Feminist Advice Friday: How can I help my wife with postpartum depression?

A reader asks…

My wife has postpartum depression. What, if anything, can I do to help her?

My answer

Short, sweet, and to the point. But unfortunately, your letter doesn’t tell us a lot about what’s going on, so I’m going to give general advice.

I want you to start by reflecting on something: the postpartum period is widely considered one of the most challenging things a woman will ever face. It’s painful, stressful, and riddled with sleep deprivation. Women are expected to perform happiness to a society that does nothing but criticize them and their parenting. They may struggle with breastfeeding. They may feel they’ve failed at motherhood before they’ve even started. While popular literature dismisses postpartum depression as hormonal, I continue to believe that postpartum depression is closely related to a person’s situation. The research backs me up. Lack of social support, current or past abuse, and lack of support from a partner are, in most studies, the biggest risk factors for postpartum depression.

This diagnosis is complex, with no single cause. You can't cure her. But you can work to mitigate many depression risk factors.

Most advice columnists will tell you to reach out to her OB/GYN—someone wholly unequipped to treat depression. I want you to start with something different.

Ask her what she needs. Don’t be accusing or defensive or exasperated. Ask her what you can do to make her life better right now, then really listen without judgment. If she names 10 things you’re doing wrong, then I want you to work on those 10 things. Because you can’t change her neurotransmitters or her hormones, but you can change your behavior.

Consider that the holidays can be an especially difficult time, filled with obligations and pressure. Consider what you can do to alleviate that pressure. Plan Christmas? Buy and wrap presents? Take over the family Christmas photo?

Next, I want you to take an objective look at her life. If you’re as involved as you should be, you should have a very good idea of what her daily life looks like. Ask yourself what is depressing about her life. Has she had to abandon hobbies? Is she getting enough sleep? Is she seeing people she loves? Are her family members judging her parenting? Are you helping enough?

Consider what you can do to immediately rectify these issues. Can you split nighttime duty with the baby? Can you hire a postpartum doula? How much of daily life can you outsource? Take-out? Cleaning help? Get as much off of her plate as you can.

Then, I want you to frame postpartum depression as a real and legitimate illness. If your wife had a brain tumor, what would you do to support her? Postpartum depression is life-threatening. The things you do to support her now may dictate the course of the rest of her life. They will affect how she feels about you and your marriage for years—possibly decades. And her experience of postpartum life will color how she feels about herself as a mother, which is likely her most important identity, forever.

I’m not saying that this is your fault. But it is your responsibility. We have a moral obligation to tend to sick partners. There aren’t many cultural messages telling men they share this moral obligation. So I want to be the one to tell you: you are obligated to step up and do way more than 50/50 as your wife works her way through this.

Living with someone who is depressed is depressing. So it’s important that you prioritize your own mental health. No, that doesn’t mean ditching her to go golfing. It means seeking support outside of her, and talking to your own therapist so that you don’t fall apart when your wife needs you the most. As you do this, I want you to continuously remind yourself that this is temporary, but the legacy of how you handled this will last forever. It’s hard, but worth it.

With that in mind, I want you to do as many of these things as you possibly can, as frequently as you can:

-Help her get more sleep. At minimum, you should be splitting nighttime parenting. If you can take over completely a few nights a week, or take over in the morning so she can sleep in, this will immediately improve her mental health and make her a lot easier for you to live with. If you can’t or won’t split night wakings for some reason, consider bringing in help, such as a postpartum doula.

-Give her lots of love and affection, if she wants it.

-Never, ever judge her parenting. Praise her for what she is doing right. Thank her. Remind her how honored you are to walk the parenting journey with this incredible person who has called forth life into the world and given you a child, sacrificing her body and mind to do so.

-Carve out time to spend with her away from the baby. This might mean hiring a baby-sitter. If she doesn’t want to do that, try to spend time with her when the baby is sleeping. Being alone is hell for postpartum depression.

-Feed her nourishing food. Make her food or order healthy food. Encourage her to eat. Hold the baby so she can enjoy her food.

-At least once a week, give her a block of uninterrupted time to herself. We’re talking 3 to 4 hours. If you can do this more frequently, do that. Loss of identity, of hobbies, of alone time are huge factors in postpartum depression.

-Protect her from negative influences. Does your mother criticize her parenting? Does her best friend mock her for breastfeeding? Tell them to shut the hell up or get the hell out.

-Do not breathe one single word about her weight or her appearance, unless it is to tell her how perfect she is. She has just pushed out a baby.

-Don’t make her tend to your emotions. Women spend a lifetime tending to their partners’ emotions. She can take a few months off.

-Communicate your love to her in ways that work for her love language. Foot rubs? Flowers? Presents? Love letters? Above all else, she needs to feel that she is loved, and that what she does and is doing matters.

And yes, finally, encourage her to get medical help. Talk to a doctor and help her find a therapist. Be mindful of the fact that sometimes no therapist is better than a bad one. So work with her to find a therapist who truly understands postpartum depression and is willing to listen without judgment. This can take some research and trial and error.

Hang in there. This can get better, and you can do a lot to accelerate the path to better.