Postpartum Depression and marital conflictPostpartum depression and marital conflict

As a therapist and former Postpartum Virginia Support Group co-Facilitator and participant member, I have witnessed and experienced a common postpartum causality and treatment dilemma for postpartum moms and couples.  The issue of “which came first:  the postpartum depression or the marital dissatisfaction or conflict?”  This chicken/egg conundrum is a controversial and common for married or partnered moms facing depression during their postpartum period.  One side emphasizes that postpartum depression negatively disrupts the way the new mom approaches and behaves in the marriage or partnership.  Postpartum depression on this front is viewed as the precursor to the marital breakdown, and the treatment emphasis is typically focused on the mom’s mental health without giving much focus on the couple’s relationship or paternal mental health.  This school of thought considers that if her depression is resolved, her marital satisfaction and conflicts will decrease. As a counselor and a mom, I find this overemphasis on treating the maternal postpartum depression to be highly stigmatizing and burdensome for the mom, and then the “postpartum depression” becomes another wrench for her to tackle while the paternal mental health and marital health is swept under the rug.  


On the flip side, marital issues are emphasized as a causal factor in maternal postpartum depression.  From a family systems perspective, once the couple becomes an expecting couple, the couple moves into a triadic system.  Triads are less stable than dyads in that there are complexities with added relationships, and the potential for triangulation to occur (e.g. prioritizing one relationship and/or role over another).  


Both theories may be experienced as shaming or stigmatizing on the new mom or for the couple’s relationship.  I encourage postpartum moms coping with depression and/or anxiety to consider that your postpartum counseling and treatment interventions needs to include working on your depression/anxiety, for your partner to work on his/her depression/anxiety, and for couples/marriage counseling simultaneously.  Change occurs best when it is tackled on all fronts, and the treatment has more of a chance for stability and resilience when all parties are involved and held accountable.