Keeping Your Relationship Strong During Postpartum Depression

Four expert tips for coming through this difficult time together

Before Sara, a teacher in Atlanta, GA, gave birth for the first time, she had a clear vision of what motherhood would be like. "I pictured my husband and I curled up in bed at 10 AM, with our daughter lying happily between us, coffee cups in hand, laughing over something adorable and brilliant that she did," the mother of two explains. "So I was incredibly unprepared for the reality, which was me alone, pacing the hallways with a screaming, colicky baby at 2 AM, [both of us] crying uncontrollably, while my husband slept peacefully."

Things got worse as Sara became more and more depressed, and her husband seemed oblivious to what was happening. "Not only was I sinking into postpartum depression, but I also felt more alone than I ever had before," says Sara. "It was like he had totally checked out. I fantasized about divorcing him, but I also thought I was totally incapable of caring for my daughter by myself, so I'd have to leave them both, which wasn't an option."

Sara's experience isn't uncommon. Postpartum depression can take a significant toll on relationships. While most of the discussion about PPD focuses on the mother and her baby, it's important to remember that in two-parent families, there's another party involved: the other parent. Five years after Sara recovered from PPD, she asked her husband what those first few months had been like for him.

"It turns out that he was scared out of his mind," she says. "He had this wife whose personality had completely changed and a baby that he didn't know how to take care of, and so he just shut down," becoming unavailable to help Sara at the moment she needed it most. "I just assumed that he'd instinctively know how to help me and felt hurt when he didn't."

"Depression is hard on a marriage," acknowledges Karen Kleiman, MSW, LCSW, founder of the Postpartum Stress Center in Rosemont, Pennsylvania, and author of the book Tokens of Affection: Reclaiming Your Marriage After Postpartum Depression.  "Feelings are hurt, thoughts are distorted, intentions are misinterpreted, clarity is absent, and joy is nowhere to be found." 

In Tokens of Affection, Kleiman helps "guide couples through the delicate and deliberate passage back toward each other." And one of the most important steps, she says, is understanding that relationships thrive in direct proportion to how much attention they are given.

"Couples who take care of their marriage by taking care of each other, experience greater satisfaction in their relationship for a longer period of time," says Kleiman. Of course, it's incredibly hard to give proper attention to a relationship when there's a new baby, limited sleep, and depression. Kleiman offers these tips to help you both connect and care for each other, even in the toughest of circumstances:

Set the tone for better communication. First, create a safe space to communicate by agreeing that no one will yell, overreact, or withdraw. Then, acknowledge your partner's emotional state. "Before expressing what you need, say, 'I know you are tired, but can we talk for a minute?' or 'I know you hate to have this conversation, but I need you to listen for a few minutes,' or 'I know you had a hard day, but I'm worried about something.'" Those are all are good starters, says Kleiman.

Find the right words. Put words to your feelings: I'm sad. I'm scared. I feel alone. I miss you. I feel resentful. I'm hurt. These "I" statements help avoid making your partner feel blamed or criticized and allow you to get in touch with, and express, your emotions and needs.

Express gratitude. Feeling grateful for your partner's actions can be hard when you don't feel those actions are meeting your needs. But in order for your partner to feel seen and heard, it's essential to acknowledge what he or she is doing right.

"Thank your partner outright," says Kleiman. "It is important that you express gratitude and acknowledgement of how challenging this time is, even when it is difficult to do. Some ways to express gratitude include: Thank you for caring. Thank you for being here. Thank you for loving me. Thank you for picking up the slack when I cannot follow through. Thank you for understanding. Thank you for trying to understand."

Keep the "healthy" partner healthy. When one partner is depressed, the other may now have to manage household tasks, be the primary caregiver of the new baby, and carry more than a fair share of responsibilities. Some of this may be inevitable, but Kleiman says, "it is essential that the non-suffering partner consider his or her own emotional and physical needs in order to fortify resilience and manage the crisis with strength and a healthy perspective."

She tells supporting partners to "not feel guilty about making smart choices on behalf of your own mental, physical and emotional well-being." And recommends that these partners make sure they are "eating well, resting as much as possible, getting out of the house or office for sunshine, walking, exercising, and breathing."

When you are in the thick of something as difficult as postpartum depression, it may be hard to believe that some good may come of it. But if you are able to work on your relationship as you work through this challenging time, you may actually strengthen your partnership in the long run. "Many couples report that depression ultimately enabled them to dig deep and work toward a stronger relationship," says Kleiman. "They find themselves emerging from the darkness with a renewed sense of intimacy and affection for each other."

That was certainly Sara's experience. After recovering from PPD, she believes that she and her husband were "much better prepared for the challenges of parenthood, especially when we had our second child. We learned to work as a team and have each other's backs when one of us is struggling. I'd say we're stronger now than ever."