Three experiences we work with most
1. Partner and paternal postpartum depression and anxiety
What it can look like
- Persistent low mood, irritability, or withdrawal that has lasted weeks.
- Working longer hours, drinking more, or finding more reasons to be away from the house.
- Feeling like a failure, an outsider, or a financial burden.
- Anxiety about money, safety, or the future that does not respond to reassurance.
- Difficulty connecting with the baby or with your partner.
- A sense that you are not allowed to feel what you are feeling because the birthing parent has it harder.
Worth knowing
Approximately 1 in 10 fathers experiences postpartum depression. Rates for non-birthing parents in same-sex couples and adoptive parents are similar. Partner PPD often emerges later than the birthing parent’s, with months three through six postpartum being a common window. It is frequently missed because the cultural script does not include it.
How we treat it
Individual therapy with a clinician who treats partner PPD specifically. Medication management is available. Many of our clients find it helpful to do partner work alongside individual work, since partner depression often shows up in the relationship before it shows up internally.
2. Relationship strain in the perinatal period
What it can look like
- Frequent friction over divided labor, sleep, and household decisions.
- A sense that your partner has become a coworker rather than a romantic partner.
- Mismatched coping styles that used to be invisible and are now constant.
- Drift in physical intimacy, with neither person knowing how to talk about it.
- Resentment that surprises both of you.
- Conversations that never resolve because there is no time and no energy to finish them.
Worth knowing
Most couples experience some version of this in the first year after a baby arrives. Relationship-satisfaction research consistently shows a measurable dip after a first child for most couples. That does not mean the strain is not real, and it does not mean it cannot improve. It does mean you are not failing at being a couple. You are running a couple under conditions that do not favor couples.
How we treat it
Couples sessions, sometimes with individual work for each partner alongside. The work is more about restoring repair capacity than about resolving any specific argument. Couples who can repair recover. Couples who cannot, struggle longer.
3. Bonding and attachment difficulties
Read this part first
Bonding is not always immediate. Many of the parents we work with did not feel a rush of love at first sight, and now have deep, secure attachments with their children. Bonding develops, sometimes over weeks, sometimes over months. The fact that you are reading a page about bonding difficulties is, in itself, evidence that you are paying close attention to your relationship with your child. That is part of attachment, not the absence of it.
What it can look like
- Not feeling the rush of love everyone told you to expect.
- Feeling distant from your baby, possibly without being able to say why.
- Going through the motions of caregiving without an internal sense of connection.
- Worry that your difficulty bonding is going to harm your baby long-term.
- Shame deep enough that you have not told anyone.
What might be underneath
- Postpartum depression or anxiety.
- Birth trauma or NICU experience (see our Birth & NICU page for more).
- Sleep deprivation severe enough to flatten emotional responsiveness.
- Early separation from the baby.
- A difficult fertility journey or pregnancy that made it hard to attach pre-birth.
How we treat it
Gently, and at your pace. We rarely treat bonding directly. We treat the things underneath, and bonding usually follows. Most parents who come in for this work are surprised by how much shifts once the underlying piece is named.
How we work with families
Most of this work happens in some combination of couples sessions, partner-inclusive individual work, and individual care for the partner or non-birthing parent.
- Couples sessions. Both of you in the room, working on the relationship.
- Partner-inclusive individual sessions. Your partner can come in for some sessions, not all. We follow your lead.
- Individual care for partners and non-birthing parents. Your own work, your own goals, your own clinician.
- Family sessions. When useful, with attention to siblings and extended family dynamics.
- On-site infant-inclusive care. Your baby is welcome in the room. This is built into the practice, not an exception we make.
If you are reading this for someone you love
Most birthing parents experiencing PMADs do not say so until they feel safe enough. If you are worried about your partner, here are a few things that we know from the work.
- Direct, specific questions help more than open-ended ones. “Are you okay?” is hard to answer. “Have you been having any of those scary thoughts again?” is easier.
- Suggesting therapy can land as judgment unless it is paired with offering to do logistics.
- You do not need to diagnose anything. Naming what you have noticed and offering a concrete next step is enough.
- Coming with them to the consult call is usually welcomed, even if they say they do not need it.
A first-conversation script you can borrow:
I have noticed you have not been yourself lately. I love you. I want us to look at this together. Here is a practice that specializes in this. Can we just call them and see what they say?
And if you are doing this for someone else, you are also welcome here for your own care.
Watching someone you love struggle in the perinatal period is its own thing. It can bring up grief, anxiety, anger, helplessness, and questions about your own readiness for the parts of life ahead. Many of the partners we work with came in initially for someone else and stayed for themselves.
If you need help right now
If you or your partner are experiencing thoughts of self-harm, harm to the baby, or symptoms that feel unsafe, please use one of the resources below.
- National Maternal Mental Health Hotline. 1-833-TLC-MAMA (1-833-852-6262). Call or text, 24/7, free and confidential.
- 988 Suicide & Crisis Lifeline. Call or text 988.
- Postpartum Support International HelpLine. 1-800-944-4773. Call or text.
- If you or someone you love is in immediate danger, call 911 or go to the nearest emergency room.
Frequently asked questions
Can my partner come in for their own care while I am doing my own work?
Yes. This is one of the most common ways our families work with us. Each of you sees your own clinician for individual work, and you both come in for couples sessions when that is part of the plan. Your individual sessions stay confidential.
Is this only for romantic partners, or can family come too?
Family sessions are available when they fit the work. Most of our family-system care still centers on the parents and the baby, but extended family dynamics often come up and we work with them when they do.
Do you work with same-sex couples and non-binary parents?
Yes. Our clinicians work with same-sex, queer, and non-binary parents and couples. The clinical work is the same. The cultural awareness has to be there, and we have made sure it is.
Do you work with adoptive parents?
Yes. Adoptive parents experience PMADs at rates similar to biological parents, and the bonding work is often more layered. We treat adoptive families as a real and important part of our practice.
Will my partner have to talk in front of me?
No. Couples work involves both of you, but partner-inclusive individual sessions can be structured so that your partner is present for parts and not others. We talk through structure at intake.
What if my partner does not want to come in?
Your work can still happen. Many of our clients start individual work and bring their partner in later, sometimes much later, sometimes never. Your healing is not contingent on theirs.
Is bonding difficulty really treatable?
Yes. We treat the things underneath: depression, anxiety, trauma, sleep, separation, shame. Bonding usually follows. The change is often more visible to the parent than to anyone else, and it is real.
Are sessions in person or virtual?
We offer in-person sessions at our office and virtual sessions across licensed states. Couples sessions can be in either format. We will figure out what fits at the consult.