Baby blues versus something more
- Baby blues: mood swings, tears, anxiety and trouble sleeping that start 2 to 3 days after birth and fade within about 2 weeks. Up to 3 in 4 new mothers have them. They are normal.
- Postpartum depression (PPD): persistent sadness or emptiness, loss of interest, trouble bonding, fatigue, guilt or worthlessness, irritability, sometimes thoughts of self-harm. It can start in pregnancy or any time in the first year. Roughly 1 in 7 to 1 in 5 mothers are affected; estimates vary.
- Anxiety and panic: constant worry, racing thoughts, physical symptoms. About 1 in 5 parents. You can be anxious without feeling sad.
- Birth trauma / PTSD: flashbacks, nightmares, avoidance after a frightening birth or NICU stay.
- Rare emergency: postpartum psychosis (about 1 to 2 in 1,000) with hallucinations, confusion, severe insomnia or mania, usually within the first 2 weeks. Call 911 or go to the ER. The person may not realize they are ill, so family must act.
When to ask for help
If symptoms last past about 2 weeks, get worse, or get in the way of caring for yourself or your baby, tell your doctor, midwife or health visitor. PPD and anxiety are treatable with talk therapy, medicine if needed (most are compatible with breastfeeding; decide with your provider), and support groups. Getting help sooner is better.
Scary thoughts
Many new parents have sudden, upsetting thoughts of harm coming to their baby. If you find them horrifying and unwanted, they are intrusive thoughts, a common symptom of anxiety or perinatal OCD, and the International OCD Foundation says acting on them is extremely unlikely. They do not make you a bad parent. Tell a clinician; they have heard it before and want to help. If thoughts come with hallucinations or a belief that harming is right, that is an emergency: call 911.
Dads and partners get it too
- About 1 in 10 dads have postpartum depression, and 5 to 15% develop an anxiety disorder, according to Postpartum Support International. Rates are higher when the mother has PPD.
- It often looks like irritability, anger, withdrawal, working longer hours, numbness, drinking more, or avoiding the baby, not tears.
- Risk goes up with a past mental health condition, money stress or a strained relationship. PSI offers dad groups and peer mentors.
Words that help
- To a partner: "I'm not okay and it isn't just tiredness. Can you sit with me for five minutes and just listen?"
- To a doctor: "Since the birth I've had [sleeplessness, panic, scary thoughts, no enjoyment], and it has lasted [X weeks]. I'd like to be screened."
- About intrusive thoughts: "I'm having upsetting thoughts about harm coming to my baby. I find them horrifying and I want to tell you in case it's anxiety or OCD."
- To family: "Please don't tell me to enjoy it. I need practical help: meals, laundry, and a night of sleep."
Numbers to keep
- National Maternal Mental Health Hotline: 1-833-TLC-MAMA (1-833-852-6262), call or text, 24/7, free, English and Spanish. Partners and family may use it too.
- 988 Suicide & Crisis Lifeline: call or text 988, 24/7.
- Postpartum Support International HelpLine: 1-800-944-4773 (not a 24/7 crisis line).
- Emergency: 911.
- Outside the US: your GP, midwife or health visitor; UK 111 or 999 in an emergency; Australia PANDA 1300 726 306.
Not feeling okay? Reach out now.
Education, not medical advice. Every baby and every parent is different. Ask your own doctor, midwife or pediatrician about anything specific to you, and call them or emergency services if you are worried. Sources for this guide: Postpartum Support International; HRSA National Maternal Mental Health Hotline; NIMH: perinatal depression; Mayo Clinic: postpartum depression; NHS: postnatal depression and postpartum psychosis; March of Dimes; International OCD Foundation: perinatal OCD; Mind (UK); PANDA (Australia); Sleep Foundation: parents and sleep deprivation. All sources.