Post-partum Depression

Dear ParentLine,

I’m writing on behalf of my wife who I think is experiencing post-partum depression. She has always been the model of a good person, caring, loving and responsible. But, since she had our daughter, three months ago, she has changed. Her mother stayed with us right after the baby was born, but after the first month, she had to return to her home. Since then, my wife calls my mother to come over on a daily basis. She doesn’t seem comfortable holding the baby and when the baby cries, my wife calls on one of us to take care of her. My wife seems moody and temperamental and very defensive every time I ask her what’s wrong and ask how I can help her. Also, she seems to be coming up with all kinds of excuses to stay away from home…saying that she has to work late or that she had to help a friend, and so on. I’m very upset and concerned and frankly, a bit resentful. This has been our dream and now, my wife is a living nightmare. Please help!

Signed, New Dad/Loving Husband in Carroll County.

Your wife and model and actress Brooke Shields may have something in common. Shields, who suffered post-partum depression (PPD) after the birth of her first child, wrote about her struggle in a book titled Down Came the Rain: My Journey Through Post-Partum Depression. Shields was a keynote speaker on the subject at the prestigious American Psychiatric Association’s annual meeting in 2007. She has also launched an anti-stigma crusade about PPD that has helped millions of women cope with this issue. You might take a look online for her interviews or pick up a copy of her book.

“My only knowledge at the time [after the birth of her first child] of the term postpartum disorder was more extreme postpartum psychosis,” Shields said. “Now I know the difference, but at the time I would have said ‘Oh, that’s only those people who harm their children.’ What I didn’t know is that there is a whole range of symptoms between what is called ‘baby blues’ and psychosis, a range of postpartum depressive symptoms that applied to me.”

So, what exactly is this malaise that millions of women experience after childbirth yet until recently hasn’t been openly discussed? The experts at WebMD advise that a certain amount of insomnia, irritability, tears, overwhelmed feelings, and mood-swings are normal during the first days after childbirth. The “baby blues” usually peak around the fourth postpartum day and subside in less than two weeks, when hormonal changes have settled down. More than half of women have temporary mild symptoms of depression mixed with feelings of happiness after having a baby.

The folks at WebMD go on to say that symptoms of PPD can follow postpartum blues. They can feel like more of the same or worse than before. Post-partum depression can also happen months after childbirth or pregnancy loss. In some cases, symptoms peak after slowly building from three or four months. If your wife has PPD, she may had five or more depressive symptoms (including one of the first two listed below) for most of the past 2 weeks, including:

Depressed mood-tearfulness, hopelessness, and feeling empty inside, with or without severe anxiety.
Loss of pleasure in either all or almost all of daily activities.
Appetite and weight change –usually a drop in appetite and weight but sometimes the opposite.
Sleep problems—usually trouble with sleeping even when the baby is sleeping.
Noticeable change in how the new mom walks and talks—usually restlessness, but sometimes sluggishness.
Extreme fatigue of loss of energy.
Feelings of worthlessness or guilt, with no reasonable cause.
Difficulty concentrating and making decisions.
Thoughts about death or suicide. Some women with PPD have fleeting frightening thoughts or of harming their babies, these thought tend to be fearful thoughts rather than urges to harm.

According to Sandra Beaudry, MS, LMFT Program Director for Child and Family Services’ Family Counseling program, “From what you describe, it does sound as though your wife is experiencing PPD. This may color her view of herself as a mother and lead her to feel shameful and incompetent, which might lead her to more bad feelings or thoughts about herself as a mother. She may be caught in a spiral that includes feeling she as disappointed you and that she should avoid you and the baby. Try to get her to talk with her primary healthcare provider or a therapist although this may be difficult because she’s defensive.”

Beaudry suggests that you might try to talk with your wife about the difference between dreaming about having a baby and having one for you both—the lack of sleep, overwhelming responsibility, and no time for each other. Your wife may be more willing to talk if she knows that you doubt your parenting abilities sometimes as well. Arrange for child care so that the two of you can go someplace that you enjoyed in the past and perhaps have a more relaxed talk with each other.

“The anxiety and resentment you feel may help to shut her down, rather than open up the communication between you,” Beaudry observes. “She may need to be reassured about your love for her and your belief in her as a mom. If your wife refuses to seek help with or without you or continues to behave in ways you describe, you might try to have a trusted friend or relative talk with her about the fact that PPD is nothing to be ashamed of, and how there is help for it.”

Beaudry says you could even talk to her doctor about your concerns. Finally, please know that it is also more common than you think for couples to struggle in their relationship after the birth of their first child. It would be wise for you to see a marriage therapist together to make sure you can keep your couple connection while adjusting to becoming a family.”

Beyond the suggestions listed above, encourage your wife to get in touch with people who can help with childcare, household chores and errands. A social support network can help her find time for herself so she can rest. Be sure to check to see if there’s a support group in your area of others who have or are experiencing PPD.

PARENTLINE WELCOMES YOUR QUESTIONS!

ParentLine is a free and confidential service of Child and Family Services, a statewide, independent, nonprofit organization dedicated to advancing the well-being of children and families. Call ParentLine, 1-800-640-6486; write ParentLine, c/o Child and Family Services, P.O. Box 448, Manchester, NH; email parentline@cfsnh.org or visit our website at www.cfsnh.org.