Postpartum Can be a Difficult Time Emotionally

Be aware of the signs and symptoms of postpartum health issues.


Welcoming a new baby into the home can be a joyful and exciting time. It can also be overwhelming and exhausting. People can experience a range of emotions following delivery, including the very typical, very common “baby blues.” Less frequently, mental health issues can develop in the postpartum period that should be evaluated by a mental health professional. About 13% of people experience emotional difficulties after giving birth that could benefit from treatment.

All parents are vulnerable to emotional difficulties after delivery. Those at increased risk include people who have suffered from depression or anxiety during the pregnancy or before, those who live in high-stress environments, or those who don't have enough emotional, social, or economic support. Sleep deprivation as well as hormonal and genetic factors also contribute to postpartum mental health issues.

It's important to be aware of the signs and symptoms of postpartum mental health issues and to get help if needed. When these issues are recognized, evaluated, and treated early by skilled, caring health professionals, there is usually a full recovery within weeks.

Baby Blues

  • Usually starts within the first few days or the first week after giving birth.
  • Baby blues occur in up to 90% of those who given birth.
  • Symptoms: crying or tearing up a lot, sadness, anxiety, irritability, edginess, moodiness.
  • Considered a normal response which usually gets better within the first few weeks after delivery (If symptoms don't improve by three weeks postpartum, call your obstetrician).
  • Treatment: Emotional support, rest, and help with household activities and chores.

Postpartum Depression (PPD)

  • A more serious condition than the baby blues.
  • May start any time within the first year postpartum, usually within first 2-3 months.
  • May include all symptoms of baby blues plus depressed mood, trouble sleeping, extreme self-doubt, appetite disturbance, agitation, fear, anger, helplessness, hopelessness, lack of or over concern for baby, thoughts of harming self or baby, not wanting to be alone with baby.
  • Treatment: may include therapy, medication, more support at home, and referral to community agencies.

Postpartum Anxiety or Panic Disorder

  • Usually begins within first 3 months postpartum.
  • May include intense anxiety, panic; racing thoughts; restlessness; excessive worry; feelings of terror, dread or sense of doom; heart palpitations; fear of being alone with baby.
  • Treatment: may include therapy, medication, and referral to community agencies.

Postpartum Obsessive-Compulsive Disorder (OCD)

  • Symptoms may include disturbing thoughts that keep coming back or that make it hard to think about other things (intrusive thoughts), or urges to perform certain activities over and over.
  • In postpartum OCD, intrusive thoughts may focus on the care and well-being of the baby.
  • Treatment: Early treatment is essential and may include therapy and medication.

Postpartum Psychosis (PPP)

  • Extremely rare: occurs in only 1-2 out of every 1,000.
  • Symptoms usually occur in the first 2 weeks after giving birth, and usually to people who have had psychotic episodes in the past.
  • Symptoms may include extreme agitation, confusion, withdrawal, strange behavior, seeing and hearing things that aren't there, paranoia, frantic energy, thoughts of harming self or baby.
  • Treatment: Postpartum psychosis is a psychiatric emergency; immediate treatment is essential. Treatment includes medication and hospitalization.

Don't Wait to Get Help

Don’t wait to call for help. Treatment is available for postpartum mental health issues. Please call for help right away if you have signs of a mental health issue as described above. Let a partner, family member, or friend know about your distress. It is important to ask for and to accept support from partners, family, and friends during this time.

Call your obstetrician, primary care doctor, or mental health professional as soon as you notice any symptoms of postpartum depression, anxiety or panic disorder, obsessive-compulsive disorder, or psychosis as described on this page. Talk to those close to you about how you are feeling.

Warning signs: Get help right away if you:

  • find it hard to function and cope with everyday activities
  • have thoughts of harming yourself or the baby
  • have feelings of anxiety, fear, panic, or depression that last several hours of the day
  • feel confused, or if you are seeing or hearing things that aren’t really there
  • are concerned that the “baby blues” are not going away

Partners and family: If you suspect that the new mother has a serious mental health issue and she is not getting help, please call her obstetrician or primary care doctor for advice.

Go to the nearest emergency room or call 911 if you ever feel you may harm yourself or someone else.

Resources

Department of Social Work Clinical social workers with expertise in postpartum adjustment provide information, referral and counseling. 617-667-3421

Postpartum Support International Caring, support and resources for mothers and families. 866-472-1897

Jewish Family and Children’s Services Services focus on the early infant-parent relationship. 781-693-5652

The Freedman Center Interface Referral Service Free referrals to perinatal support groups and psychotherapists with perinatal expertise; Helpline: 888-244-6843.

The Parent Connection A free service to first-time parents at BIDMC, connecting you with experienced parents who can provide support. 617-667-BABY (617-667-2229)