Pregnancy, childbirth, and motherhood can be all over the map, experience-wise. There are days when you’re floating on the clouds, blissed out with snuggles and baby giggles.  

And there are days when you can barely function. Your friends, family, and doctors might tell you to expect an adjustment period after giving birth, but what about how hard it all can feel? 

When all you feel is the struggle, when no matter how hard you try, it might be something more than just the baby blues or the hormonal roller coaster of pregnancy and postpartum: it may be postpartum depression or anxiety. 

Although postpartum depression and anxiety can be scary, they are temporary and treatable and it’s nothing to feel ashamed about. Lots of moms have been in your shoes. With support, appropriate therapies, and self-care, you can recover. 

The first step? Knowing the symptoms and knowing how to proceed. 

More than baby blues

In the past, when new moms expressed feeling sad or emotional after their baby was born, it was often chalked up to the “baby blues.” 

To be fair, the baby blues are a real thing, the result of the significant hormonal shifts that happen after giving birth. They're incredibly common—about 80 percent of new moms experience them—but they’re also short-lived. They typically happen within a few days of giving birth and last no more than two weeks. 

When the feelings of being overwhelmed, sad, emotional, irritable, etc. don't disappear after two weeks, though, they may be symptomatic of a larger problem. 

What causes postpartum depression and anxiety?

Mental health is an area of the medical world that is widely studied but not always well understood. That goes for depression and anxiety in the postpartum period. However, there are risk factors that make it more likely—although definitely do not guarantee—that a woman might experience postpartum depression and anxiety. 

These include:

• Dealing with stressful life events before or after birth
• Low levels of social and medical support
• Previous episodes of depression
• A family history of depression
• Infertility or difficulty getting pregnant. This can include a history of miscarriage or undergoing fertility treatments to conceive
• Giving birth to multiples
• Being a teen mother
• Having a preterm (before 37 weeks) labor and delivery
• Pregnancy and birth complications. This can include maternal or infant health issues, birth trauma, or health-related scares
• Having a baby who is hospitalized

It’s important to emphasize, though, that any mother can experience postpartum depression or anxiety. 

Signs and symptoms

Knowing what to look for helps identify the onset of postpartum depression and anxiety. Partners and family members should also be watchful, especially during the first few months when it’s most likely for depression or anxiety to occur. 

Depression, anxiety, and other mood disorders can occur anytime before your baby is born. When they occur before birth, they may be referred to as “perinatal” depression or anxiety. 

They can also happen up to a year after your baby is born. (You can still experience depression, anxiety, and other mental health issues after this period, but it’s not typically associated with pregnancy after one year.)

Postpartum depression

If any of the signs and symptoms below last for longer than two weeks, you may have postpartum depression. 

• Feeling depressed most of the day every day
• Experiencing severe mood swings 
• Feeling shame, guilt, panicked, or scared, or like a failure 
• Having little interest in things you usually enjoy
• Continually being tired or fatigued 
• Changes in appetite (eating more or less than usual)
• Changes in sleep pattern (sleeping more or less than usual)
• Difficulty concentrating or making decisions
• Difficulty bonding with your baby
• Thinking about hurting yourself or your baby
  

Postpartum anxiety

A mother experiencing postpartum anxiety may experience:

• Feeling a sense of dread or danger  
• Racing thoughts or “monkey mind”
• Constantly feeling on edge, jittery, or agitated  
• Excessive or obsessive worrying. This can include worrying about your baby’s health, your ability to parent, or other issues
• Difficulty falling or staying asleep even when exhausted
• Unwanted and persistent thoughts (known as intrusive thoughts)

Anxiety can also include physical symptoms:

• Increased heart rate
• Rapid breathing
• Chest pain
• Tingling or restlessness in your limbs
• Trembling
• Sweating

Other mood disorders

While depression and anxiety are the most frequently diagnosed pregnancy-related mental health issues, mothers also experience postpartum obsessive-compulsive disorder and postpartum psychosis. 

Postpartum OCD is an anxiety disorder and shares many of the same symptoms of postpartum anxiety, with the added difficulty of being unable to shake thoughts, worries, or behaviors. Postpartum OCD can be frightening, but its fears are based on anxiety, not delusion. On the other hand, postpartum psychosis is an entirely different condition. But while less common, it’s also very serious. Learn more about these disorders on Postpartum Support International. 

What you need to know about postpartum depression and anxiety

It’s common (really common)

Postpartum mood disorders are the most common pregnancy-related complication. 

More than 3 million American mothers are diagnosed with postpartum anxiety, depression, and other perinatal mood disorders every year. While 3 million may sound like a large number, it’s also likely an undercount—because of stigma, lack of awareness, and lack of support, many mothers don’t seek treatment. 

First time moms are more likely to get it

For up to half of women diagnosed with postpartum depression or anxiety, it’s their first experience with mental health issues. That’s another reason why it can go undiagnosed—many mothers are unfamiliar with the signs and symptoms. 

It’s not your fault

Even if you have risk factors for postpartum depression and anxiety, it’s not your fault. It’s a result of complex biochemistry but it can be treated.

You can (and should) get treatment for it

When you’re struggling with perinatal mental health problems, it makes it hard to take care of yourself and your baby. You might be too tired, too sad, too angry, too scared to do anything at all. But thankfully, perinatal mood disorders respond very well to treatment. Therapy, medication, self-care, and support are all important resources for you to consider. If you’re not sure where to start, talk to your doctor. They can help you look at your options. 

You’re not alone

A major challenge for moms suffering from postpartum depression and anxiety is feeling isolated or like no one else understands. Neither of these things is true, though! There are lots of ways to find support through your recovery. 

One increasingly available option these days are online support groups for postpartum moms. Breastfeeding-focused groups are a great option, but you’ll find options for postpartum mental health and wellbeing, too. 

Where to get help

• Postpartum Support International
• Program for Early Parent Support
• Perinatal Mental Health Alliance for People of Color
• Maternal Mental Health Leadership Alliance

If you or someone you love is having a hard time after having a baby, there is help. Jump to the bottom for a list of resources. If you’re in crisis, call your physician, local emergency number, or the National Emergency Hotline.