Abstract

Though perinatal mental health has been frequently examined in the context of maternal depression, research has minimally explored the degree to which a partner’s perinatal mental diagnosis influences perinatal mood and anxiety disorder incidence. Drawing on Bowen’s Family Systems Theory, we examine co-occurring symptoms of postpartum depression and anxiety (PPD/A) and support dynamics within couples through a cross-sectional mixed-methods study. In the summer of 2024, birthing and non-birthing caregivers (n = 907) across the United States completed a survey including a modified Edinburgh Postnatal Depression Scale (EPDS) and additional questions about partner support, screening, and communication. Post-survey interviews (n = 17) revealed further insight into the relational dynamics of co-occurring PPD/A symptoms among couples. Survey analyses indicated correlations between birthing and non-birthing partner experiences of PPD/A. Further, co-occurrence was associated with diminished emotional support and increased distress for birthing parents. Participants who desired more partner support or felt afraid to express their feelings had significantly higher EPDS scores. Qualitative findings reinforced these patterns, highlighting the roles of relational strain, gender norms, and lack of systemic support for perinatal mental health. Findings suggest couple-based screening practices and interventions that recognize the bidirectional emotional impact of PPD/A may hold promise for improving outcomes across the entire family system.

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