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Marriage and postpartum depression

A postpartum woman wrote to me about a week ago, and I cannot get her off my mind.

“All the awesome Christian marriage advice feels unhelpful if you’re depressed, and all the PPD advice seems to assume you care about yourself more than your husband.”

She asked how to navigate its affect on marriage. “Just some resource that acknowledges that we want to be well so we can serve our people well.”

I knew immediately I wanted to give her a hug.

I’m so grateful for her vulnerability and honesty. Just like back in school, one person asks the question that’s on the minds of many others.

Here are some of my thoughts based on things she said:

“We want to serve our people well.”

….But what if this is a season to receive?

I know there are the common adages:

“You can’t give from an empty cup.”

“You have to put your oxygen mask on first before helping those around you.”

While there is truth to these, I think the way your cup is filled is individual and best worked through with a therapist, spouse, spiritual director, self-reflection, etc.

The first thing that came to my mind as I sat with her message was "what if this is a season to receive."

It’s okay to have a season where others do more caring for you than you do for others.

It’s hard to hear that as a wife and mother.

It’s even harder to live it out.

Naturally you’re probably still taking care of some little people— at least one, if you're postpartum.

So let's consider this. If you had a severe physical illness and were incapable of doing certain tasks or keeping up on various duties you normally do— your spouse or other people in your community would help you.

And although you might feel guilty about it or uncomfortable with the idea— you’d have to allow it.

In fact, this is a blessing to others! It allows them to bless you and to serve you-- to live out the works of mercy. Only being the one to give and never to receive usually comes from a place of pride and believing we are only worthwhile if we are doing something for others.

Note: Please don't read this as encouraging selfishness or laziness-- or denying the importance of serving others. I am writing all of this with an assumption, as this woman stated, that the person WANTS to get better. She wants to be a good wife and mother who serves her family. She is in a season of struggle and illness.

If your spouse was sick or injured, you would lovingly take care of him— as well as any tasks he normally does while he recovering.

Postpartum depression and anxiety are serious. We can’t see it on the outside— in fact, many women are very good at hiding it. This makes it hard to understand and acknowledge its severity, even to ourselves.

PPD advice seems to assume you care more about yourself than your husband.”

If you were to ask most husbands what they want from their wife who is struggling with PPD/PPA, I would bet most (I’ve only spoken with a few personally) would say they just want their wife to get better. They want her to focus on whatever she needs to in order to get better.

That isn’t the wife not caring about her husband, just like a wife who is physically ill and can barely get out of bed isn’t acting out of selfishness.

You can show gratitude and offer your hardship for them. You can also lovingly receive their help and support. All of the work that you put in to fighting your way through PPD/PPA is an act of love— for yourself, your marriage, and your family.

The general theme of popular marriage advice can often carry the undertone of, “A good marriage is happy and fun.” The popular suggestions and recommendations can be great to help keep things a bit lighter when they often feel heavy and like drudgery. While yes, that absolutely has its place!

So does enduring hard times together and at different times, taking care of each other.

What can be lost in mainstream, broad-strokes marriage advice is the validation of the hard times. A deep, self-sacrificing love can be forged in those hard times. The soil of your marriage can be tilled in a way that is unique during harder seasons. Love can put down very deep roots in this time.

The “always be dressed well when he comes home with warm dinner on the table— and send love notes in his lunch” picture of the ideal wife doesn’t leave space for acknowledging the mother and wife who is fighting every day to get better—fighting so hard because she loves her family.

I looked up marriage advice for when your spouse is sick. This initially seems odd because you might think of cancer or a major injury-- some illness you can see. But if we are able to admit (which we should) that PPD/PPA can be as severe as an injury or illness, there are cases where this is a better approach and expectation than other marriage advice.

I looked through a variety of medical institutions' pages and other related websites for advice for couples during an illness.

The recurring themes were:

-Talk to each other. Be open and honest. Ask what each other needs.

-Have a support network and ask for help.

-Learn as much as you can about the illness (especially the husband, in this case)

-Commit to your own physical, emotional, and spiritual health-- this is for both husband and wife

-"Remember, you are still you. This illness does not define you." (or your marriage)

-"Remain intimate. Intimacy does not necessarily mean sex. It means spending time together—holding hands, reading together, talking, etc."

Give what you can. As little as that may be.

The parable of the widow putting in two copper coins because it's all she has comes to mind when I think about this. It is all she has-- and she gives it. This is where the battle through postpartum depression and anxiety is so individualized. Giving all that you can for your family looks different. And unfortunately, many of us didn't learn from this parable and still judge those who don't seem to be giving "enough."

Just like everything else in marriage, your journey, what works for you and your spouse, and how you love each other through this will be individualized to you.

  • Get help. A good therapist can work with you in your individual situation.

Example: A morning walk and daily shower helps me. Music and diaphragmatic breathing calms my anxiety. But that’s ME!

  • Give what you can.

  • Receive what you need. Allow others to serve and bless you. It is humbling, for sure.

  • Keep talking about it and being honest about what you both need.

  • Dates out of the house (when mom is physically well enough after delivery) can be great for mental health. Getting coffee and going for a scenic drive might be all you can muster, but give it a try.'

  • You may long for the intimacy of intercourse, or the idea of another pregnancy with postpartum depression so fresh in both of your minds might be terrifying and put a halt to intercourse. These are both understandable, valid, and make sense! Remember: There are other ways to experience intimacy. Sharing the truth about what you’re going through IS intimate— it requires a great level of trust and revealing yourself.

I’m not going to give too many specific ideas or tasks. Postpartum is unique to each woman and each couple. Then you add in PPD/PPA ,and it becomes even more specific to YOUR situation.

I’m intentionally leaving this a bit vague to leave room for YOUR experience, even if it looks different from someone else.

The last thing I would add is this:


When you're ready, it's okay (and probably good) to grieve.

PPD/PPA is a thief. It can steal joy during pregnancy and the year after with a new baby.

Through grief, you'll eventually reach the place of acceptance.

Accepting the reality of your pregnancy and postpartum as they were, and accepting your marriage with hopefully a deeper love and stronger bond that knows it can endure hard things.

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