A Spouse’s Guide to Understanding Postpartum Depression

New or soon-to-be parents may experience symptoms of anxiety or depression. When they happen during pregnancy or within a year of giving birth, it’s called perinatal.

Perinatal conditions include:

• prenatal depression: depression before giving birth
• postpartum depression: depression after giving birth
• prenatal anxiety: anxiety before giving birth
• postpartum anxiety: anxiety after giving birth

You may have heard the term postpartum depression before your spouse’s pregnancy. But many people also experience anxiety during this time. Sometimes, anxiety and depression happen all at once.

Perinatal mood disorders are different from mild emotional changes that come with pregnancy. These conditions have symptoms that are more severe and last 2 weeks or more.

Doctors don’t know for sure what causes PPD and PPA. But they suspect it may have to do with hormonal changes during and after pregnancy.

While your spouse is pregnant, their body has high levels of estrogen and progesterone. After giving birth, those hormone levels go back to what they were before pregnancy, within 24 hours. Researchers hypothesize this may cause some to experience depression.

A drop in thyroid levels may also contribute to depression symptoms. These changes are in addition to common experiences many new parents have, such as exhaustion and stress, that often come with caring for a newborn.

Some people are more likely to experience postpartum. This includes people who may:

• have a history of depression or anxiety
• experience a high-risk or complicated pregnancy
• lack social support

Research shows a link between partner pregnancy and spousal depression or anxiety.

There are symptoms that may indicate your spouse is experiencing a perinatal mood disorder. The signs are more severe than “baby blues,” which may include weepiness, sadness, irritability, and anxiety. These often only last 1-3 weeks, but in the case of PPD or PPA, the symptoms can continue.

Symptoms of postpartum depression include:

• persistent sadness
• feelings of guilt or hopelessness
• loss of interest in enjoyable activities
• low energy or fatigue
• trouble sleeping
• physical aches and pains with no known cause
• abnormal appetite
• persistent doubts about ability to care for the baby
• thoughts of suicide or harming oneself or the baby

Symptoms of postpartum anxiety include:

• lightheadedess or dizziness
• restlessness and inability to sit still
• faster breathing
• irregular or fast heartbeat
• sweating
• nausea
• inability to sleep
• panic attacks
• feeling tense or nervous
• excessive worrying or rumination

Sometimes, spouses can see these symptoms. But other times, new parents hide what they’re feeling and don’t open up about emotional changes, even with their partners.

It’s not uncommon to experience mood changes the first few days after birth, but these symptoms usually resolve on their own within the first 2 weeks after birth.

When these symptoms linger beyond 2 weeks and start interfering with your day-to-day life, you may be experiencing postpartum. Symptoms typically appear within 4 weeks after birth, but for some, they can start as early as the first 72 hours.

In some cases, the symptoms may not show up until 6 months or a year after delivery.

If a new parent is living with postpartum, the symptoms usually won’t improve without treatment.

Postpartum is typically treated with psychotherapy, medication, or a combination of both. These tools are often successful, but they can take several weeks to work.

It’s not always easy to know how to help a spouse with postpartum depression or postpartum anxiety. But you can take some steps to help.

As soon as you feel there might be a change in your spouse’s emotional well-being, you can express your concerns in a thoughtful, supportive, and non-judgmental way.

Here are a few ideas of ways to do this.

• Start the conversation. Ask your spouse how they’re doing.
• Tell them what you notice. Let your spouse know that you see they’re not sleeping or eating well and want to know how they’re feeling.
• Say you’re worried. Ask them what they’re experiencing or feeling.
• Promise to listen. Give your spouse the space to express what they’re going through.

If you’re not sure if your spouse is going through PPD or PPA and don’t know how to talk to them directly, you can speak with a family doctor or a mental health professional. They may be able to provide support.

Partner support is known to help prevent perinatal depression and anxiety. Ideally, this support is reciprocal, with spouses helping each other.

Here are ways to support your spouse during their experience of PPD or PPA:

• encourage them to talk about their feelings and seek professional help
• share the labor at home, such as giving your partner a rest from caring for the baby
• seek help from family and friends for childcare, meal prep, and housework
• demonstrate emotional affection by expressing love and care for your spouse

Each partnership is different, so how you choose to show support may depend on your relationship. Consider being open to new ways to relate to one another now that your family has grown and you’re all undergoing emotional changes.

Caring for your spouse is essential, but your health and well-being are also important. One review found that 8% to 10% of fathers experience symptoms of postpartum depression. More men experience it within 3 to 6 months after delivery. This same review found that up to 18% of fathers reported higher levels of anxiety during this time, too.

If your spouse has postpartum, you’re more likely to live with the symptoms as well.

There are a few ways you can look after yourself:

• Consider talking with a doctor or nurse. They can help connect you with mental health support and treatment, if needed.
• Try to eat healthy food and exercise. Good physical health can help you manage depression.
• Consider practicing mindfulness or meditation. Quiet time can help you get a break from your current experience.
• Try to reach out to friends or family. They may offer practical support, like childcare, and give you relief from stress.
• Consider open and honest communication with your spouse. Together you can find solutions to postpartum and support each other.

Most people find it helpful to admit that they’re also going through a new emotional experience and also need support just like their spouse.

Perinatal mood disorders happen to many people. Fortunately, they are treatable.

A healthcare or mental health professional can help you support your spouse through this time. There are also organizations that can offer support.

• Postpartum Progress Support Groups
• Centre of Perinatal Excellence (COPE)
• Postpartum Support International (PSI)
• Postpartum Education for Parents
• Health Resources & Services Administration (HRSA)