marcus says the Depression Center fosters interdisciplinary research connections that, for her work, are absolutely essential. “Bringing together investigators who have different mindsets and capacities to influence depression and its treatment – from nursing to schools of public health, social work, psychology – is one of the ways that the Depression Center supports better understanding of depressive illnesses,” she says. “I think that the way that the Depression Center will most influence this is by understanding patterns of risk and resilience in people very early in life so that we can better identify and treat depressive illnesses – or, better yet, identify people at risk before the illness is present.”