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Postpartum depression and the couple By Ilyene Barsky, LCSW The arrival of a baby is a powerful event that brings permanent changes to the life of the couple. Parenthood affects the perception of one's self, one's partner, other relationships and the world in general. To be totally responsibly for the life of a helpless infant is an awesome realization. Whether or not this is the couple's first baby, its arrival is always a time of transition and possible crisis. Many marriages that were based on a foundation of equality and sharing, often lapse into traditional roles after the baby is born. The man views himself as the breadwinner and the woman (whether she works outside of the home or not) views herself as housekeeper as well as the one responsible for the emotional and physical well-being of the family as supporting the family falls on him while she is resentful that the whole burden of baby and domestic care is thrust on her. It is no wonder that many new parents end up separating and/or divorcing because they cannot cope with the overwhelming changes. The stress and strain on the marriage is exacerbated if the woman is suffering from postpartum depression (PPD). The mother feels exhausted, depresses, anxious and unable to deal with the baby ad household chores. The new father is also confused (and possibly depressed) by his wife's behavior. He usually does not know what to do or say so he'll try to help by pitching in with the housework. Those men who have been helping all along with the housework may double their efforts and do even more. They may also take over some (or most, or even all) of the childcare responsibilities. The woman suffering from PPD knows she needs the help and that she "should" appreciate her partners efforts. However, as her husband takes over more and more of "her" duties, she believes to feel increasingly inadequate. This puts the man in a double bind situation. In order to help his wife, he does more of her work. The more of her work he does, the more inadequate she feels and then starts to resent him. Meanwhile, he starts to resent her for being unable to cope. In addition, the new mother may be overwhelmed by her own reaction. PPD carries with it, its own shock factor. The woman didn't expect to feel depressed or anxious. The depression begins to feed on itself - she feels guilty and inadequate because she was weak enough to become depressed in the first place. Rather than help with the housework, sometimes all the new mother needs is; emotional support. If she is caught up in the grips of PPD, she may not even know what she needs. Or, worse, she may expect her husband to instinctively know what she needs or wants and if she has to ask for it, his response (no matter how positive) becomes meaningless. This is, of course, irrational and implies that the husband should be able to read her mind and anticipate all her needs. What the new mother might really need is a simple hug, kiss or some display of physical affection. However, she may be unable to ask for this because experience had taught her that physical affection often leads to sexual activity. A very real symptom of PPD is loss of libido or sexual drive. In the book, The New Mother Syndrome, Carol Dix cites a Masters in Johnson study which has discovered, "A lower level of sexuality even at three months postpartum and that achieving orgasm after birth can be more difficult because of fatigue or tension, because of breast tenderness, soreness after episiotomy, exhaustion from a C-section delivery, or fears that sexual organs have changed and that vaginal muscles are either tighter or looser." Difficulties with sex adds to the postpartum woman's sense of low self esteem. This is also related to her body image. There are probably stretch marks and excess weight to contend with. She probably doesn't spend as much time or effort taking care of her appearance as she used to. She simply doesn't have the time or energy and if she's depressed, she doesn't have the motivation. All of this can be perceived by her partner as a rejection of him (rather then PPD). He may react by distancing himself from her emotionally and physically by working longer hours, or "going out with the boys." He might even seek other relationships and have an affair. His withdrawal may cause her to feel even more isolated and deepen the depression. Therefore, anger, resentment, and even jealousy can rear its ugly head on both sides. Each may be envious of the other's attention to the baby. This is especially true for the father of the breastfed baby. Even though he may know rationally that he is not being replaced by the baby, he still feels the loss of his partner's attention. On the other hand, the new mother may feel as though the baby is more interested in the the baby than her. If there are other children around, they will naturally gravitate to their father who is more likely to be more available to them than their mother whose time and energy is more absorbed by the infant. This can be quite devastating. Unfortunately, all of this happens at a time when each of the parents really need extra doses of nurturing from the other. Most issues that arise during this stage of the marriage can be resolved through communication, compromise, and commitment to making the relationship work. Being a parent is a tough job - there is no previous training, no "how-to" manuals. It requires choices which include giving up things previously valued in the interest of the child and the marriage. As each individual adapts, the relationship may very well be strained, but with a concerted effort by both, the couple can grow and not break. |