For Partners: 5 Ways to Support Your Partner with a PMAD
Trayvon has noticed a significant shift in his partner Doneisha. Since she had their baby 3 months ago, she just hasn’t seemed like herself. When she’s taking care of their baby, she seems like she’s on autopilot, showing little emotion. When she has time to herself she isolates and stays in bed. Or, on the other end of the spectrum, she’s uptight and rages about the smallest things. Trayvon wants to talk about how his partner’s feeling, but has no idea where to start. He feels totally stuck.
Watching your partner go through pregnancy, labor, and delivery can make you feel pretty useless. After all, they’re growing and birthing an entire human!
Add mental health challenges on top of things, and you might be feeling a whole new level of helplessness.
If you’ve noticed a shift in your partner since becoming a parent–or if they’ve actively told you they’re struggling with their mental health–this blog is for you.
What’s a PMAD?
Perinatal or postpartum mood and anxiety disorders (PMADs) describe a group of mental health conditions that occur during pregnancy (perinatal) and within the first year after pregnancy (postpartum). They affect approximately 1 in 7 women. They include diagnoses like:
Depression.
Anxiety.
Obsessive-compulsive disorder.
Posttraumatic stress disorder.
Bipolar disorder.
Psychosis.
PMADs can feel (and be) really scary—whether you’re experiencing them or your partner’s experiencing them. So please know this: You’re not alone. And there’s help available.
Let’s start together.
Postpartum Depression
Postpartum depression (PPD) is the most common PMAD and we know for certain it affects between 10 and 15% of new moms. But the number is likely much higher. It’s estimated that only 40% of all cases of PPD are diagnosed, and only 60% of those receive treatment.
PPD has a long list of symptoms. Your partner may experience only some of these:
Sadness
Increased tearfulness or crying
Feeling overwhelmed
Feelings of "this doesn't feel like me"
Irritability and anger
Loss of interest
Poor concentration
Changes in appetite and sleep
Unexplained physical ailments, like headaches or stomachaches
Having a hard time caring for oneself (or baby)
Lack of feeling toward the baby
Isolation
Guilt and shame
Hopelessness and helplessness
Co-occurring anxiety symptoms
Suicidal thoughts
If your partner has expressed thoughts of harming themselves or someone else, call 911 or go to the emergency room right away.
PMADs vs. Baby Blues
One of the reasons PMADs aren’t diagnosed and treated as they should be is that our society often doesn’t listen to new parents when they express their experience with a PMAD. Often their symptoms are written off as the “baby blues.”
But, it’s important to recognize that baby blues and PMADs are very different things.
Baby blues is a totally normal response to becoming a parent, with 50-80% of new moms reporting symptoms like:
Crying.
Feeling overwhelmed or uncertain.
Acute sleep deprivation and fatigue.
Emotional reactivity.
Mood swings.
These symptoms overlap with PMADs like PPD. To distinguish between a PMAD and baby blues, we have to look at timing, duration, and severity.
Baby blues isn’t a psychiatric condition or diagnosis. It’s an ultra-common, time-limited, spontaneously-resolving, hormone-induced phenomenon. Baby blues occur within a few days of delivery, usually peaking around days three to five postpartum, and should last no more than a few weeks. And while the baby blues can really suck, the symptoms are generally mild. It shouldn’t disrupt day-to-day activities.
PMADs can present at any time during pregnancy or the entire first year of the postpartum experience, usually peaking four months post-delivery. Symptoms will last longer, occur almost daily, and last throughout the day. Symptoms are also generally more severe, particularly if left untreated. What Causes PMADs?
What Causes PMADs?
There’s no single cause for PMADs. They can affect people regardless of age, race, income, culture, education, number of births, or even gender! (It’s estimated that 10% of male partners also experience symptoms similar to PPD after the birth of their child.)
There are, however, risk factors that increase someone’s likelihood of developing a PMAD. They involve a series of complex physical and environmental changes that can affect your partner’s overall mental health. These risk factors include:
Significant hormonal changes during pregnancy and after birth.
Poor sleep.
Personal or family history of mental health concerns or substance abuse.
Birth trauma.
Poverty and other financial stressors.
History of infertility, child loss, or miscarriage.
Lack of social support.
5 Ways to Help Your Partner with a PMAD
Untreated PMADs can have unwanted and negative effects on your family. If there was ever a time to support your partner in their mental health journey, it’s right now.
Use these suggestions to help your partner get back on track, whatever that looks like for them!
#1 Check in with yourself.
This is #1 for a reason. Before you can take care of anyone else, you need to take care of yourself. To do this, ask yourself a couple of questions just to check in:
Do any of the above symptoms resonate with me?
What do I need to be the best version of myself for my partner?
What are my biases about mental illness?
What boundaries do I need to set in this process of supporting my partner?
Do I feel the need to fix my partner?
Do I feel like I need to know everything about PMADs before jumping in to help?
#2 Ask the question.
We often avoid bringing up the obvious because we don’t know what to do on the back end of someone’s answer. We don’t ask our partner how they’re doing because if they say anything negative, we’re not sure how to respond.
But one of the most important things you can do for your partner who’s experiencing a PMAD is to ask how they’re feeling. In those early days, this question can help your partner recognize the changes you’re seeing in them. This early intervention sets the foundation for success in diagnosis and treatment.
When asking the question, it’s important not to blame or shame. Your partner isn’t the cause of their own PMAD. And they likely have little to no control over their symptoms. Try starting the conversation like this:
There’s something I want to talk to you about. I’ve noticed X, Y, and Z. I’ve been doing some reading on [diagnosis] and I’ve noticed some similarities. What do you think about that? I want you to know whatever you’re going through, I’m with you 100%.
Asking the question also includes asking how they’d like to be helped. It’s important to come in with ideas of your own, to reduce the mental load on your partner. This can look like:
I have a few ideas of how to lighten your load, like taking over dinner duties or picking up some night-time wakings. But I also want to know how I can best support you! Do you have any ideas of what you need right now? I’m all ears.
#3 Show love.
PMADs take love out of the equation. People with a PMAD often have difficulty feeling love for themselves, their babies, and their relationships. Replace that love and fill your partner’s cup!
If you don’t know your partner’s love language, send them this quiz. Then, show them love how they’ll best receive it (their primary love language). If it’s words of affirmation, tell your partner how confident you feel in her as a parent. If it’s gift-giving, bring home flowers often. If her love language is an act of service, do an extra load of laundry.
Replenish the love in your relationship, however that needs to happen.
#4 Validate, validate, validate.
When our partners are struggling, we often resort to “fix it mode.” With the best intentions, we’ll say anything and everything to help someone move past their feelings:
You’re ok.
This is nothing to worry about.
You’ll be back on your feet soon.
You need to do X, Y, Z.
But these statements are dismissive. They don’t fully validate the pain your partner is experiencing.
In order to “fix” the problem–help your partner decrease and/or better manage their PMAD symptoms–we need to first sit with them in the yuck. We need to validate that what they’re experiencing is really hard, scary, and life-changing.
Instead of, “I think X, Y, or Z would help,” try saying:
I’ve noticed you’re really struggling with [their diagnosis]. It’s really scary and hard to watch you go through this. I can’t imagine what it’s like to be you right now. But I want you to know, even though it’s hard, I’m with you every step of the way. We can do this together.
This not only validates their feelings, but also shows your commitment to your partner that you’re with them for the long-haul. Even in the face of a PMAD!
#5 Encourage them to seek additional help.
Your support is invaluable. Effectively treating a PMAD involves talking with a professional. (Even if you’re a professional—a doctor or therapist—it’s important for your partner to see a third party.)
Support your partner in effectively engaging with a doctor or therapist by:
Exploring their fears/concerns about seeking help.
Researching providers in your area.
Offer to make consultation appointments for your partner and follow-through.
Accompanying them to their first session.
Asking how therapy is going.
Picking up their medications from the pharmacy.
Support is everything.
That doesn’t mean it comes easy. If you’re finding it challenging to communicate with your partner, or maybe your words fall short, I want to introduce you to my free resource, Navigating Touchy Topics. I’ll share 46 scripts for tough conversations with your partner so you can experience less drama and more connection. Check it out here.
Sources & Additional Reading
Anokye, R., Acheampong, E., Budu-Ainooson, A., Obeng, E. I., & Akwasi, A. G. (2018). Prevalence of postpartum depression and interventions utilized for its management. Annals of general psychiatry, 17, 18. https://doi.org/10.1186/s12991-018-0188-0
Bass, P. F., & Bauer, N. S. (2018). Parental postpartum depression: More than “baby blues.” Contemporary PEDS Journal, 35(9). https://www.contemporarypediatrics.com/view/parental-postpartum-depression-more-baby-blues
Children's Hospital of Philadelphia. (2018, October 19). Perinatal or postpartum mood and anxiety disorders. Children's Hospital of Philadelphia. Retrieved from https://www.chop.edu/conditions-diseases/perinatal-or-postpartum-mood-and-anxiety-disorders#:~:text=Perinatal%20or%20postpartum%20mood%20and%20anxiety%20disorder%20(PMAD)%20is%20the,be%20mild%2C%20moderate%20or%20severe.
Ream, A. (2019, November 25). Is it baby blues or postpartum depression? How to tell the difference. Motherly. https://www.mother.ly/life/is-it-baby-blues-or-postpartum-depression-how-to-tell-the-difference.
Shepherd, S. (2018, June 8). How to cope with postpartum 'baby blues'-from a clinical psychologist. Motherly. https://www.mother.ly/life/how-to-cope-with-postpartum-baby-blues-from-a-clinical-psychologist.