Having a baby is supposed to be one of the happiest times in a person's life. What we don't talk about nearly enough is what may be happening to the mother behind all of those pictures.
Having a baby is supposed to be one of the happiest times in a person's life. At least, that's the picture we're often shown. There are smiling photographs, tiny clothes, congratulatory messages and people asking how the baby is doing. What we don't talk about nearly enough is what may be happening to the mother behind all of those pictures.
For some women, the weeks and months after childbirth bring feelings they never expected. Instead of feeling joyful, they may feel deeply sad, anxious, disconnected, irritable or overwhelmed. They may love their baby and still wonder why they don't feel the happiness they thought would come naturally. They may even feel guilty for having those emotions at all.
Postpartum depression is real, and it is more than simply having a difficult day or adjusting to the demands of a newborn. It is a medical condition that can affect a mother's mood, thoughts, energy, sleep, relationships and ability to function. Most importantly, it is treatable.
More than the "baby blues"
After giving birth, many women experience what is commonly called the "baby blues." Hormonal changes, physical recovery, interrupted sleep and the enormous adjustment of caring for a newborn can create an emotional roller coaster. A new mother may cry more easily, feel anxious or irritable, have trouble sleeping or question whether she's capable of handling everything that suddenly depends on her.
The baby blues usually improve within several days to about two weeks. Postpartum depression is different. The feelings tend to be more intense, last longer and can begin interfering with everyday life. According to the National Institute of Mental Health, many episodes of perinatal depression begin within four to eight weeks after the baby is born, although symptoms can occur beyond that early period.
That distinction matters because a woman may keep waiting for herself to "snap out of it," believing that what she's experiencing is simply part of becoming a mother. If the sadness, anxiety, hopelessness or other changes are severe, aren't improving after about two weeks or are making everyday functioning difficult, it is time to talk with a healthcare professional rather than simply waiting for things to get better.
Postpartum depression doesn't always look like sadness
When we hear the word depression, we tend to picture sadness. But postpartum depression can show itself in many different ways. A mother may feel empty or hopeless, but she may also become unusually angry or irritable. She may withdraw from family and friends, lose interest in things she normally enjoys, have difficulty concentrating or constantly question whether she is a good mother.
Some women have trouble bonding with their babies. Others may feel intense anxiety about something happening to the baby and find themselves unable to relax even when everything is fine. Changes in appetite, overwhelming fatigue, difficulty sleeping even when the baby is asleep and persistent feelings of guilt or worthlessness can also occur.
This is one reason it can be so difficult for families to recognize postpartum depression. A mother may still be feeding the baby, changing diapers, answering messages and doing everything expected of her while struggling internally. Functioning doesn't necessarily mean someone is doing well.
The pressure to be a "good mother"
There is an enormous amount of pressure surrounding motherhood. New mothers are often bombarded with advice about breastfeeding, sleeping schedules, bonding, development, nutrition and what they should or shouldn't be doing. Social media adds another layer by showing carefully selected moments from other people's lives that can make motherhood appear effortless.
Then comes comparison. Why does everyone else seem to be handling this better than I am? Why am I exhausted when she looks so happy? Why don't I feel the way I thought I would?
Those comparisons rarely tell the whole story.
Having postpartum depression does not measure someone's love for her baby or her ability to be a good mother. Perinatal depression is associated with a combination of biological and environmental factors, including hormonal changes, the physical and emotional demands of childbirth and caring for a newborn, life stress and personal or family history of depression or bipolar disorder.
Sometimes helping means doing something practical
When someone is experiencing postpartum depression, telling her to "get some rest" or "enjoy the baby because they grow up so fast" probably isn't what she needs to hear. Practical help can sometimes mean far more.
A partner, friend or family member can offer to prepare a meal, wash clothes, run an errand, sit with the baby while Mom showers or sleeps, accompany her to a medical appointment or simply spend time listening without immediately trying to fix everything. NIMH specifically notes that family and friends can help by encouraging a mother to speak with a healthcare provider, helping her get to appointments and assisting with childcare and household responsibilities.
There is also something important about changing the question we ask new mothers. Everyone naturally wants to know, "How's the baby?" Maybe we should get into the habit of following that question with another one: "And how are you doing?"
Then listen to the answer.
Small acts of self-care can help, but they aren't a substitute for treatment
When you're caring for a newborn, the phrase "take care of yourself" can almost sound unrealistic. A long vacation or a day at the spa probably isn't what most new mothers need or can easily arrange. Self-care during this period may be much simpler. It might mean accepting someone's offer to watch the baby while you sleep, getting outside for a short walk, eating a real meal, taking a shower without rushing or telling someone that you need help instead of continuing to say you're fine.
Physical activity, rest, social support and asking others to help with the baby and household responsibilities may be useful parts of recovery. But postpartum depression should not be reduced to a problem that can be solved with a walk, a bubble bath or a good night's sleep. Professional treatment may be necessary.
Treatment can include psychotherapy, medication or a combination of approaches. Cognitive behavioral therapy and interpersonal therapy are among the evidence-based therapies used for perinatal depression, and there are also medications specifically approved for postpartum depression. A physician or qualified mental-health professional can help determine which options are appropriate based on a woman's symptoms, medical history and individual circumstances, including considerations related to breastfeeding.
Know when something may be more serious
There is another postpartum condition families should know about because recognizing it quickly can save lives. Postpartum psychosis is not the same thing as postpartum depression. It is rare, but it is a psychiatric emergency.
A woman experiencing postpartum psychosis may become extremely confused or paranoid, hear or see things that aren't there, develop beliefs that aren't based in reality, experience mania or behave in ways that seem dramatically unlike herself. These symptoms require immediate medical attention and generally require hospitalization.
Thoughts of suicide, self-harm or harming the baby also require immediate help. In the United States, call or text 988 to reach the Suicide & Crisis Lifeline. If there is immediate danger, call 911 or go to the nearest emergency room.
There are people who understand
One of the most important things a mother experiencing postpartum depression can do is tell someone what is happening. That conversation can begin with an obstetrician, primary-care physician, therapist or another qualified healthcare professional. ACOG advises women who think they may have postpartum depression to contact their healthcare professional rather than waiting for the next scheduled postpartum visit.
The National Maternal Mental Health Hotline is another excellent resource specifically for pregnant women, new mothers and their families. It provides free, confidential support 24 hours a day, seven days a week. Call or text 1-833-TLC-MAMA (1-833-852-6262) to speak with a trained counselor who can listen, provide support and connect callers with additional resources.
The National Institute of Mental Health also provides extensive information about perinatal depression, including symptoms, treatment and finding professional help. Postpartum Support International offers support and resources for women and families experiencing pregnancy and postpartum mental-health challenges.
Remember the mother, too
When a baby arrives, attention naturally shifts toward this new little person. People want to hold the baby, photograph the baby, buy things for the baby and hear about every new milestone. That's understandable. A new life has entered the world.
But another life has changed dramatically too.
The mother may be recovering physically while functioning on very little sleep. Her hormones may be changing, her responsibilities have changed overnight and the person she was before childbirth may suddenly feel very far away. She may be trying to understand who she is now while simultaneously being responsible for someone who needs her around the clock.
So when you visit a new mother, don't only look at the baby. Look at her.
Ask how she's sleeping. Ask whether she's eating. Ask whether she needs anything. Ask how she's feeling emotionally, and make it clear that she can give you the real answer.
And if you are the mother reading this and something simply doesn't feel right, don't convince yourself that you have to endure it because other women seem to be managing. Tell someone. Talk with your doctor. Accept help when it is offered and ask for it when it isn't.
Motherhood was never meant to require suffering in silence.
This article is intended for general educational and informational purposes only and is not medical or mental-health advice. It is not intended to diagnose or treat postpartum depression or any other condition, nor should it replace the advice of a physician, obstetrician, licensed mental-health professional or other qualified healthcare provider. Anyone experiencing persistent or severe postpartum depression or anxiety symptoms should seek professional medical guidance. If you are having thoughts of suicide, self-harm or harming your baby, call or text 988 in the United States for immediate crisis support. Symptoms of postpartum psychosis, including hallucinations, delusions, severe confusion or paranoia, require immediate emergency medical attention.
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