Having a baby can bring so much change all at once.
You may feel joy and love. You may also feel very tired, worried or sad. You may have feelings that are hard to explain. You may even wonder why this time feels so hard.
Whatever you’re feeling, you deserve support.
Postpartum mental health concerns do not all look the same. Depression is one possibility, but anxiety and obsessive-compulsive disorder (OCD) can also happen during this time. Understanding the differences can make it easier to talk about what you are experiencing and get the right support.
You don’t need to know what to call what you’re experiencing. And you don’t need to wait until things feel unbearable to talk to someone.
What is postpartum depression?
Postpartum depression is a mental health condition that can happen after having a baby. It can affect how you feel, think and manage everyday life.
It may look different for everyone. You may:
- Feel sad, anxious or overwhelmed most days
- Have trouble sleeping, even when your baby is asleep
- Have trouble thinking clearly or making decisions
- Feel disconnected from your baby
- Feel hopeless, guilty or unlike yourself
- Experience scary or unwanted thoughts
Dr. Thase explains that depression can include worry or anxiety, but persistent fear and worry may also be signs of postpartum anxiety rather than depression.
You may recognize several of these feelings, just one, or something that isn’t on this list at all.
If you don’t feel like yourself, that is enough reason to reach out.
Talking about how you feel can be hard. You may worry that someone will judge you. Or you may not know how to explain what you’re feeling.
You don’t have to have the right words. You can simply start with, “I haven’t been feeling like myself.”
What is postpartum anxiety?
Postpartum anxiety can cause worry or fear that feels hard to control. Instead of sadness or loss of interest being the main concern, you may feel like your mind and body are constantly on alert.
You may:
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Worry constantly that something bad will happen to you or your baby
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Have racing thoughts or feel unable to relax
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Feel restless, tense, irritable or on edge
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Have physical symptoms such as a racing heart, nausea or difficulty sleeping
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Check on your baby repeatedly or find it hard to let someone else provide care
Anxiety and depression can happen at the same time, but they are not the same experience. If worry or fear is interfering with sleep, daily life or your ability to enjoy time with your baby, it is worth talking with a healthcare provider.
What is postpartum psychosis?
Postpartum psychosis is a rare and serious mental health condition that can happen after childbirth.
Someone experiencing postpartum psychosis may lose touch with reality. They may feel very confused, have unusual or strongly held beliefs that are not based in reality, or see or hear things that other people do not. They may not recognize that what they are experiencing is a symptom or that they need help.
In postpartum anxiety or OCD, frightening thoughts are typically experienced as unwanted and distressing. In psychosis, hallucinations or delusions can feel real to the person experiencing them. This distinction matters: intrusive thoughts alone do not mean someone is experiencing psychosis.
Postpartum psychosis is a medical emergency that requires immediate care. With treatment and support, recovery is possible.
If you or someone you care about is experiencing these symptoms, call 911 or go to the nearest emergency room.
Grief can be part of this time, too
The postpartum experience doesn’t always look or feel the way you imagined it would.
You may be grieving a pregnancy or birth experience that didn’t go as planned. A NICU stay, medical complications or being separated from your baby can bring fear, uncertainty and grief during a time you may have expected to look very different. You may miss parts of your life before having a baby. You may be getting used to changes in your body, relationships, work, sleep or sense of self. You may also be experiencing pregnancy loss or another loss during an already emotional time.
There is no right or wrong way to experience grief, and there is no timeline you need to follow.
Be gentle with yourself. Stay connected with people you trust, accept help when you can and remember that you don’t have to carry everything on your own.
If you're worried about someone you love
Sometimes it’s hard for someone to recognize that they’re struggling or to know how to ask for help.
You don’t need to know exactly what is wrong to check in.
Ask how they are doing — not just how the baby is doing. Give them space to talk without trying to fix how they feel. Listen without judgment and remind them that they don’t have to handle everything alone.
Dr. Thase encourages loved ones not to react with alarm or judgment if someone shares frightening or intrusive thoughts. Instead, encourage them to describe what the thoughts feel like and talk with a healthcare provider. A provider can help them understand whether they may be experiencing anxiety, OCD, depression or another concern.
If you notice big changes in how they feel, act or get through the day, encourage them to talk with a healthcare provider. You can also offer to help make the appointment, go with them or simply stay close while they take that next step.
Sometimes support starts with something as simple as “I’m here. You can talk to me.”
Whatever you're feeling, we're here
You don’t have to decide whether what you’re experiencing is “serious enough” to ask for help.
You don’t have to have a diagnosis.
You don’t have to have the right words.
You can simply tell us how you’ve been feeling.
Your Marathon Health care team is here to listen with compassion and without judgment. We can help you understand what you’re experiencing, talk through your concerns and connect you with the care and support that’s right for you.
Whether you’re experiencing sadness, anxiety, exhaustion, grief, unexpected emotions or simply don’t feel like yourself, you don’t have to go through it alone.
Need support now?
The National Maternal Mental Health Hotline offers free, confidential support for pregnant and postpartum people and their families. Call or text 1-833-TLC-MAMA (1-833-852-6262).
If you are having thoughts of harming yourself or your baby, call or text 988 for immediate support.
If you or someone else is in immediate danger, call 911 or go to the nearest emergency room.
Sources
National Institute of Mental Health. (n.d.). Perinatal depression. National Institutes of Health.
Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2023). What should I know about postpartum depression? National Institutes of Health.
