How to Help Your Wife With Postpartum Depression
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?
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.
Published March 19, 2010. Last updated July 23, 2017.