Your emotional health
is part of your health
If you're not feeling like yourself right now — if something feels off, if you're struggling more than you expected, or if this season feels heavier than you thought it would — you are not alone. Perinatal mood and anxiety disorders affect 1 in 5 mothers and are among the most common complications of pregnancy and childbirth. Many people improve with the right support, and reaching out early can be helpful.
This guide is for educational purposes only and does not constitute medical advice. If you are struggling — even a little — consider talking with your OB, midwife, or a mental health provider. You do not have to be in crisis to explore support.
What is perinatal mental health?
Perinatal mental health covers emotional wellbeing during pregnancy and the first year after birth. It includes a range of conditions — not just one — that can affect both birthing and non-birthing parents. Whatever you're experiencing, it is real, it is not your fault, and support is available.
Up to 80% of new mothers [5]
In the first few days after birth, most new mothers experience tearfulness, mood swings, anxiety, and irritability — sometimes in the middle of moments that are supposed to feel joyful. This is the baby blues. It's caused by the sharp hormonal drop after delivery, combined with sleep deprivation and the overwhelming reality of new parenthood. Research suggests symptoms typically peak around days 3–5 and often resolve within about 2 weeks. If you're in this window and it feels intense — you're not alone, and it often does ease. That said, only your provider can assess what you're experiencing. If something feels wrong, or you're not sure, reaching out can be a helpful next step.
When something feels like more
If what you're feeling is more intense than you expected or is making it hard to function or care for yourself and your baby, consider talking with your provider. You don't have to have the perfect words. If something feels off, support can help you explore what is going on.
You are not the only one affected — and you are not alone
Perinatal mood disorders touch the whole family. When a parent's mental health is supported, it can benefit the whole family — including relationships, bonding, and day-to-day wellbeing. Exploring support is not selfish; it is one way to care for yourself and the people who depend on you.
Perinatal mood and anxiety disorders
Most people have heard of postpartum depression — but it's just one of several distinct conditions that can emerge during the perinatal period. Many mothers and partners experience symptoms that do not fit the "sad new mom" picture they expected. If that's you, there may be a name for what you're going through, and there are providers who can help.
Postpartum depression (PPD)
Affects approximately 1 in 7 mothers. [6] It does not always look the way people expect. Postpartum depression (PPD) can present as numbness, anger, or a sense of disconnection from your baby rather than sadness — and many women do not recognize it in themselves because of that. It can begin at different points in the first year after birth.
Symptoms: persistent emptiness, loss of interest, irritability, difficulty bonding, withdrawal, exhaustion beyond normal tiredness, changes in appetite and sleep.
Postpartum anxiety
Very common, but often less discussed than postpartum depression. [7] It does not always look like worrying about the baby — it can feel like constant dread, a racing mind that is hard to quiet, or a persistent sense that something terrible is about to happen. It can occur on its own or alongside postpartum depression.
Symptoms: excessive, hard-to-control worry, racing heart, shortness of breath, inability to rest even when the baby sleeps, hypervigilance, intrusive "what if" thoughts.
Prenatal depression and anxiety
Depression and anxiety can also occur during pregnancy, not just postpartum, and may increase the likelihood of postpartum symptoms. [7] They are sometimes dismissed as "normal pregnancy emotions" or "just hormones." If you are not feeling okay during pregnancy, that matters and may be worth discussing with a provider.
Symptoms: persistent low mood, loss of interest or pleasure, excessive worry, difficulty sleeping beyond physical discomfort, feeling detached or overwhelmed. Particularly common in the first and third trimesters.
Postpartum OCD
Characterized by intrusive, unwanted, repetitive thoughts — often about harm coming to the baby. These thoughts can be a symptom of anxiety, not intent. They can be deeply distressing and are often kept secret out of shame. A perinatal mental health specialist can help you talk through them safely and without judgment.
Symptoms: distressing intrusive thoughts, compulsive checking, avoidance of certain situations, rituals to "neutralize" thoughts.
Birth trauma and postpartum PTSD
A difficult, frightening, or medically complex birth can be associated with PTSD symptoms. This may include intrusive memories, avoidance, or feeling constantly on alert.
Symptoms: flashbacks, nightmares, emotional numbness, avoiding reminders of birth, hypervigilance, difficulty talking about the experience.
Postpartum rage
Not a formal diagnosis, but a widely reported experience — intense anger that can sometimes occur alongside postpartum depression or anxiety. It may prevent women from seeking help because it does not match the "sad new mother" picture they expected. If this is you, you are not a bad mother, and support may help.
Symptoms: explosive anger at minor frustrations, intense guilt afterward, fear of your own reactions.
Postpartum psychosis
A psychiatric emergency affecting approximately 1–2 per 1,000 births, [8] most commonly in women with bipolar disorder. Onset is rapid — usually within the first 2 weeks. Call 911 or go to the emergency room immediately. With urgent treatment, many women recover.
Symptoms: hallucinations, delusions, rapid mood swings, confusion, disorganized thinking, severely disrupted sleep.
Paternal postpartum depression
1 in 10 fathers and non-birthing partners experience postpartum depression, [2] rising to 1 in 4 when the birthing partner also has PPD. Often presents as irritability, withdrawal, or overworking rather than sadness — and is far less likely to be recognized or treated.
Symptoms: withdrawal from family, increased anger, overworking, numbing behaviors, anxiety about providing, loss of connection.
Who is most at risk
Perinatal mood disorders can affect any parent. But certain factors increase vulnerability — knowing yours can help you and your care team plan support. Having risk factors does not mean you will develop a disorder.
Personal or family history of depression or anxiety
One of the strongest predictors of perinatal mood disorder. [10] Some people choose to share this with their OB, midwife, or therapist before birth so they can plan support in advance.
Previous perinatal mood disorder
Women who experienced PPD with a prior pregnancy may have a higher chance of recurrence. [11] Planning support in advance may help.
Difficult or traumatic birth
Emergency C-sections, long labors, NICU stays, unexpected interventions, or births that felt frightening or out of control may increase risk of PTSD and postpartum mood disorder symptoms.
Fertility struggles or pregnancy loss
Infertility, miscarriage, stillbirth, and recurrent pregnancy loss can be associated with grief or trauma symptoms that may continue into subsequent pregnancies and may benefit from specialized support.
Inadequate social support
Social isolation, limited partner support, and lack of community are important modifiable risk factors. Many people benefit from building support before and after birth.
Thyroid dysfunction
Postpartum thyroiditis affects up to 10% of women in the first year after birth [12] and can cause depression and anxiety that closely mimic postpartum mood disorders. If you're being evaluated for perinatal mood symptoms, you may want to ask your provider whether thyroid testing is appropriate for you.
History of trauma or abuse
A history of childhood trauma, sexual assault, or domestic violence may be reactivated by the vulnerability and physical intensity of pregnancy, birth, and postpartum recovery.
Breastfeeding difficulties
Persistent pain, supply concerns, and feeding pressure are associated with postpartum mood symptoms. The relationship can run both ways — mood symptoms may affect feeding, and feeding struggles may add stress.
If you are in crisis right now
If you are having thoughts of harming yourself or your baby, or simply feel like you cannot hold on right now — please reach out. You do not have to be certain it's serious. You do not have to have all the words. Reaching out can be an important first step. These resources are confidential and available 24/7.
988 Suicide & Crisis Lifeline
Call or text 24/7. Any mental health crisis qualifies — you do not have to be suicidal.
Postpartum Support International
Trained volunteer helpline. Peer support, referrals, and online groups.
National Maternal Mental Health Hotline
Free, confidential, 24/7. Specifically for pregnant and postpartum people.
Crisis Text Line
Text-based support 24/7 — useful if you can't talk out loud.
What treatment looks like
Perinatal mood and anxiety disorders often improve with the right support. Many people see meaningful improvement with care that fits their needs, and reaching out earlier may support recovery.
Therapy
- CBT (Cognitive Behavioral Therapy) — a commonly used, evidence-supported approach for perinatal depression and anxiety [13]
- IPT (Interpersonal Therapy) — an evidence-supported approach for postpartum depression; focuses on relationship and role transitions [13]
- EMDR (Eye Movement Desensitization and Reprocessing) — sometimes used for trauma symptoms, including birth trauma and perinatal PTSD [14]
- ACT (Acceptance and Commitment Therapy) — a mindfulness-based therapeutic approach that may help with anxiety, intrusive thoughts, and emotional adjustment
- Telehealth therapy — can make support more accessible during new parenthood [13]
Medication
- FDA-approved medications specifically for postpartum depression now exist — your OB or psychiatrist can discuss whether they're appropriate for you
- The decision to use medication is nuanced, individual, and best made with your healthcare provider, who can help weigh potential benefits and risks, including the risks of untreated symptoms
- It is generally recommended not to stop psychiatric medication without speaking with your prescriber
Practical support
- Sleep — uninterrupted rest can play an important role in mood and recovery, and even small improvements may help
- Physical movement — even short walks may support mood for some people [16]
- Peer support groups — structured groups can reduce isolation and may help symptoms for some people [13]
- Postpartum doula — may reduce isolation and provide hands-on support in the early weeks
- Baby sleep consultant — if your baby's sleep is contributing to exhaustion, a sleep consultant may help you explore routines that fit your family. Sleep and mood can influence each other.
Finding support locally
If you are looking for perinatal mental health support, matrea can help you find therapists, psychiatrists, and support resources near you.
Support can help — even if this has been going on for a while
Perinatal mood disorders can begin at any point during pregnancy or in the first year after birth. Whether you are 3 days postpartum or 10 months postpartum, whether symptoms are new or have been building for a while, support can still help. Many people do improve, and you do not have to navigate this alone.
Common misconceptions that keep people from getting help
Stigma and misinformation can make it harder to seek care. Here is a gentler, more accurate way to think about it.
"Good mothers don't get postpartum depression."
PPD is influenced by biology, hormones, genetics, environment, and circumstance — not by how much you love your baby or how hard you're trying.
"If I tell my doctor, they'll take my baby away."
Seeking mental health support is a sign of good parenting. In most situations, providers connect parents with treatment and support when a parent asks for help. If there is an immediate safety concern, they may help create a safety plan.
"It'll go away on its own if I push through."
Unlike baby blues, perinatal mood symptoms may persist without support. Talking with a provider can help you understand what is happening and what support may fit.
"I wanted this baby so much — I can't be depressed."
PPD is not caused by ambivalence. It can happen after planned, wanted pregnancies too, and is influenced by biological, psychological, and social factors.
"Medication will hurt my baby."
Some SSRIs have more safety data in pregnancy and breastfeeding than others. [15] Your prescriber can help weigh potential medication risks and benefits alongside the risks of untreated symptoms.
"Partners don't get postpartum depression."
1 in 10 fathers and non-birthing partners experience postpartum depression. [2] It may present as withdrawal, anger, or overworking — and may be less likely to be recognized or treated.
We put this guide together because so many people move through pregnancy or the early postpartum months feeling unlike themselves and unsure how to say it out loud. What you are feeling may be more common than you realize, and it is okay to want support. Sometimes the first step is simply naming that something feels different.
If you take one thing from this page, let it be this: you do not have to reach a certain level of suffering before exploring support. A phone call to your OB, a text to the PSI helpline, or a conversation with someone you trust can be a gentle first step.
Sources
- American Association of Medical Colleges. Maternal Mental Health. 2023. aamc.org
- March of Dimes. Baby blues after pregnancy. marchofdimes.org — "Up to 10% of partners can have feelings of sadness or depression after the birth of a baby."
- Maternal Mental Health Leadership Alliance. Maternal Mental Health Conditions and Statistics. 2024. mmhla.org — "75% of women impacted by maternal mental health conditions remain untreated."
- March of Dimes. Baby blues after pregnancy. marchofdimes.org — "Up to 4 in 5 people who give birth (80%) experience the baby blues."
- UPMC HealthBeat. Postpartum Depression vs. Baby Blues. 2025. upmc.com — "PPD affects about one in seven mothers."
- Fawcett EJ, et al. The prevalence of anxiety disorders during pregnancy and the postpartum period. J Clin Psychiatry. 2019;80(4). pubmed.ncbi.nlm.nih.gov
- StatPearls / NCBI. Postpartum Psychosis. 2023. ncbi.nlm.nih.gov — "Affects around 1–2 per 1,000 females of childbearing age."
- Abramowitz JS, et al. Obsessive-compulsive symptoms in pregnancy and the puerperium. J Anxiety Disord. 2003. Referenced in postpartum OCD literature as up to 70% of new parents experience intrusive thoughts in mild form.
- Dennis CL, Hodnett E. Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database of Systematic Reviews. 2007. Cited in perinatal mental health guidelines.
- Postpartum Depression Statistics. PPD Research & Data. 2025. postpartumdepression.org — "Previous PPD increases the risk of recurrence by up to 50%."
- American Thyroid Association. Postpartum thyroiditis. Cited in ACOG Practice Bulletin; affects approximately 5–10% of women in the first postpartum year.
- Sockol LE. A systematic review of the efficacy of cognitive behavioral therapy for treating and preventing perinatal depression. J Affect Disord. 2015;177:7–21.
- Novo Navarro P, et al. 24 years of EMDR application in PTSD: a meta-analytic study of randomized controlled trials. Ansiedad y Estrés. 2018.
- Weissman AM, et al. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Am J Psychiatry. 2004;161(6):1066–78. pubmed.ncbi.nlm.nih.gov
- Yuan M, et al. Effect of physical activity on prevention of postpartum depression: A dose-response meta-analysis. 2022. Cited in MMHLA resources.
- Policy Center for Maternal Mental Health. 2025 U.S. Maternal Mental Health Risk and Resources by County. policycentermmh.org