Postpartum depression and anxiety: 10 signs to look out for

Mama, are you okay?

We ask that question so casually. Perhaps it's time we listened more closely to the answer.

Too many women are struggling through postpartum while the world around them calls it normal, tells them it will pass, or simply doesn't notice. And the line between "this is hard" and "I need help" isn't always obvious.

Around 1 in 6 women worldwide experience postpartum depression,¹ and postpartum anxiety is thought to be about as common.² It doesn't always look like sadness. It can look like rage, intrusive thoughts, being unable to switch off, feeling disconnected, or simply not being okay.

The first weeks with a newborn bring huge change. Your body is recovering, your hormones are shifting and sleep looks nothing like it used to. So exhaustion gets put down to the baby, irritability to lack of sleep, and constant worry to being a new mum. Often those explanations are right. But when feelings don't lift, get stronger or make it hard to cope, they can be signs of postpartum depression (also called postnatal depression) or postpartum anxiety.

The American College of Obstetricians and Gynecologists (ACOG) recommends that everyone is screened for depression and anxiety as part of postpartum care.³

Baby blues or postpartum depression?

Most women who give birth experience the "baby blues" in the first days after birth, often around days three to five. You might feel tearful, anxious or irritable.⁴ ⁵

The key difference is that the baby blues pass within a couple of weeks. Postpartum depression doesn't. If low mood, anxiety or irritability continues, gets worse or makes it hard to cope, talk to your midwife, doctor or child health nurse.⁵ ⁶ Postpartum depression can begin during pregnancy, soon after birth or any time in the first year.⁷

 

10 signs of postpartum depression and anxiety

Almost anyone caring for a newborn will feel some of these some of the time.

1. Feeling more emotional than usual

Tears can come easily in those early weeks. There’s a lot happening physically and emotionally. But if you’re feeling low or tearful most days and it doesn’t seem to be lifting, it’s worth checking in with someone.⁷

 

2. Finding it hard to switch off

A new baby can bring a whole new world of worries. If your mind feels constantly “on”, you’re always anticipating something going wrong, or the worry is becoming hard to quieten, you don’t have to carry that alone.³

 

3. Struggling to sleep when you finally get the chance

Broken sleep comes with newborn territory. But if baby is sleeping and you’re exhausted, yet you still can’t seem to settle or switch off, mention it to your midwife or doctor.⁶

 

4. Everything feels like a lot

Some days, simply getting everyone fed and dressed feels like an achievement. But if everyday things are regularly feeling overwhelming or harder to manage than usual, that’s worth talking about. You don’t need to reach breaking point before asking for support.⁶ ⁷

 

5. Not quite feeling like yourself

Sometimes it isn’t sadness. Things can simply feel a little flat. If you’ve lost interest in things you usually enjoy or you’re finding it hard to feel much enjoyment at all, take notice of that change.⁷

 

6. Feeling more irritable or on edge

Sleep deprivation can test anyone’s patience. But if you’re regularly feeling angry, restless, snappy or unusually irritated with the people around you, it can be another sign that you might need a little more support.⁶ ⁷

 

7. Being really hard on yourself

Motherhood can come with an enormous amount of self-doubt. If thoughts like “everyone else is coping better than me” or “I’m not doing this right” are becoming a constant soundtrack, tell someone. Having a hard time has nothing to do with how much you love your baby or how good a mother you are.⁷

 

8. Finding it harder to think clearly

A certain amount of newborn brain fog is very real. But if concentrating, remembering things or making simple decisions feels particularly difficult, especially alongside some of these other changes, it’s worth mentioning.⁷

 

9. Connection is taking a little longer

Not everyone feels an instant rush of connection with their baby. Bonding can happen slowly, and that’s okay. If you’re consistently feeling very disconnected, distressed or troubled by how you’re feeling towards your baby, it’s something you can talk about openly and without judgement.⁷

 

10. Having thoughts that frighten you

Sometimes new mothers experience intrusive or upsetting thoughts that feel completely unlike them. If you’re having thoughts that feel unlike you, overwhelming or difficult to shake, please reach out to someone you trust. You don’t have to sit with them on your own, and support is there when you need it.³

If you have these thoughts, or concerns, please say them!

And if you don’t quite know how to put what you’re feeling into words, start small. Tell someone you feel safe with, “Something doesn’t feel quite right,” or even, “I’m finding things harder than I expected.” You don’t need to explain it perfectly for someone to listen.

People you can speak to:

+ Your doctor or GP

+ Your midwife or maternal health nurse

+ Your obstetrician

+ Your partner

+ A parent, sibling or family member

+ A close friend

+ Another mum you trust

+ A counsellor, psychologist or therapist

+ A postpartum or maternal mental health support service

+ A local helpline or support line

You don't need to justify why you're finding it hard, and it doesn't have to get worse before you talk about it. It doesn't have to sound better than it feels, either.

This isn't the moment to put on a brave face.

If it all feels a bit too much to put into words, you can just start with "I'm not okay today."

Or try:

• "I haven't felt like myself lately."
• "I'm feeling anxious most of the time."
• "I think I need some help."

Postpartum depression and anxiety are treatable, and saying something is the first step.⁵ ⁶

 

How to support a new mum

We ask new mothers about their babies constantly. Ask about her too. Instead of "How are you?", try "How are you finding everything, really?" Then listen.

Practical help matters. Help with meals, housework and other children so she can rest.⁴ So rather than "Let me know if you need anything," try "I'm bringing dinner tonight. What time suits?"

Motherhood exists in a new reality, but the systems meant to support women haven't kept up. Your body is recovering at the same time as your mind. After a vaginal birth, soreness can last a couple of weeks, especially with tearing or stitches. Recovery after a C-section usually takes longer.⁴

Care can also look like an uninterrupted shower, a meal someone else made, or letting someone hold the baby while you sleep. None of these treat postpartum depression or anxiety. They are part of caring for the whole mother, which ACOG also recommends: postpartum care should look at mood, sleep, physical recovery and wellbeing together.⁸

Frequently asked questions

How common is postpartum depression?
Around 1 in 6 women worldwide experience postpartum depression.¹

How long do the baby blues last?
The baby blues usually start a few days after birth and pass within a couple of weeks. If feelings persist or get worse, talk to your midwife or doctor.⁴ ⁵

What is the difference between postnatal depression and postpartum depression?
They are the same condition. "Postnatal" is more common in Australia, New Zealand and the UK; "postpartum" is more common in the US.

Can postpartum anxiety happen without depression?
Yes. That's why ACOG recommends screening for anxiety as well as depression.³

If you need support now

All services below are free and confidential, designed to help and support you.

Australia

• PANDA National Perinatal Mental Health Helpline: 1300 726 306 (panda.org.au)
• Lifeline, 24/7: 13 11 14
• Emergency: 000

New Zealand

• Need to Talk? Call or text 1737, 24/7 (1737.org.nz)
• Emergency: 111

United States

• National Maternal Mental Health Hotline, 24/7: call or text 1-833-TLC-MAMA (1-833-852-6262) (hrsa.gov)
• Call or text 988
• Emergency: 911

References

1. Wang Z, et al. Mapping global prevalence of depression among postpartum women. Translational Psychiatry, 2021. nature.com
2. Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. British Journal of Psychiatry, 2017. cambridge.org
3. American College of Obstetricians and Gynecologists. Patient screening: perinatal mental health. acog.org
4. Health New Zealand. The first week after the birth. healthnz.govt.nz
5. healthdirect Australia. Postnatal depression. healthdirect.gov.au
6. Health New Zealand. Postnatal depression. healthnz.govt.nz
7. NHS. Postnatal depression. nhs.uk
8. ACOG. Clinical Practice Guideline No. 4: Screening and diagnosis of mental health conditions during pregnancy and postpartum (2023). acog.org