Postpartum depression doesn’t only affect women, it also affects her husband and children. It affects teammates, friends, and co-workers too. Though my husband and I have discussed my PPD experience many times, he sat down with me recently to answer some questions so that you can hear “his side.” And let me just say, my husband was going through his own transition into fatherhood, while also wrestling with our departure from Africa, and making plans for our move to Asia. He had a lot on his shoulders but was incredibly attentive to our son, and to me. I am forever grateful for his tenderness toward me, and his willingness to press into my life, even when I wanted to run and hide. For the sake of length, I have trimmed our conversation.
What did you know about postpartum depression prior to the birth of our son?
My Husband: I knew it existed. I knew that it affected new mothers because I learned about it in my psychology classes in college. I had also seen my older sister go through it with her two kids, as well as a cousin who really struggled with her firstborn. I knew that postpartum depression was more extreme than baby blues, and had a lot to do with genetics as well as hormonal changes a woman goes through after having a baby.
I didn’t think PPD was a “bad thing” or was indicative of the woman not doing something right. I understood that every birth brought its own challenges because of what I observed my sister and cousins experience—recovery was overwhelming at times, there was sadness, joy, and fatigue. Having lived in other cultures prior to the birth of our son I understood that societal expectations, religious beliefs, and culture can have a large impact on a woman’s emotional and mental health after childbirth as well.
Beyond the expected surge of emotions and baby blues, at what point did you get concerned about me?
It’s hard to say, it’s so long ago now! But probably after four months or so. You have always described yourself as a bit of a melancholic person, and I know that you feel things quite deeply. It’s what makes you such a good nurse–you are emphatic, caring, and have a way of entering into others’ pain. But this was different. As we began to discuss our return overseas, you seemed really energized and eager. And then at other times, even an hour later, you would spiral into worry, becoming incredibly anxious and weepy. I remember you sitting in your nursing chair, crying, and me being like, “Look, I want to take care of you. We can wait to go to Asia. If you aren’t ready, we can hold off.” You would shake your head “no” and convince me that you were fine, that you would probably be happier overseas anyway.
So we forged ahead because I trusted that you knew yourself best, and I didn’t want to “make you” delay. Even in the tears, I saw joy and laughter in you when you were with our son. We seemed to be partnering well as we made plans. We had a good community and it seemed like you were engaging with people on a regular basis–you weren’t avoiding me or staying in your room, locked away. I never heard or saw you express antagonism toward our son; it was always self-directed (if you let yourself slip).
What were the red flags you observed once we were in Asia? How did you confront them?
There was a time, soon after we arrived, that you brought up that I’d be better off without you. That scared me. So, we talked about it, and when I offered to get help, you panicked. I suggested we talk to someone in member care, but you were too nervous. We talked about going back home and that also put you in a tailspin. Primarily, I remember certain settings and emotions and feeling helpless because you were so deep in your head, convinced that you were worthless and a terrible mother. I remember checking in, listening, comforting you, and taking on extra responsibility for our son so that you could do language study or rest.
I didn’t tell you to keep it together or get over it; I could see you were going through a hard time, even while you tried to put a positive spin on our new life in Asia. It was hard to see red flags, to be honest, because a lot of the ways you were behaving were in hiding. Also, there was the layer of culture stress–you were edgy, expressed frustration about our living situation, and felt anxious about going out. You didn’t like to be away from me either. At the time, I might have felt like you were being clingy, but looking back I realize that you were probably afraid you might hurt yourself if I was gone. I took your feelings of worthlessness seriously, but you would always backtrack, saying you’d never do anything “crazy.” I remember praying a lot for you and with you–that God would bring you out of the valley you were in. I wanted to help you.
Did you know how bad it really was?
No. I didn’t know about the window visits, the ideations, or the crying bouts in secret until you told me ten years later. That was hard.
Looking back, is there anything you would have done differently?
Again, this is hard. If I knew then what I know now, I would do three things differently.
1) I would have advocated to delay our departure for Asia and get you the care you needed. We did talk about delaying our departure, but we felt a lot of pressure from our home churches and expectations from the field. I think you would have also felt more comfortable reaching out for help in a community and healthcare setting you were comfortable with.
2) Once overseas, knowing what I know now, I would have initiated a frank conversation with our member care to discuss a medical leave–for you to see a doctor or counselor. I do remember talking to member care, but they just discussed our transition as normal with all the changes we had gone through.
3) I would have made sure to get you care on the field or at home. We knew it would be a hard transition from Africa to America to Asia (and having a baby), so we were primed to think, “This is difficult, and it will get better; just push through.” Seeking outside help felt like it might delay “the work” and let down our organization and senders. But my overarching desire was for you to be well. I would have been ready to take you home or to a place for you to get medical care or counseling in a second.
It was a fragile line, however, between protecting you and your journey, and protecting you from yourself, and getting you the care you needed. I think your fatigue and deep depression made it almost impossible for you to imagine getting help outside of our setting, this added to your resistance toward seeing a doctor or counselor. You didn’t want to be perceived as a failure.
What advice can you offer spouses as far as checking in with their partners?
I think a husband can reassure his wife that her well-being is his greatest value. Even though they have a shared purpose and a desire to do cross-cultural work, supporting her heart and mind through a new transition is his priority. Don’t come across as judgmental or critical, be patient and kind. And remember, as men and women, there are layers upon layers of past trauma, hurts, family of origin stories, and life experiences that inform how we perceive one another and ourselves.
These things can exacerbate the emotions a couple goes through when postpartum depression is in the mix. On top of this, the way we communicate, the people we listen to, and our perceived expectations can impact discussions around mental health–whether we are comfortable broaching the subject or not. Christians husbands must open their hearts to the reality of postpartum depression and that it affects millions of women. Support and compassion must be offered rather than judgment. Husbands, keep talking, keep pressing in, and seek support.
Finally, people from our sending church were well-meaning, good-hearted people who were eager to see us be “successful” and make an impact overseas. But I have learned over the years, that in most cases, the NEEDS overseas outweigh the concerns of those being sent, especially when it comes to mental health. Cross-cultural life is hard enough–no amount of training, inventories, and conversations can completely equip or prevent the struggles overseas workers face. However, being intentional about the emotional and mental health of the “goer” and determining if people are prepared for the life changes ahead, should be a top priority of any sending organization.
To my husband: Thanks for talking with me and revisiting this stressful time. Though PPD is physically experienced by the mom, I know it affects others too. It’s helpful to hear what it’s like for the dad/husband and to see PPD from your perspective.
In this series:
Part 1: My story with Postpartum Depression on the Field
Part 2: Postpartum Depression—What it is and What to do about it
Part 3: A Conversation with my Husband about PPD
Part 4: How Organizations Can Support Women Going Through PPD