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JACKSONVILLE, Fla. -- It's shocking to many of us but more than 200 women a year kill their own children in the United States, according to a study by the American Anthropological Association. First Coast News sat down with a mental health professional to get an inside look into what makes these mothers snap.

Denise Marzullo is a proud, loving mom. Displayed on her desk and walls are photos of her 4-year-old son, Jonathan, who she says means everything.

"My son gets a cut and I want to cry," said Marzullo.

A recent case that made news headlines she says was difficult to see. Volusia County deputies say 32-year-old Ebony Wilkerson of Cross, South Carolina, drove a van with her three children inside into the ocean in Daytona Beach Tuesday afternoon. All four of them were rescued.

RELATED STORY: Woman allegedly mentioned demons before going into ocean

The mother is undergoing a mental health evaluation.

"There are a couple of things that could be going on," said Marzullo. "There are women who struggle with major bouts of depression."

Marzullo is also a mental health professional. During her 16 years in the business, she says she's seen and treated mothers who have felt as if they were at the end of their ropes.

"They just don't have the strength to keep going on," said Marzullo. "But that doesn't mean they don't love their child."

Unimaginable crimes have gripped the nation over the years. Diane Downs in 1983 shot her three children, killing one of them.

Susan Smith in 1994 drowned her two young sons pushing her car into a South Carolina lake, while the boys were buckled inside. Andrea Yates in 2001 drowned her five children in a bathtub in Houston, telling the police Satan ordered her to do it. China Arnold of Ohio was sentenced to life in prison for killing her 3-week-old daughter in a microwave oven in 2005.

Marzullo says there are cases where a person hears voices and it's difficult to distinguish what's real versus what's a part of their mental illness.

"It could be a very dangerous combination to where they could be hearing voices (saying) you need to die and take your kids with you," said Marzullo. "That's the only way you guys are going to be able to be together. They hear this constantly."

First For You, if you are depressed or going through a difficult time it's important to get help. Call United Ways 2-1-1, it's a free call and you can get a list of resources for help. The mhajax.org is a helpful site for resources and support groups.

Marzulla says it's important to reach out and tell someone because you're not alone.

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