Postpartum Depression

Postpartum Depression

Know the Signs (and it’s not what you think)

When most people think of postpartum depression, they think of a lethargic new mother, hardly able to function, with possible thoughts of harming herself or her baby. While this can occur in a rare, but serious condition called postpartum psychosis occurring in approximately 0.089-2.6 of births in the United States, the majority of women experiencing postpartum depression typically present with more anxious symptoms. If these symptoms persist beyond two weeks postpartum, a period commonly referred to as the “baby blues,” postpartum depression must be ruled out.

The majority of new mothers that come to my practice present with difficulty sleeping (even when the baby is sleeping), crying easily, irritability, loss of interest, and being extremely concerned with being a “perfect” mother. Furthermore, anxious, looping thoughts are common as well as a constant feeling of being overwhelmed.

Some women are embarrassed or afraid of their intrusive thoughts and feel troubled by them, especially if they are experiencing scary thoughts about something bad happening to their baby. Many women fear that if they speak up about these thoughts, their baby will be taken from them even though they would never do anything to want to harm their baby. In fact, the desire to do everything so well, is creating its own anxiety.

Obsessions and compulsions can develop around housework, schedules and caring for the baby. Sadly, these mothers can greatly benefit from treatment for postpartum depression, but instead they suffer in silence, often experiencing a worsening of symptoms.

It is important to understand the difference between postpartum depression and postpartum psychosis. Women experiencing postpartum psychosis typically present with auditory or visual hallucinations, delusions, mania, insomnia, agitation, disorganized thinking, a flat affect, a detachment from reality.

Thoughts of self-harm and harm to the newborn can occur. Additionally, women who have a history of bipolar disorder, a major depressive disorder or schizophrenia are at a greater risk of developing postpartum psychosis. For this reason, it is imperative that women with a personal or family history of one of these conditions discuss a prevention plan with their doctor prior to giving birth.

There is good news and bad news. Unfortunately, because most women don’t realize that what they are experiencing classifies as postpartum depression, they do not seek help and therefore do not get treatment for it. The good news is that once postpartum depression is treated, symptoms typically improve relatively quickly.

Symptoms of postpartum depression include, but are not limited to:

  • anger, irritability and mood swings
  • loss of interest
  • hopelessness
  • anxiety
  • restlessness
  • panic attacks
  • difficulty sleeping
  • fatigue
  • lack of concentration
  • unwanted thoughts/repetitive thoughts

If you or someone you love is experiencing any of these symptoms, please know that good help is available. You cannot “think” your way out of postpartum depression and the longer it is left untreated, the worse the symptoms typically get.

This is especially the case when there is a chronic lack of sleep. Postpartum depression is not a weakness, a failure or a character flaw. It does not make someone a bad mother. Postpartum depression occurs for a variety of reasons that are well beyond a woman’s control. Most women report wishing they had sought treatment sooner once they began to feel better and more like themselves again.

Avery Neal, PhD, LPC is a practicing psychotherapist, international author and speaker. In 2012 she opened Women’s Therapy Clinic, which offers psychiatric and counseling support to women. Avery is the author of If He’s So Great, Why Do I Feel So Bad?: Recognizing and Overcoming Subtle Abuse, which has been translated and published in twelve languages. Visit for publications, interviews and courses.



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