Having a baby is a time of joy but adjusting to a new baby in the family can be very stressful and demanding for both new parents. When the new mother is also experiencing Postnatal Depression (PND) this time can also be very confusing and distressing for her and her partner and family members as well. Your lifestyle has now changed with the addition of your new baby but it will not always be so difficult and you will be able to enjoy the blessings of your new family.
What will it mean for you?
Be aware that many of the stressor or problems that you perceive during the period of PND may not be an indicator of your relationship, but in fact are consequences of the illness. Your partner may be saying or feeling things that she does not really mean, but may be symptoms of the illness and the way she is feeling at the time. It can help to try not to take these things personally and to understand that it is the PND talking.
You may feel very worried or concerned about the well being of your partner or her ability to look after the baby or any other children you have. This experience may be the first contact you have ever had with mental illness, you may even have never heard of PND before. You might find it more difficult to leave your partner and go to work or you might find that she calls you frequently or tells you to come home from work.
A woman with PND may lose interest in having sex with her partner. Try not to take it personally if your partner does not feel like having sex. She may be feeling inadequate or self conscious about her body or her ability to be fully involved in this intimate aspect of your relationship.
Other factors such as her recovery from the pregnancy or childbirth, the effect of medication on libido and fear of subsequent pregnancy may also be an issue.
Ways to help your partner
Sometimes it can be very difficult to know how to help your partner and you may feel that whatever you say or do is not helping her to feel better. You may feel that you have tried many different things that haven't worked – it can help to keep trying different things and they may work the next time you try. There are some many things that you can do to help support your partner and yourself.
Providing support for her treatment
Make sure that your partner has sought proper medical assessment and ongoing monitoring, as well as accessing other support resources such as counseling, support groups or getting helpful friends and family involved. If possible, try to go with her to her medical appointments and be actively involved in her treatment (in most cases). Ultimately the decisions about her care will be hers but you can discuss the options and the advice of her treating health care professional together and decide on the best course of treatment.
- Do not be afraid to ask for accurate information about PND and its treatment from your doctor or health worker. Getting information about PND is important for you so that you can understand some of the symptoms of the illness and to be aware of what might be the most supportive way to help your partner and yourself. There may be times when you will question the validity of the illness but be assured that PND and its symptoms are very real for your partner and with proper treatment can be resolved.
- Taking medication can present issues of concern for many people. Try to be supportive if medication is required and encourage her to take it until the doctor says otherwise. This is very important for her recovery.
- If it is suggested that your partner be admitted to hospital or a mother-baby unit, this can seem very scary for you both. Be assured that she will receive appropriate treatment that will be necessary for her recovery. Having the baby with her ensures that the mother-baby relationship is not interrupted and can be enhanced by a hospital stay. Make the most of visiting times to maintain your contact with your partner and baby. Going home to an empty house, which you expect to be filled with your partner and baby, can be very disheartening. You could use this time to catch up on some rest or maybe spend time with you other children if this is not the first baby.
Providing emotional support
- Don't worry if you feel that you don't know what to say. It is a difficult time for you both and you will learn the best way to deal with it together. Try to be patient and reassuring, rather than responding with logic and advice, as your partner may misunderstand what you are saying or it may make her feel more incompetent.
- Try to validate her experiences or worries and understand that they are very real for her, even if you think her concerns are not warranted.
- Encourage her to express her feelings and not bottle them up. Be prepared to listen to her talking even if you feel that you are hearing the same things over and over. Try to remember that she might not need you to fix things or to offer her a solution but just to listen and let her know that you have heard her.
- Try not to be discouraged if she seems withdrawn or you do not get a response from her. There will be a time when she will be able to respond and will be able to express gratitude for your support.
- Encourage and support her accomplishments, even the little things. Knowing that you are okay with whatever she can manage and that you will chip in when you can, can be enormously supportive.
- Try not to tell her that she is lazy if the housework is not done and she is resting. She may be feeling exhausted which is a very common symptom of PND. Rest is very important for the both of you and other things can wait.
- At all times be reassuring of her relationship with your baby. There may be times when she struggles to take care of the baby herself and you or others need to take over, but always reassure her that she is the baby's mother and there will come a day when she can care for the baby fully herself.
- Try to avoid making any major decisions while your partner has PND, if possible wait until she recovers. You may find that many of the problems or issues that you thought existed start to resolve as your partner recovers.
- You will be told that PND is temporary but she may feel that it will never go away (which is a symptom of the illness). It will help to reassure her if you say something like, ‘I understand that you feel bad now, but the doctor believes that you will return to your old self again', rather than saying, 'Don't worry about it, you will get over it.'.
- Also try to reassure her that you will stand by her as one of her fears may be that you will tire of her and the illness and leave.
- Try to reassure your partner that you are okay if she is not interested in sex for the time being. Touching or cuddling may be more comfortable at this time, without leading to sex. It's important that you both communicate what you want and how you feel. If sex is still an issue perhaps you could talk it over with your medical practitioner.
Providing practical support
- Try to help out with the housework and baby care as much as you can. This may be difficult if you work long hours but she will benefit from any involvement that you can give her. For example identify a task that you can make a part of your routine, for example bathing the baby.
- If family members offer to help make sure that you take it. There is nothing wrong with allowing others to help with things such as housework or shopping.
- Offer to cook dinner or pick up take away.
Concerns for you:
- You may feel more tired or exhausted if your sleep is disturbed or you are worried.
- You may feel anxious and confused about what is happening to your partner and whether she and the baby will be okay. You might feel a sense of loss that the woman that you knew has gone and that you don't know how to help her come back.
- You may feel that the demands of your home life and the extra responsibilities of caring for the children are impinging on your time and demands at work. You may also feel concerned about your family finances, especially if you are needed more at home.
- You may be experiencing a loss of social contacts and feeling unsupported as the need for you to be at home and other family demands increase.
- There is a risk of depression in men after childbirth (the estimates are around 2-8%), especially if you have experienced depression before. Having a partner with depression and the extra stress and responsibility you face may also put you at risk so make sure that you look after yourself.
Support for yourself:
1. Do not forget that you need special attention at this time also. Make sure that you have someone you can talk to about your concerns and frustrations, eg a trusted family member, friend or your doctor.
2. Give yourself credit for what you are doing. It is okay for you to feel disappointed or frustrated about the situation without feeling guilty. It is natural to feel this way as things are not going the way you anticipated, however try not to let these feelings get the better of you.
3. Try not to feel that you have to do everything yourself. If you need a break, get a friend or family member to be with your partner and baby if necessary. Make sure that you get help as a family, PND effects you as a family and you should get help that benefits all of you.
4. Don't blame yourself, PND is no one's fault.
5. Get plenty of rest. If you are waking up frequently throughout the night to tend to the demands of the baby or your partner's sleeplessness is disturbing you, you will need to catch up on you rest and sleep at other times.
6. Remember that this is temporary and your partner will recover with the appropriate help.
Danger signs to look for
Always trust your instincts if you become more concerned about her well being or that of your children or any deterioration in her PND. It might mean that you need to contact her doctor or support services directly to let them know or to seek advice. For example, your partner might show any of the following signs and symptoms:
- Talk of harming herself or the baby
- Bizarre thoughts or speech patterns, or risk taking behaviour
- Behaviour that seems odd or is out of character
- Severe change in mood
- Withdrawal from all social contact
- Extreme despair
- Obsession with morbid ideas, or statements like 'you'd be better off without me'.
When your partner has Postpartum Psychosis
This is an extremely uncommon and difficult time for you and your partner. Communication with your partner will be affected if her thoughts are confused, if she is saying things that don't make sense or if she has delusions or hallucinations. If this happens it can be a good idea to seek counseling yourself as you will be very affected and you will also have many questions. Try to find a trusted health professional for yourself. Some things your partner may say may seem highly distressing or inappropriate, but try to remember that this is her illness talking. With appropriate treatment and support, the rate of full recovery is high and you will one day have back the woman that you knew.
For the future
If you are planning future pregnancies be sure to consult your health professional for medical guidance as there is a higher risk of PND a second time once a woman has already experienced it. Most medical practitioners recommend a woman should have discontinued medication for at least a year before attempting a subsequent pregnancy.
PND is very treatable and has an excellent prognosis for full recovery. However it can sometimes take many months, but if you persevere you will be rewarded with the family you have been waiting for.