After giving birth, parents are often asked how the baby is sleeping, eating, growing, and adjusting. But there is another question that deserves just as much attention:

How is the parent doing?

Changes in hormones, physical recovery, interrupted sleep, feeding challenges, new responsibilities, and the enormous adjustment of caring for a newborn can all affect emotional well-being. Some mood changes are common after childbirth, but persistent or severe symptoms should never simply be dismissed as “new-parent exhaustion.”

Perinatal mental health conditions are real medical conditions, and treatment is available. Recognizing the signs and asking for help early can make an enormous difference for both parents and their babies (Dennis et al., 2024).

The “Baby Blues”

Many new mothers experience what is commonly called the baby blues during the first days after delivery.

Symptoms may include:

• Crying more easily than usual
• Irritability
• Feeling overwhelmed
• Mood swings
• Anxiety or worry
• Difficulty sleeping
• Feeling unusually emotional

Baby blues typically begin shortly after delivery and improve within approximately two weeks.

If symptoms are severe, are getting worse, interfere with daily functioning, or continue beyond two weeks, it is important to speak with a healthcare professional.

Postpartum Depression

Postpartum depression is more than simply feeling tired, overwhelmed, or having a difficult day. It is a medical condition that can affect mood, thinking, sleep, relationships, bonding, and a parent's ability to function.

Possible symptoms include:

• Persistent sadness or frequent crying
• Feeling hopeless, empty, guilty, or worthless
• Loss of interest in activities that were previously enjoyable
• Severe anxiety or constant worry
• Feeling disconnected from the baby
• Difficulty bonding with the baby
• Feeling like a “bad” or inadequate parent
• Significant changes in appetite
• Difficulty concentrating or making decisions
• Sleeping excessively or being unable to sleep even when given the opportunity
• Feeling unusually angry or irritable
• Withdrawing from friends or family
• Feeling unable to cope with everyday responsibilities
• Thoughts about death, suicide, or harming oneself

Postpartum depression is not a reflection of someone's ability to be a good parent. It is a health condition that deserves the same attention and treatment as any other medical condition.

Research supports screening during pregnancy and the postpartum period so symptoms can be recognized and treatment initiated as early as possible (Dennis et al., 2024).

What About Postpartum Anxiety?

Anxiety can also become overwhelming during pregnancy or after childbirth.

Some worry is expected when caring for a newborn. However, anxiety may need professional attention when worry becomes difficult to control or begins interfering with sleeping, eating, leaving the house, caring for the baby, or enjoying everyday life.

Symptoms can include:

• Constant fear that something bad will happen
• Racing thoughts
• Feeling unable to relax
• Repeatedly checking on the baby
• Difficulty sleeping because of worry
• Panic attacks
• Physical symptoms such as a racing heart, nausea, dizziness, or shortness of breath
• Avoiding activities because of fear
• Feeling constantly “on edge”

Parents do not need to wait until symptoms become severe before asking for help.

Intrusive Thoughts Can Be Frightening

Some postpartum parents experience unwanted and upsetting thoughts or mental images. These are sometimes called intrusive thoughts.

Having an unwanted thought is not automatically the same as wanting to act on it. However, frightening or persistent thoughts should be discussed honestly with a qualified healthcare professional so the parent can receive an appropriate assessment and support.

If a parent believes they may act on thoughts of harming themselves or someone else, seek emergency assistance immediately.

Postpartum Psychosis: Know the Emergency Signs

Postpartum psychosis is different from postpartum depression. It is rare, but it is a psychiatric emergency that requires immediate medical treatment (Toor et al., 2024).

Warning signs may include:

• Hallucinations—seeing or hearing things that others do not
• Delusions—strongly believing things that are not based in reality
• Severe confusion or disorientation
• Paranoia or extreme suspiciousness
• Dramatic or rapidly changing moods
• Extremely unusual behavior
• Severe agitation
• Mania or unusually elevated energy
• Going for long periods with very little or no sleep
• Appearing disconnected from reality
• Thoughts or commands involving harm to oneself or the baby

Do not leave a parent experiencing these symptoms alone with the baby. Seek emergency medical care immediately.

Postpartum psychosis is treatable, but rapid intervention is extremely important.

Partners and Families: You May Notice the Change First

Sometimes the person struggling does not recognize how much their behavior, thoughts, or mood have changed.

Partners, grandparents, relatives, and friends should pay attention when someone seems significantly different from their usual self.

Instead of saying:

“It's just hormones.”

“You're just tired.”

“Every new mom feels like this.”

Try:

“I've noticed you haven't seemed like yourself lately, and I'm concerned about you. You don't have to handle this alone. Let's find someone who can help.”

Offering practical support can matter too. Bring a meal. Wash bottles. Hold the baby while the parent showers. Help arrange an appointment. Sit with them while they make a phone call.

Supporting a new baby also means supporting the person caring for that baby.

When Should I Ask for Help?

You do not have to wait until you are in crisis.

Contact your OB/GYN, primary care clinician, psychiatrist, therapist, or another healthcare professional if emotional symptoms:

• Last longer than two weeks
• Are becoming more intense
• Make caring for yourself or your baby difficult
• Interfere with sleeping or eating
• Cause significant anxiety or panic
• Make you feel disconnected from yourself or your baby
• Concern you or the people close to you

Treatment may include counseling, additional support, medication, or a combination of approaches depending on the individual's symptoms and circumstances.

GET HELP NOW

Call 911 or go to the nearest emergency department if there is an immediate danger to the parent, baby, or another person.

For suicidal thoughts, a mental-health crisis, or immediate emotional support, call or text 988.

988 Suicide & Crisis Lifeline
Call or text: 988
988 Suicide & Crisis Lifeline

National Maternal Mental Health Hotline

Pregnant and postpartum individuals and their families can call or text:

1-833-TLC-MAMA (1-833-852-6262)

The hotline is free, confidential, and available 24 hours a day, 7 days a week.

National Maternal Mental Health Hotline

Postpartum Support International

Postpartum Support International provides support groups, education, a provider directory, and resources for parents and families.

Postpartum Support International — Get Help

Massachusetts Resources

Massachusetts provides information and resources for families experiencing perinatal mood and anxiety disorders.

Massachusetts Perinatal Mood & Anxiety Disorder Resources

Massachusetts healthcare professionals can also access MCPAP for Moms, which assists providers with consultation and connecting patients with appropriate behavioral-health resources.

MCPAP for Moms

One More Reminder

You do not need to wait until you're “sure” something is wrong before asking for help.

If something doesn't feel right, tell someone.

Pregnancy, childbirth, and caring for a newborn can be enormous physical and emotional transitions. Asking for support is part of taking care of yourself—and taking care of your baby.

References & Additional Reading

Dennis, C.-L., et al. (2024). Postpartum depression: A clinical review of impact and current treatment solutions. Journal of Obstetric, Gynecologic & Neonatal Nursing.
PubMed — Postpartum Depression Clinical Review

Toor, R., et al. (2024). Postpartum psychosis: A clinical review. Current Psychiatry Reports.
PubMed — Postpartum Psychosis Review

American College of Obstetricians and Gynecologists. Perinatal mental health screening and treatment guidance.
ACOG Perinatal Mental Health

National Institute of Mental Health. Perinatal depression.
NIMH Perinatal Depression

This information is provided for general patient education and is not a substitute for individualized medical or mental-health care. If you are concerned about yourself or someone else, contact a qualified healthcare professional.

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