Q&A: helping a partner with PPD

Jim writes:

"I have a question for you -- my wife and I have a 3 month old son, and I think she's going through a bout of depression right now.  Looking back, I guess all of the ingredients were there for it  -- we live far away from family and friends, and she's been at home with our son for the last 3 months.  We had a lot of family come and visit at first, but since the beginning of September we've been alone.  It doesn't help that her dad tells her things like "you know, I think that whole PPD thing is baloney - if anyone would have had it, it would have been your mother and she was fine."

My question is what can I do about it as her husband and as a father? No matter what I do (try and take the baby, let her get extra sleep, etc.) it doesn't seem to help - I realize this is a medical issue, and it's not her fault. If it's a hormonal imbalance, obviously more sleep and help aren't going to fix things.  I've tried to get her to consider seeing the doctor, but she flat out refuses.  She's been saying things like "I wish I was dead" and "I just want to go away."  Obviously this scares me, more than a little ...

When I got to work this morning I called her doctor and left a message to talk to a nurse.  I worry though that I'm going around her back and she'll be hurt.  But right now I don't think I have an option.

So, long story short, what can a partner do for someone suffering PPD?"

Oh, you poor family. This must be so scary.

It does sound like she has post-partum depression. Many non-depressed moms think or say things like "I just want to go away," but we mean on a long weekend by ourselves to the Canyon Ranch, not to really disappear. And wanting to be dead is a sure sign of depression.

I agree that you don't have an option, even if it makes you feel bad to be going behind her back to try to get her help. If she had another illness, like diabetes, you wouldn't think twice about calling her doctor and getting her meds if you saw she was crashing. You'd know she wasn't able to get help for herself. This is no different. Her denials that she needs or wants help are part of the disease.

(Having been there with regular depression, I can attest that even when you know something could make you feel normal again, it still feels like shameful weakness to admit that you need help. If you were a worthy person you'd be able to get a grip and pull yourself up out of it. Except that you can't, since it's not anything you caused or had control over. But still you think you should be able to fix yourself.)

And better she be hurt right now that you sought treatment than she spend weeks or months in pain, or do something to hurt herself or the baby. Let her really give you hell for going behind her back once she's feeling normal again. Except that once she's feeling normal again she'll be grateful you loved her enough to look for something to pull her out of the pit.

I'm deliberately not talking about what could happen to your son if your wife stays depressed or gets worse. You're probably scared shitless about it already, so there's no need to belabor it. Your wife and son are a unit, and as she goes, so he goes. So to protect him you have to protect her.

It might take a few phone calls to get someone to help her. Not everyone takes PPD seriously. I hope that the nurse called you back right away and you somehow convinced your wife to go to the doctor, who prescribed an anti-depressant for her immediately. But if that didn't happen, don't give up. If the nurse doesn't take it seriously, ask to talk to the doctor. If they don't take it seriously, call the maternity department of the hospital she gave birth in and ask for a recommendation of a doctor who treats PPD. If they can't help, call a local midwife and ask for a rec. If they can't help, call a local lactation consultant (even if your wife isn't nursing they'll still help you find help for PPD).

There are several antidepressants that are safe for nursing moms and babies, if your wife is nursing. The preferred heirarchy according to researcher Thomas Hale, PhD (the medication-and-breastmilk researcher) via Kellymom.com is:

  1. Zoloft
  2. Paxil
  3. Celexa
  4. Effexor
  5. Prozac

It can take up two weeks for the anti-depressants to start working. (If nothing changes in a few days, don't switch from one to another hoping for a quick resolution. That can just prolong the depression. If things get worse, though, call the doctor who prescribed them ASAP.) While you're still making calls or waiting for the meds to take effect, you can do some other things to help your wife:

  • Don't let her be alone too much. If you can arrange for friends to come spend time with her and the baby during the day that would make things a lot better for all of you. If you don't have a local support system, see if you can hire a post-partum doula for a few hours a week at least. Even a local teenager who could come over after school and play with the baby would be a help.
  • Encourage her to go outside and get some sunshine. 30 minutes a day would be great.
  • While she's outside, why not take a walk with her for 20 or 30 minutes? The exercise will help her immensely.
  • Make sure she's still taking her prenatal vitamins. Try to get her to take an Omega 3 supplement (I'm still not sure what's at the bottom of this flax seed oil thing yet, despite lots of helpful analysis from kind readers on studies that all seem to contradict themselves and each other), too, as we know Omega 3s help stabilize mood.
  • Sleep deprivation greatly influences hormones, so you're totally on track with helping her get some extra sleep. If she has trouble falling asleep the Omega 3 supplements will help, as will a calcium and magnesium supplement right before bed.
  • Protect her from ignorant and negative influences telling her it's all in her head, like her clueless father. I'd like to write more about him, but I can't think of anything to say about him that isn't profane, violent, or both.
  • Encourage her to make local mom friends. Having a support system of other women going through the same things is invaluable.
  • Check out kellymom.com. She has a bunch of great resources about PPD, including a quiz on how to tell if you have PPD.

I just want to say thank you for taking this so seriously and for being willing to do the heavy lifting your wife is going to need for the next few months to get out from under this disease. You're saving her, and you're saving your son, and you're saving your family. Please let me know how it's going.