Postnatal depression (PND) is a type of depression that some women (and some men) experience after having a baby. It can affect around 10 to 15% of women [1] and it tends to occur within the first twelve months after birth. Like other types of depression, it is often misunderstood. If your partner doesn’t understand or underestimates the effects of PND, they might not be able to empathise with you and support you through it. This can cause a conflict in the relationship. Why is this happening? Your partner's misunderstanding or ignorance might be frustrating, but it may just be a lack of knowledge. As a nation, we’re not very good at differentiating between having a low mood, and being depressed. Your partner might assume that, if you have PND, you’ll be sad all the time and cry a lot. So, if your PND manifests itself in other ways, such as sleeping a lot, feeling numb, or withdrawing, it may not be recognised for what it is. Your partner may also assume that, if you didn’t get PND in the first few months, then you can’t be experiencing it now. However, PND can happen any time within the first year after giving birth. How can I help? Firstly, it might be helpful for your partner to know and recognise PND symptoms, some of which may include: Low mood. Loss of interest in usual activities. Feelings of worthlessness. Loss of energy. Crying spells. Insomnia. Fatigue. Anxiety. Poor concentration [1] [2]. PND is a real illness, and anyone suffering from it needs professional help. So it’s important your partner not only understands what PND is, but is willing to learn how it affects you. Try to open the conversation more broadly. Rather than trying to explain PND, try simply asking your partner for support. Different people have different ideas what kind of behaviour is supportive, so your partner may just have a different perspective to you on the subject of PND or depression in general. Relationships between couples following the birth of their child can be fraught, and depression is more likely to develop in both mothers and fathers in the first year of birth [3]. If you feel that your partner is not really paying attention or seems to lack interest, try to remember that people's perspectives are often formed through other people’s attitudes to depression – usually someone quite influential like their own parents. Stick with it, and ask for your partner's undivided attention to explore the issue. Encouraging your partner to speak to a medical professional or a health visitor could be helpful, as they are equipped to explain PND from a psychological and biological standpoint. They may also be able to provide further support resources for you both. References [1] Yiong Wee, K., Skouteris, H., Pier, C., Richardson, B. and Milgrom, J. (2011) Correlates of Ante- and Postnatal Depression in Fathers: A Systematic Review. Journal of Affective Disorders 130(3), 358–77.[2] Andrews-Fike, C. (1999). A review of postpartum depression. Primary care companion to the Journal of clinical psychiatry, 1(1), 9.[3] (Davé, Petersen, Sherr, & Nazareth, 2010).” (p.29)

One in five people will experience a form of depression at some point in their lives [1]. If your partner is depressed, you can play an important role in helping them get better. Depression is more than just a low mood. It’s a prolonged illness, whose symptoms include a lack of energy, a loss of interest in things you might normally enjoy, feelings of low self-worth, and changes in sleep and appetite [2]. A sudden onset of depression in your partner can have an impact on your relationship. You may have to take on a temporary caring role, which can put unexpected strain on you [3]. Some of your partner’s symptoms can affect you too: Low mood. When your partner is feeling down most of the time, it can feel like you don’t have access to the person who is most important to you. Loss of interest and energy. Your partner may lose interest in the things you like doing together, like going out, cooking, and even sex. Concentration. Depression can affect concentration, even to the extent that your partner struggles to stay involved in a conversation. Sleep and appetite. You may notice changes in your partner’s eating and sleeping patterns, which can affect their mood even further. It can also disrupt your own eating and sleeping as established routines get lost. Low self-worth. You may notice your partner being more critical of themselves and possibly lashing out at you too [2]. You may also wonder if you are responsible for your partner’s mental health problems. While there are sometimes external causes, including relationship problems, depression can often come along out of nowhere [4]. You can play a positive role in your partner’s recovery [3]. One of the first things you can do is notice the signs of depression and encourage your partner to seek help. Often, the quickest route to support is through your GP, who can make a diagnosis and refer your partner to appropriate support. There are many forms of mental health support, but it’s likely that your partner will undertake some form of talking therapy. They may be given exercises to take home. You can offer support by encouraging your partner to complete the exercises or, if appropriate, by getting involved directly. Your partner’s doctor may recommend couples therapy, which has been shown to be effective for people with depression [5]. If this is recommended to your partner, it doesn’t mean that your relationship is in trouble; it just means that you are being asked to get involved in your partner’s recovery. Attending sessions together means you can be better informed and more involved. Whether you are directly involved in your partner’s treatment or not, there are many ways you can be supportive: Encourage them to seek support. Getting your partner into professional support is one of the best ways you can help. Learn about depression. Read up on depression and its symptoms. A good place to start is the OnePlusOne and NHS guide, ‘Depression and low mood: A guide for the partner’. Set aside blame. Accept that the illness is happening, and don’t blame your partner or yourself. It’s here, and it’s treatable, so just focus on recovery. Notice the signs. Be aware of your partner’s symptoms and the things that can set off an episode of depression. Get support if things seem to be getting worse. Solve practical problems. When someone is depressed, problems can be magnified and may seem insurmountable. You can help your partner by solving practical problems, which could be as simple as doing more than your share of housework for a little while. Listen more. Clear communication and active listening can help your partner to feel better supported and more in control. Do some exercise. Help your partner to get some gentle exercise, even if it’s just a walk around the block. This can have the added benefit of helping with sleep problems. Get your partner out of the house. While it might seem easier to avoid social situations, it’s often best to try and turn up to things that they would usually enjoy. Even if you plan just to go out for half an hour, you can help your partner break out of the loop of depression and inactivity. Notice what helps. What usually makes your partner feel better – a morning walk? Cooking a healthy meal? Make a note of what works, and encourage your partner to do more of it. Keeping a mood journal can also help you to show your partner that they have been making improvements, as they may find it hard to focus on the positives [6]. Seeing a partner go through depression can be upsetting but, with the right support, even the most severe cases can be treated. As with any illness, you should seek professional help if you are worried. Recovery is likely to be gradual, but it is possible, and you can play an important part. This article gives just a quick overview of how you can support a partner with depression. For a more in-depth look, we recommend reading, ‘Depression and low mood: A guide for the partner’, co-produced by OnePlusOne and Northumberland, Tyne and Wear NHS Foundation Trust. References [1] Bolton, J., Bisson, J., Guthrie, E., Wood., S. (2011) Depression: key facts. Retrieved from http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/depressionkeyfacts.aspx [2] NHS (2015). Low mood and depression - NHS Choices. Available at http://www.nhs.uk/conditions/stress-anxiety-depression/pages/low-mood-and-depression.aspx  [3] Crowe, M. (2004). Couples and mental illness. Sexual and Relationship Therapy, 19:3, 309-318. [4] Hickey, D., Carr, A., Dooley, B., Guerin, S., Butler, E., & Fitzpatrick, L. (2005). Family and marital profiles of couples in which one partner has depression or anxiety. Journal of marital and family therapy, 31(2), 171-182. [5] Bodenmann, G., Plancherel, B., Beach, S. R., Widmer, K., Gabriel, B., Meuwly, N., ... & Schramm, E. (2008). Effects of coping-oriented couples therapy on depression: A randomized clinical trial. Journal of consulting and clinical psychology, 76(6), 944. [6] NICE (2009) Depression: The Treatment and Management of Depression in Adults (Update). NICE clinical guideline 90. Available at www.nice.org.uk/CG90.

One in ten pregnant women experience mental health problems, and often go undiagnosed until after the baby is born. The pregnancy and parenting charity Tommy’s has produced a video encouraging pregnant women to seek support if they feel anxious or depressed. The short clip follows the story of a woman’s journey through pregnancy as she realises she’s not coping and finds someone to talk to. Around 10-15% of pregnant women experience mental health problems like anxiety and depression [1] but, despite antenatal depression being very similar to postnatal depression, many go undiagnosed and untreated until after the baby is born. Symptoms of anxiety and depression can include feelings of sadness, hopelessness, irritability, and losing interest in activities that used to be fun. Most women feel more emotional than usual during pregnancy, but the video urges you to seek help if you notice that you’re unhappy more than half of the time, or if feelings linger for more than a couple of weeks. When you’re pregnant, it might seem like there’s a pressure on you to feel happy all the time, or to be flushed and glowing with the joys of impending motherhood. If this doesn’t describe your experience, it can be quite distressing and you may even feel guilty for not living up to the expectations of those around you. Your midwife or health visitor will understand. Speak to them and let them know that you need support. You partner, family, and friends can also offer support, by talking things through with you and offering practical support. Let them know you’re not feeling yourself and that you might need some extra support. If you can, hand some of your regular chores over to your partner, or ask someone to help out. Friends love to feel like they are helping, but sometimes need to be given specific tasks like popping to the shops or watering your plants when they come over. Try to eat as healthily as possible, take some gentle exercise, and rest whenever you have the opportunity. Getting regular sleep can have a positive impact on your mood. Take time out to focus on yourself and do something you enjoy. Allow yourself a chance to relax and ease some of the pressure. If you are worried about other areas of your life, such as finances, housing, or your relationship, look into the support available for these specific issues. If you can keep external factors under control, you may find it easier to cope with whatever feelings you are juggling. Keep talking to your partner. Help them to understand what you’re going through, what you’re doing to try and make things better, and what kind of support you need at home. References [1] National Institute for Health and Care Excellence (NICE) (2014). Clinical guideline 192: Antenatal and postnatal mental health: clinical management and service guidance https://www.nice.org.uk/guidance/cg192 (Accessed July 2018) [2] Howard L.M, Molyneaux E, Dennis C et al (2014).  Non-Psychotic mental disorders in the perinatal period.  Lancet 384: 1775-1788.

Most new dads are aware of the responsibilities that are coming their way well before the baby is born. But, unfortunately, not all of them step up to the plate when the times comes. If your baby’s dad isn’t helping out, three things can happen: The baby can miss out on vital care. Your partner can miss opportunities to bond with the baby. You might feel let down and resentful. Your partner might assume that his role is to provide for the family, and not necessarily to offer care [1]. By putting food on the table, and clothes on backs, he may feel that his job is done, leaving the nurturing side of things to you. If his parents followed a similar family structure, he may be influenced by his own upbringing. The support that parents offer each other is at its strongest during birth, and then steadily drops for both mothers and fathers. Fatigue and tiredness probably have a part to play in this, and it’s quite likely that this time will not accurately represent the supportiveness that you normally show each other in your relationship. Most couples return to their standard level of supportiveness within a year of the baby being born [2].   Boosting the bond  If your partner has embraced the provider role and not the carer role, it might be helpful for him to try and bond more with your baby. If he bonds with the child early on, he’s more likely to develop a stronger attachment, which can encourage him to play more of his caring role. Try to provide regular opportunities for him to bond – feeding times, going for walks, and skin-to-skin contact are all great ways to support this. The more the father engages himself during the delivery and postnatal period, the stronger will be his attachment to the baby [1]. It might be worth having a conversation with your partner and asking him how he sees his role. Be sensitive in your approach – he may not feel he’s neglecting the caring aspect of fatherhood, or he may feel that you don’t appreciate how hard he works to be the provider. Lead with how you feel and how it appears to you, rather than throw any accusations. Use “I feel” more than “You make me feel”. Ask him about his expectations of fatherhood: What did he expect it to be like? Is it what he imagined? What could you do to make him feel more involved? Does he feel like he’s connecting with the baby? Explore these questions together and see if you can start to find some solutions together. References  [1] Plantin, L., Olukoya, A. and Ny, P. (2011) Positive Health Outcomes of Fathers’ Involvment in Pregnancy and Childbirth Paternal Support: A Scope Study Literature Review. Fathering: A Journal of Theory, Research, and Practice about Men as Fathers, 9(1), 87–102. [2] Howard, K. and Brooks-Gunn, J. (2009) Relationship Supportiveness During the Transition to Parenting Among Married and Unmarried Parents. Parenting, 9(1–2), 123–42.