By PANDA (Post and Antenatal Depression Association)
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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 parents. Postnatal depression (PND) can make this time even more confusing and distressing. But there are ways to support a woman suffering from PND.

What will it mean for you?

Be aware that many of the stressors or problems that you perceive during the period of PND might not be an indicator of your relationship. Rather, they’re consequences of the illness. 

Your partner might be saying or feeling things that she doesn’t really mean. These might be symptoms of the illness and the way she’s feeling at the time. It can help to understand that this is the PND talking. Try not to take these things personally.

You might feel very worried or concerned about the wellbeing of your partner or her ability to look after your baby and any other children. This experience might be the first contact you’ve ever had with mental illness. You might not even have 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 might lose interest in having sex with her partner. Try not to take it personally if your partner doesn’t feel like having sex. She might 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 her fear of subsequent pregnancy might also be issues. 

Ways to help your partner

Sometimes it can be very difficult to know how to help your partner. You might feel that whatever you say or do isn’t helping her to feel better. You might feel that you’ve tried many different things that haven’t worked.

Although it’s natural to feel that you should be able to help fix your partner’s distress, she’ll need more treatment and support than you can provide. Try to focus on providing practical and emotional support, and ensure that she receives these extra services.

Providing support for her treatment

  • Make sure that your partner has sought proper medical assessment and ongoing monitoring. Also check that she’s accessing other support resources such as counselling, support groups or helpful friends and family. 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 still discuss the options and the advice of her treating health care professional together, and decide on the best course of treatment.
  • Don’t be afraid to ask your doctor or health worker for accurate information about PND and its treatment. Getting information about PND is important for you to understand some of the symptoms of the illness. It will also help you to be aware of what might be the most supportive way to help your partner and yourself. There might be times when you will question the validity of the illness. Be assured that PND and its symptoms are very real for your partner. With proper treatment, it can be resolved.
  • Taking medication can present issues of concern for many people. You might like to learn about the medication and how it should be taken. Talk to the doctor, pharmacist or drug information lines. Try to be supportive if medication is required. Encourage your partner to take it until the doctor says otherwise. This is very important for her recovery.
  • If it’s 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’ll 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 the stay in hospital. 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. You could also spend time with your other children if this isn’t your first baby.

Providing emotional support

  • Don’t worry if you feel that you don’t know what to say. It’s a difficult time for you both. You’ll learn the best way to deal with it together. Try to be patient and reassuring. This might be better than responding with logic and advice, which your partner might misunderstand. It could also make her feel more incompetent.
  • Try to validate her experiences or worries and understand that they’re very real for her. This is the case even if you think her concerns aren’t 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’re 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. She might just want you to listen and let her know that you’ve heard her.
  • Try not to be discouraged if she seems withdrawn or you don’t get a response from her. There will be a time when she can respond and will be able to express gratitude for your support.
  • Encourage and support her accomplishments, even the little things. Knowing that you’re OK 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’s lazy if the housework isn’t done and she’s resting. She might be feeling exhausted, which is a very common symptom of PND. Rest is very important for you both. Other things can wait.
  • At all times, be reassuring of her relationship with your baby. There might be times when she struggles to take care of the baby herself and you or others need to take over. Always reassure her that she is the baby’s mother. 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 (for example, buying a house). If possible, wait until she recovers. You might find that many of the problems or issues that you thought existed start to resolve themselves as your partner recovers.
  • You will be told that PND is temporary, but she might 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’. This might be better than saying, ‘Don’t worry about it. You will get over it’.
  • Also try to reassure your partner that you’ll stand by her. One of her fears might be that you’ll tire of her and the illness and leave. 
  • Try to reassure your partner that you’re OK if she isn’t interested in sex for the time being. Touching or cuddling might 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 might be difficult if you work long hours, but your partner will benefit from any involvement that you can give. Identify a task that you can make a part of your routine – for example, bathing the baby.
  • If family members offer 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 food. 

Problems that might arise for you

  • You might feel more tired or exhausted if your sleep is disturbed, or you’re worried about the wellbeing of your partner.
  • You might feel anxious and confused about what’s happening to your partner and whether she and the baby will be OK.
  • You might feel a sense of loss that the woman you knew has gone and that you don’t know how to help her come back. 
  • You might 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 might also feel concerned about your family finances, especially if you’re needed more at home. 
  • You might feel like you want to withdraw from your partner and home life by spending long hours at work. You might also feel like increasing your use of drugs and alcohol. Try to avoid these situations. They are likely to cause additional problems.
  • You might be experiencing a loss of social contacts and feeling unsupported. This can happen as the need for you to be at home and cope with other family demands increase. 
There is a risk of depression in men after childbirth (the estimates are around 10%), especially if you’ve experienced depression before. Having a partner with depression and the extra stress and responsibility you face might also put you at risk. Make sure that you look after yourself and build your own support network.

Support for yourself

  • Don’t forget that you need special attention at this time too. Make sure that you have someone you can talk to about your concerns and frustrations – for example, a trusted family member, friend or your doctor.
  • Give yourself credit for what you’re doing. It’s OK for you to feel disappointed or frustrated about the situation, without feeling guilty. It’s natural to feel this way, because things aren’t going the way you expected. Try not to let these feelings get the better of you, and avoid expressing anger and resentment towards your partner.
  • 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 affects you as a family. You should get help that benefits all of you.
  • Don’t blame yourself. PND is no-one’s fault.
  • Get plenty of rest. You might be waking up frequently throughout the night to tend to the demands of the baby, or your partner’s sleeplessness might be disturbing you. If so, you’ll need to catch up on your rest and sleep at other times.
This is temporary. Your partner will recover with the appropriate help.

Danger signs to look for

Always trust your instincts if you become more concerned about your partner’s wellbeing, your children’s wellbeing, 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 changes 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’s saying things that don’t make sense, or if she has delusions or hallucinations. 

Once your partner is receiving care, it can be a good idea to seek counselling yourself. You’ll be very affected, and you’ll also have many questions. Try to find a trusted health professional for yourself. 

Some things your partner says might 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.

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. There is a higher risk of PND 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. It can sometimes take many months. But if you persevere, you’ll be rewarded with the family you’ve been waiting for.

Video: practical ways to help new mothers

Download Video  13mb

If you’re a new father whose partner is suffering from PND, it can be hard to know what to do.

A good place to start is with the basics. The dads and mums in this short video have lots of practical suggestions for helping with everyday activities like feeding, changing and settling baby, and giving mum time to rest. Dads also share their experiences of supporting their partners in the period following birth.

 
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    Buist, A. (1996). Psychiatric disorders associated with childbirth: A guide to management. McGraw Hill: Sydney.

    Dalton, K. (1996). Depression after childbirth. Oxford University Press: Oxford.

    Hamilton, J.A., & Harberger, P.N. (Eds) (1992). Postpartum psychiatric illness: A picture puzzle. University of Pennsylvania Press: Philadelphia.

    Kleiman, KR., & Raskin, V. D. (1994). This isn’t what I expected: Overcoming postpartum depression. Bantum: USA.