Post-Partum Depression: What You Can Do

By: Shoshana Bennett, Ph. D.
Image By: Nihan Aydin, Stock.xchng
January 7, 2008

Editor's Note: This article is the second in a series by Dr. Bennett. The first article, an overview of Post-Partum Depression, can be found in our December 3 issue by following this link: Post-Partum Depression: What You Need To Know.

When your wife has postpartum depression (PPD), which affects about 1 in 7 women after childbirth, you might feel confused, annoyed, scared, sad, worried or any combination of these. My husband certainly did. You might be thinking, "Why can't she just be happy? What's wrong with her? Aren't new moms supposed to be happy now that the baby's finally here? What's going on?" Remember that PPD is a biochemical disorder which is no one's fault not yours or hers. Although you can't fix it like you can a broken cabinet or leaky faucet, it's your job to support her as she recovers.

Warning signs of PPD include anxiety, lack of energy, frequent crying, inability to sleep at night even when the baby's sleeping, low self-esteem, guilt feelings, appetite problems, irritability or anger, overwhelmed feelings, forgetfulness, decreased sex drive, and hopelessness.

The normal Baby Blues should be gone by two weeks postpartum, so if she's still feeling weepy, she needs help. Or, if the symptoms are more severe than the mild Baby Blues even during the first two weeks, don't wait get her help right away. You or she should call a healthcare practitioner you trust and ask for a referral to a therapist who specializes in postpartum depression.

Here are some pointers that will help you to help her and your relationship:

- Just being there with her is doing a great deal. Letting her know you support her is often all she'll need. Ask her what words she needs to hear for reassurance, and say those words to her often. Things like, "We'll get through this. I'm here for you. I love you very much. You're a great mom. The baby loves you. You'll get yourself back. The PPD is temporary. I'm sorry you're suffering that must feel awful. This isn't your fault."

- Share at-home responsibilities. Even a non-depressed new mom can't realistically be expected to cook dinner and clean house. She may be guilt-tripping herself about not measuring up to her own expectations and worrying that you'll also be disappointed with her. Remind her that parenting your child(ren) and taking care of your home is also your job, not just hers. Your relationship will emerge from this crisis stronger than ever.

- Let her sleep at night. She needs at least 5 hour of uninterrupted sleep per night to receive a full sleep cycle and restore her biorhythms (Chapter 11 of Postpartum Depression For Dummies explains in detail how splitting the night can work even if she's breastfeeding or you need to leave the house early for work.) If you want your wife back quicker, be on duty for this time without disturbing her. Many dads have expressed how much closer they are to their children because of nighttime caretaking. If you can't be up at night taking care of your baby, hire someone who can take your place. A temporary baby nurse will be worth her weight in gold.

- Get the support you need so you can be there for her. Often a husband becomes depressed during or after his wife's depression. You can help protect yourself by getting your own support from friends, family, or professionals. Regular exercise or other stress-relieving activity is important, so you can remain the solid support for your wife. Provide a stand-in support person for her while you're gone.

- Don't take it personally. Irritability is common with PPD. Don't allow yourself to become a verbal punching bag. It's not healthy for anyone concerned. She feels guilty after saying hurtful things to you and it's not good for her. If you feel you didn't deserve to be snapped at, calmly explain that to her.

- Back her up in her decision- making. If your wife needs to see various practitioners, take medication, join a PPD support group, stop breastfeeding, or whatever else, she needs to know you're behind her 100 percent. You can certainly participate in the decision-making process, but the decisions themselves are ultimately hers.If you're the one returning from work at the end of the day, make sure you greet your wife first, before you greet any other member of the family (including the furry, four-legged ones). The relationship with her is the most important one and without it, no other little person would be there (see Chapter 15 for other sex and intimacy issues).

It can be helpful for you to accompany her to a therapy or doctor's appointment so you can ask any questions you may have regarding her treatment. As a therapist, I find the partner's attendance useful and I encourage it at least once. My client is always relieved to know that her husband is getting support and now understands more about her situation and the illness.

- Don't mention how much her care costs. She's already feeling guilty about what she's costing the family, both emotionally and financially. Without your wife's mental health in tact, nothing else matters. During PPD recovery, couples may use up savings and take out loans consider it an investment in launching your new family in a healthy way. Be open to doing (and spending) whatever it takes to get her the right, specialized help, not just whoever is covered by the insurance plan.

- Practice the work/life balance. You've probably read your employee handbook about your company's work/life balance program. Now's the time to make it work for you. Tell your manager what's going on at home, that you need to leave work every evening on time, and that you can't take expended business trips for the foreseeable future. You may see this practice as career suicide, but it isn't. Many of my clients' husbands have taken parental leave, and have made the effort to be at home on time every night during this difficult period. Federal law provides husbands job-protected time off from work following the birth of a baby or to care for a seriously ill spouse. If you're a domestic partner, it depends on the state in which you live whether or not you'll be covered.

If necessary, go ahead and move off the corporate fast track to help your partner recover. Your physical presence to her is more important than the next promotion, and years from now, when you look back on your life, you'll never regret having chosen family over work. I hear over and over from my clients that they don't care about the big house (with the big mortgage). They just want their husbands at home. So, if you're thinking that it's for her and your kids that you're working long hours, traveling, and so forth, you may want to ask her what she thinks you many be surprised.

- Maintain intimacy. As you and your wife walk the road to recovery, it's important to maintain intimacy, even if it's (for now) void of any sexual activity. You may be rolling your eyes with the thought of "just cuddling." After all, what's the point of cuddling if it doesn't lead to anything? But for her, just being close to you and being held by you is comforting and healing. She may also have some physical healing to do following the birth process. Remember not to take her lack of interest in sex personally. This isn't a rejection of you it's mainly about hormones, brain chemicals, and life changes.

Refer to the first bullet for ideas of what to say to your wife that will truly help her. There are also some clear no-no's to avoid. Here are a few:

DO NOT say:

- "Think about everything you have to feel happy about." She already knows everything she has to feel happy about. One of the reasons she feels so guilty is that she's depressed despite these things.

- "Just relax." This suggestion usually produces the opposite effect! She's already frustrated at not being able to relax in spite of all the coping mechanisms that have worked in the past. Anxiety produces hormones that can cause physical reactions such as increased heart rate, shakiness, and muscle tension. This is not something she can just will away.

- "Snap out of it." If she could, she would have already. She wouldn't wish this on anyone. She can't snap out of PPD any easier than she can snap out of the flu.

Be patient, non-judgmental, and upbeat. With the right kind of professional help along with your consistent and loving support, your wife will recover and your marriage will likely be stronger than ever.

Dr. Shoshana Bennett is a licensed psychologist who founded Postpartum Assistance for Mothers in 1987 after her second undiagnosed postpartum illness. Dr. Bennett is the Immediate Past President of Postpartum Support International and a past president of California's state organization Postpartum Health Alliance. She is an author and noted guest lecturer, and her work has been the subject of numerous newspaper articles around the country.

Portions of this article were excerpted from Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression by Bennett and Indman and Postpartum Depression For Dummies by Bennett.

Links:

Beyond the Blues on Amazon.com
Postpartum Depression for Dummies on Amazon.com
Dr. Shoshana Bennett's website: drshosh.com