Through the Storm: Dealing with the effects of postpartum depression on your relationship

By Angela Nunes

The birth of a new baby is an amazing time in a parent’s life.  Regardless of how many children you have, the birth of each new baby presents new challenges and experiences.  This is confounded when the mother suffers from Postpartum Depression (PPD). PPD is different from the “The Blues” which about 90% of all women experience after childbirth. These feelings tend to dissipate a few weeks after birth. The rapid decrease of hormones, adjustment to motherhood, and sleep deprivation are among many of reasons why women experience these feelings. When the symptoms persist and worsen, a mother may be diagnosed with PPD.

            PPD affects as many as 10-20% of women. Fathers can experience PPD as well. In fact, the risk for paternal depression increases when the mother is suffering from PPD. Perhaps one of the most common areas PPD affects is the couple relationship. Even couples without PPD experience a readjustment in their relationship. Often times, this is when couples will seek professional help. If there were problems in the marriage before the birth of a baby, they will be highlighted during the early phases of parenting. That is not to say that couples with a relatively healthy relationship before the baby don’t experience difficulty. These couples experience distress also and often are surprised by how much the baby has affected their relationship. These changes can lead to disappointment or disillusionment between the partners.

            PPD places a big black cloud over the relationship. The postpartum adjustment period, without PPD, can cause couples to get angry with other quickly, increased discord, decreased intimacy, decreased communication, decreased sexual desire and overall dissatisfaction with the relationship. Now add the weight of PPD in one or both partners…the results can be disastrous.  When a mother experiences PPD her self esteem is affected, she may have feelings about the baby she never expected she may feel that she has let her partner down or that she is not a good mother. Her husband may wonder “where is the woman I married?” or “why isn’t she getting better?”. She may reject the father’s attempts to help her. This leaves the father with a myriad of feelings including hopelessness, anger, resentment, confusion, feeling unloved or disregarded. These feelings obviously have terrible effects on the relationship but can also impede bonding with the baby. Getting professional help to discuss these feelings is important. A therapist can help the father express his emotions to his partner without creating increased separation. A therapist can also work on increasing positive communication, asking directly for needs and wants, negotiation and can provide a sense of normalization. For a woman experiencing PPD, a therapist will also be able to conduct an evaluation of symptoms and refer her to an individual therapist specializing in postpartum mood disorders if necessary.

            For fathers, it may become critical to learn effective ways to communicate with their partners. With decreased self esteem, guilt and sadness a mother is going to have a difficult communicating. Some fathers make the following statements:

“You’ll get over this”

“It won’t be this way forever” or “This will pass”

“If you just put your mind to feeling better you will”

“We have a beautiful baby, you should be happy”

“All of the other mothers don’t look like they’re having such a hard time”

All of these statements could be said in an effort to fix the problem or out of love and concern. However, someone with PPD might hear something along the lines of “Your feelings are wrong” or “You aren’t a good mother”. The amount of guilt that comes with PPD is enormous and it taints the way statements are understood.

            Some Dads have the feeling of walking on eggshells to avoid a disagreement. Here are some suggestions to deal with this difficult time:

1. Empathize…Don’t try to “fix the problem”: Say “It must be so difficult for you right now” or “I can’t imagine what you must be feeling”. Then invite her to explain what’s she’s feeling. Being honest about your inexperience with the feelings will give your partner the room to talk openly. When she does try to tell you how she’s feeling, avoid thinking of a way to solve it. Ask her what she wants. Does she want someone to listen and validate her feelings or is she looking for a suggestion.
2. Don’t judge: Your partner may have feelings about the baby or others in her life that may be difficult to hear. It is a common experience with PPD to have thoughts of hurting the baby or visualizing awful things happening to the baby. These thoughts and images are disturbing to a PPD mother. She’ll feel guilty about them and know that they are wrong. Don’t assume that having the thoughts means she will not be safe with the baby. Women suffering from Postpartum Psychosis will also have similar thoughts but will not know the thought are wrong and won’t feel disturbed by the thoughts. This is however, a time to get help. Tell her you would go with her to seek help or research options with her. Another way to prevent judging her is to become well informed about the postpartum experience. You’ll find out what common symptoms are, interventions and when to seek help. This information will be helpful for you but only offer the information if she seems open to it. If she feels judged, she’ll shut down and reject your offers to help.
3. Don’t tell her she needs medication: For many people, this can feel like a form of judgement. Do encourage her to seek professional help. You can say “We are both adjusting to the baby. How about if we go talk to someone that has experience with this?” Saying something like this removes to indication of the problems being one partners “fault” and allows the partners join together against a common/shared problem.  Let a professional make the determination about medication.
4. Give her time for self care: Ask if she’d like some time to rest or shower. She may resist going out by herself when you take over baby care. Don’t make statements about what she does with her time. Many moms will choose to stay home while Dad is taking care of the baby. It’s not a judgement of you, it’s likely she’s experiencing anxiety in addition to PPD. Cook dinner or bring dinner home to ensure that she is eating. Baby care can leave Moms so caught up in their day, they can’t remember the last time they ate, went to the bathroom or showered. Another suggestion is to participate in the baby care with her. For example, rather than telling her to take a break while you bathe the baby, enjoy doing the task together. Over time she will feel better about being away from the baby. Remember that many mothers feel an internal pull towards the baby that makes it difficult to be away from them. If she doesn’t want to be away from the baby, suggest some family time.
5. Gently encourage your partner to find support: Finding a safe supportive group of women can be an important asset to your partner’s recovery. If you can’t find a local support group, encourage your partner to consider joining an online mother’s support group. Many mothers state they are comforted by the ability to log on and post a question or write how she’s feeling whenever it’s convenient to her.
6. Find support for yourself: Join a Dad’s group or confide in a good friend. There are also online father support groups. Having a safe place to discuss your emotions, anger, and frustration leaves you in a healthier place to be there emotionally for your partner. She may not be able to provide the kind of support you need right now.
7. Get professional help early on: Don’t wait until your relationship is falling apart. Many fathers believe their partners feelings will pass. While PPD does seem to get better as the baby gets older, it can also reek havoc before it gets better. Feelings of resentment and anger do not just pass. Also, the depression just goes below the surface until it is treated properly. It will resurface again under stress and with subsequent pregnancies if not addressed.

Postpartum depression is difficult to deal with on various levels. It effects a mother’s perception of herself and those closest to her. It also effects relationships (both intimate and extended family), communication, sleep patterns, and in some cases attachment. The good news is that there are interventions that help PPD and its effects.

With understanding of the symptoms, empathy and patience you can be a great support to your partner. With professional help you and your partner can work on treating the PPD as well as discover new ways to communicate better. With these interventions a difficult relationship can become one that leads to good parenting, a deeper understanding of each other and a strengthening of the relationship.

  Angela Nunes is a Licensed Marriage and Family Therapist with a private practice in Campbell, California. She works primarily with couples, especially couples adjusting to the birth of a baby. Angela is also a mom of 2 wonderful little boys. She can be reached at (408) 813-1885 or angiemnunes@gmail.com