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How to Help Your Wife With Postpartum Depression

Mar19

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This was left in the comments section of the Birth Control and Postpartum Depression column from a few weeks ago. I trust you’ll agree that it’s important enough to merit a full response.

I am a concerned husband. My wife and I are very much in love but have had a rocky marriage to say the least, and we had our second son now going on 6 months ago. About 2 months ago my wife started the mini pill and in the last month has become very unhappy. She has very emotional breakdowns and just starts crying and is self proclaimed depressed at times. She is breast feeding and was very aware that her hormones are out of whack just from that. Some days are good but many are very bad. On her worst days she has gone as far to say she thinks she wants a divorce, She now also claims she is no longer in love but is trying. Our sex life was very limited prior because of the breastfeeding and the affect on her hormones and it was similar after our first son but now it is non-existent. All of this feels like it is out of nowhere and in the last month or so. We both agreed it could be the pill and she is finishing this cycle and then her doctor prescribed her the patch. Am I crazy or is this from the current pill and possibly ppd. Is the patch a bad alternative? Should I convince her to be evaluated? (she is very stubborn when it comes to these things) Thoughts?

Adam

No, you are not crazy: this very much sounds like a bad reaction to the mini-pill or postpartum depression, or both. (I’d put my money on both, actually.) Yes, the patch is a bad alternative, as is any other hormonal birth control. Yes, you should VERY MUCH convince — nay, INSIST — that she get evaluated for PPD (postpartum depression).

You should also volunteer for couples’ therapy to address the stated pre-baby rockiness of your marriage. I mean, that’s just flat-out a good idea, especially with the added strain of a second baby and all, but it’s important that you don’t seem like you’re blaming all the stuff she says (divorce, not in love anymore) on the fact that she’s “depressed” or “crazy” or “not herself.” Whether or not it’s simply the pill or PPD, don’t devalue what she says she’s feeling. It’s likely very hard for her to see beyond the clouds that have settled over her right now, but that doesn’t mean there aren’t some very real feelings under there that need to be addressed.

For the record, symptoms of PPD include: Insomnia or extreme fatigue, anxiety, lack of interest in the baby OR irrational concern over the baby, feeling hopeless or overwhelmed, withdrawing from physical and/or social contact, thoughts of harming self or the baby.
Low (or non-existent!) libido is really common for women after giving birth, even without PPD, but the “emotional breakdowns” and overwhelming sadness and threats of divorce you’re describing are NOT. PPD symptoms can start out mild (similar to the “baby blues,” just a general sense of sadness, irritability, crying spells, mood swings) but get worse over time. Much worse, and often progress quite rapidly. I’m not a doctor and don’t know your wife, but it’s possible that she was suffering from an extended case of baby blues and the mini-pill accelerated things into full-blown PPD. Simply changing birth control is not going to cure that. She needs help, and she needs it now. If she won’t call her OB or a psychiatrist herself, call for her. Tell them everything you typed here.

Other things to do:
1) Tell her you love her. Tell her you love your family, the children, the baby and that they love her too. Tell her this ISN’T HER FAULT.
2) Attend doctor’s appointments with her. I’m guessing, given that her doctor went and prescribed the patch as an alternative, that she’s not telling him/her the real story. (A good OB would know to take any and all hormonal birth control options off the table for a woman complaining of possible PPD.) She could be ashamed or in denial — this is normal, but you might need to speak up on her behalf for awhile.
3) Give her breaks. Take over chores around the house or hire a cleaning service, if possible. Take the kids out with you so she can rest or do whatever she wants without feeling guilty. Send her to the movies, make dinner, basically anything you’d step up and do if your wife was critically ill. Which (if it is PPD), SHE IS.
4) Make sure she’s getting enough sleep. Sleep deprivation, though almost inevitable when caring for and breastfeeding a new baby, exacerbates the symptoms. (Maybe this could be the changing factor between her “good days” and “bad”?) If she still needs to nurse at night, let her stay in bed while you retrieve the baby and handle all the night-time diaper changes. Offer to give the baby a bottle (pumped milk or formula) at night, no guilt involved: I am all for breastfeeding but big-picture-wise, the baby needs a healthy, rested, functional mother.
5) Attend a PPD support group in your area — your wife’s OB or hospital or birthing center can help you find one. Go with or without her (though try to find a friend or family member stay with her while you’re out). This will help you know how to help her waaaay more than one little online advice columnist. (Check out Postpartum Support International or call 1.800.944.4PPD)

Good luck, dude. Thank you for paying attention and seeking information and advice: Now it’s time to bring in the Big Medical Guns and get your wife some professional help. Again, it’s not her fault, it’s not your fault, it’s not the baby’s fault. It’s extremely common, but even more important than that, it’s completely treatable and curable.

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About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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15 Responses to “How to Help Your Wife With Postpartum Depression”

  1. Muirnait Mar 19 at 9:49 am Reply Reply

    IMHO, one of the things a husband can also to do help if the hormonal BC is causing a lot of trouble is offer to take care of birth control himself – that he can be in charge of buying condoms (and not complaining about using them!) or even getting a vasectomy (after a time when they’ve decided they don’t want any more children.)

  2. Muirnait Mar 19 at 9:52 am Reply Reply

    Oh, and that being said, because I just realized I sound like a bit of an abrupt jerk, kudos to the husband for doing his best to help, and for seeking further ways to do so.

  3. Nel Mar 19 at 9:53 am Reply Reply

    Adam, I just wanted to say that I am really proud of you for seeking help on behalf of your wife. I hope my husband would do the same for me. Good luck. Things will get better!

  4. Anonymous Mar 19 at 10:05 am Reply Reply

    Mirena is another option. Easy to use, easy to get inserted, and perfectly fine for breastfeeding. I had PPD with #1, and #2 is now 5 months old. I went on medication this time around because of my previous PPD, and it has truly been a HUGE help. I know this isn’t what everone wants to do, medicate themselves, and it may only hurt your current sex life, but it is truly amazing at how different things are this time around.
    I have to say that I love how you are working to help her. All the advice given is very good. I LIVED for those few breaks I would get from the kids, so make sure you do that if you can. Good luck!!!

  5. Kiesa Mar 19 at 11:23 am Reply Reply

    I second the suggestion of giving her breaks. I should point out this is especially important when the children are crying, not just when they’re happy . . .
    My husband thought I should get counseling after our baby was born but I resisted because I couldn’t figure out how to fit it into my schedule. That may sound insane to some people but I was so overwhelmed I couldn’t figure out how to stop long enough even in hopes of making it better. Eventually, I decided that the days I went to counseling I got a treat of some sort such as getting takeout for supper. I’m still not terribly excited about taking the time to go to a counselor but at least now I have something to look forward to after it’s over.

  6. Bethany Mar 19 at 12:06 pm Reply Reply

    I just want to give some support to the husband. That sounds like hell. My bf has been helping me deal with(nonpregnant) anxiety and I can’t say how much it means to have someone step up and say “hey, do you need me to call someone for you?” or just pitch in and do the dishes when I can’t because I’m behind on work because I panicked earlier in the day.
    Some part of your wife will recognize that you’re trying to help and even if she can’t express it, I’m sure she’ll appreciate it.

  7. B Mar 19 at 1:52 pm Reply Reply

    This is a bit of a side question. (Or several.) How common is it w/ PPD to voice feelings of not being in love and wanting a divorce?

  8. Jen & The Amazing Trips Mar 19 at 4:27 pm Reply Reply

    Now that I look back, I’m certain that I, too, had PPD. When our fourth child was born, our triplets were two. So, we had four children under the age of three. I remember, very clearly, locking myself in the broom closet one day and contemplating how to get OUT from it all.
    Here I was, a woman that had wanted nothing more in her life, than to become a mother. We went through hell and back undergoing years of treatment and thousands of dollars spent. And then, before our triplets had even turned two, BOOM, I was pregnant with a surprise baby.
    Amy, your advice is right on.
    To Adam, lend your support wherever you can. Take on the chores. Do things without her asking. Bring her home flowers and make her dinner. Come home from work early. Do whatever you can to make her feel loved and this might be especially difficult when she behaves unlovable. Line up some special time for her so that she get away and have her “quiet” time. If she can meet with other women who have similarly aged children, ALL THE BETTER. And definitely have her talk to her doctor and adjust medication, if necessary. Also, I have found that exercise is a huge stress reliever for me. And chocolate. The year after our baby was born, I did two triathlons, one marathon and ate my body weight in M&Ms.
    For what it’s worth, my husband and I didn’t have sex for almost two years after our fourth child was born. I wrote a post about it on my blog and was AMAZED at how many women came out of the woodwork to confess that they too had completely lost their sex drive. Libido is related to hormones. When your hormones are in the tank after giving birth to a baby and nursing, so is your sex life. But don’t worry, it WILL rebound and when it does, your wife will be a love tiger.
    Until then, don’t give up on her. You two will be stronger in the end.
    To B: Regardless of whether you have PPD or not, when someone feels overwhelmed, I think it is very common for them to voice feelings of not being in love and wanting a divorce. It’s happened to me on several occasions. But fortunately, once the insanity passes, I’m fully aware that I love my husband dearly and want to stay with him until the end of time.
    Damn, I just go on and on, don’t I?
    Sorry. :)

  9. Stefanie Mar 19 at 5:35 pm Reply Reply

    Adam, good for you for taking steps to help your wife. I was diagnosed with PPD after my husband insisted, over and over again until I listened, that the way I was feeling and acting could not be normal. It was incredibly hard to get the help; it felt like I was admitting that I couldn’t handle being a mother. Of course that wasn’t true, but the hormones don’t allow for much logical thinking.
    I don’t know your wife, so I don’t know the best way to get her to listen to you that she should get help, but I do know that I never would have done so on my own. I know it wasn’t easy for my husband to have that fight with me over and over while I sobbed at him and told him that I was not a bad mother and I was FINE! but him doing so saved our family, because I certainly was not fine.
    Do whatever you can to help her. Sleep is incredibly important. Before I was treated, a stretch of sleep for more than 4 or 5 hours meant the difference between just feeling down and sobbing all day. Exercise too. When my husband came home and found me cranky and emotional, he would send me out of the house with the dogs for a walk. I would protest because I was tired, but when I came home I would always thank him for kicking me out because I would feel better. I know that therapy and medicine are helping me, but it’s my husband who is making the biggest difference in my depression. You can do this for your wife too. It may take her a little while, but she will thank you for it. Two months after beginning treatment, I actually feel like I can cope most of the time. It has made a HUGE difference.

  10. Morgaine Mar 20 at 11:41 am Reply Reply

    The patch is a horrible thing to be on. It is a bad word in our house because it made me the psycho bitch from hell for about six months before switching to non-hormonal BC.

  11. Jasmine Mar 20 at 1:15 pm Reply Reply

    and
    6) Take good care of yourself, Adam.

  12. lindswing Mar 22 at 3:52 pm Reply Reply

    Oh, B,
    SO common. SO, So, so common. When a person is depressed, they often feel as if no one could possible like or love them, and it becomes a way of “freeing” their spouse to say they want a divorce. Depression obscures clear thinking and inhibits one’s ability to see beyond today’s blackness. If at all possible, please see a counselor. Your doctor can recommend one.

  13. Fiona Mar 23 at 2:16 pm Reply Reply

    It could definitely be the pill. I was on hormonal bc from the age of 16 without really having any problems. For some reason when I hit my early twenties the bc literally turned me into a nutcase. I was crying and depressed all the time. I felt completely out of control of my emotions and I think it contributed to the break-up of a 5 year relationship because for 3 of those years I was so psychologically out of whack. When I got off the birth control my entire life changed. I’m in a healthy relationship now and I marvel that the same things that would send me into a crying screaming fest when I was on bc, are water under the bridge with very little argument. I’ll never go on bc again. We use condoms and I monitor my fertility.

  14. Lanze Langill May 04 at 8:27 pm Reply Reply

    Hello,

    I am not sure if this is the right place to put this or if there might be a better one. I have been surfing around for anyone in my situation but have not found them. 

    First the background. I have a son from another marriage, my ex, well there is a reason she is my X. My current wife and my ex do not get along. My son is 9, and can be a bit of a handful. He is not my biological son, but I have taken responsibility for him since he was born. My current wife and I have a 20 month old baby.

    Now the issues… My wife hates my son. I know that sounds harsh, but it is true. Today, I had made her breakfast as she was spending the day studying. She was on her way out to eat when my son came in from outside for a drink of water. She turned around and slammed the bedroom door. 

    I have been taking care of my daughter all day and cleaning house, and cooking meals, and doing yardwork… Not an easy thing when taking care of a baby and another child. At one point I went into the room to get changed after spending time in the yard, she was laying in bed staring at the wall. 

    Usually I would be taking my son for half the summer, he currently comes to our house every other weekend. When I mentioned this to my wife, we fought for the better part of the evening. She does not understand (in her words) Why he has to be in her house for half the summer… Because he is my son! 

    Am I wrong? Should I give in? HELP. Please. 

  15. tyler Nov 14 at 3:38 pm Reply Reply

    Lanze langill , you said it was your WIFE that dislikes your SON from a previous relationship. Though not biological, you still accepted the not as if he were. In the worlds eyes, that is your son despite the birth certificate, despite the blood you don’t share. You took care of him as he were your own ( I’m assuming). Which is something many of us fathers can’t even do. For you to take charge for a little boys life is great beside the point. Point is, assuming you didnt tell your wife the day after the marriage about your son from another relationship, no I would not give in to her. That is your son, and she would expect the same from you if it were hers. Maybe her issue is you are more concerned with your son than your daughter when your son is around, just a thought. In any case, I empathize with your situation. I hope it worked/ works out .

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