Postpartum Depression And Relationships: Treating the Whole Family

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postpartum depressionMoms who suffer with postpartum depression and anxiety feel alone.  Almost always.  They feel misunderstood, unseen, isolated and lost.  Moms who suffer with a perinatal mood or anxiety disorder feel, when they sit in my office, like they are in battle all by themselves.

But here is the thing, and perhaps one of the biggest differences between treating postpartum depression and treating generalized depression and anxiety: the moms who sit in my office are not my only clients.  When I treat a mom for symptoms of depression and anxiety, I am also treating the whole family. She is there in the context of all of her relationships: the one with her baby, her other children, her husband/partner, her own parents, her friends and her extended community.   I cannot treat that mom for her symptoms without understanding the deep complexity between her symptoms and the rest of her world.  Postpartum depression is one big tangle of symptoms and relationships and to work with that mom in a bubble simply misses the most complex piece of these illnesses: she is ill at a time when relationships matter most.

There is the mom who feels detached from her baby and worries that she will never love him as she should.  There is the mom who loves her baby so much that she is afraid to ever let her cry or be cared for by others.  There is the mom whose pregnancy was unwanted or unplanned and who feels resentment for the growing belly or the baby who she wants desperately to love but feels anger towards.  There is the mom who feels unable to manage her toddler once the new baby comes or who feels unrelenting guilt about not being able to give enough of herself to anyone.  There is the mom who feels let down by her partner and who wants nothing more than to be understood by the one person she knows best.  There is the mother who feels a new wave of anger toward her own parents for not providing her with what she feels she needed during her own childhood or who are not there to support her now, as she suffers.  There is the mom who feels threatened by her in-laws and whose uncertainty around these relationships is interfering with her marriage.  There is the mom who feels let down by her community of friends during a time when she needs them so much.  For each of these moms, recovery comes not just in the reduction of symptoms, but also in the repair of the relationships that feel so damaged to her.

So how do I do this?  There is attention paid to her definition of a “good enough mother,” her development of confidence with her baby, and work around attachment and bonding.  We invite dads and partners in to discuss missed communication, each others’ needs and expectations, and ways to work together as a team to get mom (and her family) well.  There is talk of new boundaries and shifting relationships with parents and in-laws so that mothers feel comfortable in the changes that occur in these relationships when a baby is born.  There is work done around asking for and receiving support from community so that she feels more connected and less alone.  There are often conversations with those who are important to her (partners, parents, friends, siblings, in-laws) about what postpartum depression and related illnesses are so that the judgment decreases and the understanding and support becomes more tangible.

You have heard it before: Happy mom, happy family.  At times, this statement may feel like an undue amount of pressure that is put on a mother to be well for others.  The way I see it, mom and family are so interrelated during postpartum depression that the many players deserve support and attention in the effort to get mom well.  She cannot do it all alone, nor should she be expected to.

So, moms, if you are suffering and feel alone, know that you are not.  There are others who need you as much as you need others even if there are relationships that may need readjusting and repair.  When you sit in my office, or the office of any other expert in postpartum depression, know that you are being seen both as an individual and also as a part of something much larger than you, even if you may not feel connected to much of anything at the moment.

~ Kate Kripke, LCSW


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About Kate Kripke

Kate Kripke is a Licensed Clinical Social Worker (LCSW) specializing in the prevention and treatment of perinatal mood and anxiety disorders. She is also a Colorado state coordinator for Postpartum Support International. Kate lives in Boulder with her husband and two daughters and writes an eponymous blog.

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  1. Love this article, Kate! One of the best pieces of advice I ever learned as a psychologist was, “Whenever you are working with an individual, always assume you’re working with a family.” The family approach works every time:)

  2. Kate, I am so happy you wrote this blog. So many times new moms are trying to do it all and not disappoint anyone. There are so many issues to look at with Postpartum Depression. Women are trying to be superheroes, staying up all night for feedings, having little sleep, time to shower, or feed and nuture themselves. All the while, there are hormonal changes going on and a big chasm between being a prenant woman getting nourished by many, to the new mom who, while they may have lots of support, feels quite alone on a new adventure where they have little experience. It can be incredibly overwhelming. Please mothers, now you are not alone. Kate is an amazing support and there are many others to help you. She has a great list of resources. All you have to do is reach out.

  3. I just want to a big thumbs up for this wonderful blog. I really like the info, Thanks…!!

  4. Dear Kate,

    Unfortunately, I’m one of those moms. I went to a psycologist but she treated me as an individual separate from any other relationships I was damaging. She encouraged me to write a letter to my mother about my childhood and to send it to her, the result was more damage that had already been done after my mother came for the birth of my firstborn. She then encouraged me to send the letter to anyone whom my mother had spoken to, which was most close relatives but this did even more damage to every relationship I have with any family members. I live about a 15 hours flight away from my family and live in the country of my husbands family who are tight knit, interfering and demanding…the loneliness and despair is agonizing leaving me thinking that suicide is sometimes the only answer to getting away from all the damage I have caused not only to my family but to my children. It has been almost three years of hell! I have been to so many doctors and psychologists who speak English but none of them could ever write what you have written….it is like they just do not understand the relationships, the intricacy of peoples lives together and the connections which circle and circle until there is no hope of repair. Many of them treat this with medication but fail to see that if they help fix the connections, recovery would be faster…it is possibly the root cause in my case. Both mother in law and mother issues just after my baby was born and they stayed with me until 7 weeks postpartum. Those weeks haunt me and the anger from not being able to control what happened, from not being able to set boundaries or just to say ‘no!’ has been the deepest sadness I have ever experienced. What should have been the happiest time of our lives turned out to be a nightmare…but both these women knew what could happen but neither of them sacrificed themselves for me…I would like to thank you for understanding, for looking deeper, for searching, for helping! Just knowing that there is someone out there who understands, helps me more than anything.


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