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Coping With Postpartum Depression

Cavan Images / Getty Images

Emotional Tips

Physical wellness, social strategies.

While nobody wants to be deal with postpartum depression , receiving a diagnosis can actually be a welcome relief in some ways. Now that you and your medical team have identified the problem, you know what needs to be done and can begin treatment.

These days, there are so many resources out there to help moms who are struggling with a postpartum mood disorder—from therapists, psychiatrists, medications, and support groups. So you are well on your way toward feeling better and more like yourself again. 

Still, the day-to-day life of a mom caring for a young child (or several!) can be a struggle, and living with postpartum depression only makes it harder. That’s why no treatment plan would be complete without tips for how to cope with postpartum depression on a daily basis, and what lifestyle changes may be necessary to get you through this difficult time.

So here are some tried-and-true, mother-to-mother tips for coping as you navigate your journey through postpartum depression. These tips may also come in handy for anyone who is supporting or caring for you along your journey.

When you first start your journey toward healing from postpartum depression, it may feel nearly impossible to do much of anything—and that is understandable. You can talk with your therapist or counselor—along with the support people in your life—about how to motivate yourself to make necessary life-changes and manage your postpartum depression.

Still, even if you feel stuck at first, a little goes a long way. Even just making one small conscious choice toward emotional wellness per day can make a huge difference—and each small step adds up.

Here are some emotional self-care tips to manage the roller coaster of postpartum depression:

Make Time for Yourself

This may sound completely impractical when you are caring for a baby! Yet one of the triggers of postpartum depression is feeling overwhelmed and like your sense of self has been lost in a pile of diapers and burp cloths.

Taking time for yourself doesn’t have to be extravagant. Maybe it means letting the dishes pile up in the sink while you read the next chapter in your favorite novel. Maybe it means getting in a sweat session while your baby naps . Whatever it is, take a handful of minutes out of your day just for you. Make yourself a priority.

Recognize When You Need Help—And Ask for It

Many new moms think they need to “do it all” or they aren’t a good mom . But that’s far from the truth. You simply can’t do everything, and you won’t be failing yourself or your baby in any way if you reach out for help. Yes, that may mean learning to ask for the help—because not everyone knows what would help you the most in any given situation.

It also means recognizing that there are a lot of people in your life who are ready to do things like drop off a meal for you or hold your baby while you take a nap—you just have to be willing to accept that help into your life.

Help can also mean talking to your mental healthcare provider (or seeing your primary care physician for a referral if you don't yet have one). Regular talk therapy has shown to have many emotional benefits.

Postpartum Depression Guide

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Give Yourself Time To “Feel The Feels”

When you are busy caring for a baby and are “on” all the time, it can be easy to push your feelings aside, or keep them bottled up. That only makes managing the symptoms of postpartum depression that much harder. You need to be able to feel the difficult feelings in order to move through them.

Of course, feeling everything at once can be intense! It can be helpful to carve moments into your day where you consciously sit down, close your eyes, and just let yourself feel.

You can add some deep breathing to this, or you can take a few moments to write down your feelings, or share them with a loved one. Either way, make time for this. You deserve it.

Recognize Your Limits

Many moms who live with postpartum depression feel an intense amount of pressure to be a “perfect mom,” but understanding that that is virtually impossible is an important step toward letting go and feeling better. It is just not possible to have a tidy home, a happy baby, a streamlined schedule, and a freshly cooked dinner on the table each night—at least not all at once.

Recognize your limits right now. Remember that the season when your baby will need you this intensely is only a season. Prioritize your mental health, and the health and well-being of your baby, above all else right now. The laundry can wait—and so can that long list of baby gift “Thank You” notes.

The idea of fitting in exercise, sleep, and other healthy habits may sound completely far-fetched right now. The thing is, taking care of your physical health can have a direct effect on your mental health, so it’s vital that you focus on this right now, at least to some extent. Here again, you need to remember that more does not equal better.

Taking care of your physical health can happen in small spurts, between your baby’s feeds and naps. But each thing you do adds up and will help you feel better.

Exercise has been shown to have a positive effect on decreasing postpartum depression symptoms. A meta-analysis of 12 research studies published in the journal Birth found that, “physical exercise during pregnancy and the postpartum period is a safe strategy to achieve better psychological well‐being and to reduce postpartum depressive symptoms.”

How to fit exercise in when you are a busy, exhausted mom? There is almost no baby out there who doesn’t like motion. So strap your baby into a carrier , or safely into a stroller, and go on a walk. If you prefer solo exercise, try to fit it in when your baby is napping, or you have care for your baby. The laundry and dishes can wait. Even 10-15 minutes of exercise a day can help you tremendously.

Research has found that inadequate sleep increases your risk of postpartum depression symptoms.   But most of us don’t need to read a research study to know that lack of sleep makes it very difficult to function—and can lead to all kinds of emotional upset.

The problem is that sleep disruption and new motherhood go hand in hand. Babies don’t sleep the same way that adults do. They sleep in short spurts and wake frequently at night—and there’s not much you can do to change that, especially in the early months. Your best bet here is to find creative ways to make your own sleep a priority.

How to do that? Go to sleep earlier than you normally do (again, those chores can wait!). Ask your support people to hold your baby while you nap for a few hours. Ask your partner to let you sleep later in on the weekends. Have your partner take a few middle of the night feeds, or have them bring your baby to you for feedings. Think outside the box, but do make sleep a priority.

Healthy Eating

Healthy eating is another thing that can fall by the wayside when you are caring for a baby, but you will feel better overall if you nourish your body with healthy foods. Yes, you want to make meal prep as simple as possible right now, but that doesn’t mean you should skimp on quality.

For many of us, it can be helpful to have healthy snacks laid out around the house for easy access while we are feeding our baby. Same goes for drinks. Remember that if you are breastfeeding, you will likely need more calories right now. Whenever possible, focus on whole foods that are nutrient-dense, such as nuts, meats, eggs, and other proteins; fruits and veggies; and whole grains.

Remember that you can’t do this alone. Motherhood is not meant to be an isolating experience. For most of human history, your community (“the village”) would support you when you had a new baby.

With so much of that lost these days, we often have to create those communities ourselves. But many are out there, if you only seek them.

Join a New Parent Support Group

There are many new parent support groups—whether at the hospital you gave birth, a community rec center, a library, or a new parenting support center. There are support groups that are specific to moms who are battling postpartum depression, and there are support groups specific to your interests or circumstances, including breastfeeding support groups, general parenting support groups, and more.

These groups are there to address any issues and questions you may have, but they are also about forming bonds with other moms, and taking comfort in the fact that you are not alone in your struggles.

Join an Online Support Group

These days, so many moms find their tribes online. There are so many online parenting support groups. Some may deal specifically with postpartum depression, but others may just have to do what a hobby, such as knitting or scrapbooking.

What’s great about online moms groups is that you can connect to other moms while you breastfeed your baby on the couch, or while you’re up again feeding your baby in the middle of the night. There is true value in having that kind of a lifeline.

Resources and Organizations

Here are some wonderful organizations and support networks that can help you on your postpartum journey:

Anxiety and Depression Association of America (ADAA)

National Alliance on Mental Illness (NAMI)

The American College of Obstetricians and Gynecologists (ACOG)

Postpartum Support International: Find Local Support and Help  

Postpartum Progress: Support Groups

A Word From Verywell

One of the important things to remember about postpartum depression is that it will take time for you to feel completely better. Healing is a day-to-day type of thing, and you need to have patience, and be gentle with yourself. You will not be able to make all of the changes to your life all in one day, or even one week. And all of the suggestions offered here are only suggestions, too. You can take what feels right to you, and leave the rest behind.

Remember that you can’t—and shouldn’t—do this alone. Your doctors and therapists are there for you. So are your friends and loved ones. Reach out to them whenever the need arises. They can help you answer any questions and concerns you have, especially when the day to day reality of parenting a baby feels all-consuming and insurmountable.

Above all else, remember that you and stronger and resilient than you even know. You’ve got this, and you are going to be okay.

Poyatos-león R, García-hermoso A, Sanabria-martínez G, Álvarez-bueno C, Cavero-redondo I, Martínez-vizcaíno V. Effects of exercise-based interventions on postpartum depression: A meta-analysis of randomized controlled trials . Birth. 2017;44(3):200-208. doi:10.1111/birt.12294

Lewis, B.A., Gjerdingen, D., Schuver, K.  et al.   The effect of sleep pattern changes on postpartum depressive symptoms .  BMC Women's Health   18,  12 (2018). doi:10.1186/s12905-017-0496-6

By Wendy Wisner Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.

7 Postpartum Depression Survivors Share Their Stories Of Having More Children

by Katherine Stone | 41 comments

[Editor’s Note: This week we’re doing a special five-part series featuring seven mothers who survived postpartum depression or a related illness and went on to have more children. The series was put together by Amber Koter-Puline, and will feature input from these mothers on their experiences. I know you’re going to love this. -Katherine]

Welcome to our world. The world of survivors of perinatal mood and anxiety disorders, like postpartum depression, who have decided to have more children. Some of us are well down the path with those additions, and others are waiting. You’ll learn more about that later. For now, I invite you to sit back, relax, maybe even grab a cup of tea and meet the women who changed my life.

Amy Brannan

Amy blogs at Living Life Joyously .

Amy has a four-and-a-half-year-old daughter and is working on adopting the next. She and her husband have been married for five years and live in Washington State. Here’s Amy, in her words.

I never had any symptoms until my daughter was five months old. I went to numerous doctors because I knew something was “off” but no one mentioned postpartum depression ever and that is the hardest thing for me to still accept. I finally started doing my own research and found a website about PPD; I had every symptom listed. My husband and I went to my doctor and I was finally diagnosed with postpartum depression and anxiety with OCD tendencies in 2008. I started counseling and medication when my baby was ten months old. This continued for 2.5 years. In late 2010, I wasn’t getting better or at least felt like I was stuck, like I was almost over the last hurdle. I was encouraged to start seeing a psychiatrist and she helped tremendously. I also began to diligently start seeking out women who have/had postpartum depression which was when I found PPD blogs and finally started seeing the light at the end of the tunnel so to speak. Facebook, PPDChat and this group of survivor moms saved my life and my sanity and allowed me to accept what is now my testimony in hopes to help others. I also started my own PPD survivor’s blog, to start writing as a way of healing for me. I still battle anxiety and depression that was brought on by the PPD but it is no longer PPD. We have chosen to not get pregnant again because of the severity of my postpartum depression so we are on the waiting list of adopting our next baby! That in itself was the hardest decision to make—choosing not to become pregnant again and feeling like I was broken, no good, choosing second best and a failure. I’d like to assure women that everyone will have a different journey and every woman will have different symptoms. I’d like to encourage women that they are not damaged or different, that they are not failures as moms or wives. Guilt can be a very damaging aspect of PPD; I am proof of that. I’d like to share some thoughts on choosing “not” to become pregnant after PPD again and how women make that decision. I really needed to read about that and I found very little last year when I was struggling the most over this. I hope to be able to reach women like me who found help when they thought they had reached the end. Women who don’t know what is wrong with them and feel alone. I want to offer support and encouragement to their families, especially their husbands. I would not have made it if it weren’t for my incredible husband and his support and love.

Deborah Rimmler

Deborah is a married mom to two boys. Meet Deborah.

In this series, I would like to share what we as a group and individually found that worked to help create a new postpartum experience for us and our families. I hope we’ll reach any moms thinking of having a baby after postpartum. Kind of like those who have successfully had a vaginal birth after c-section or VBAC. We are the “BAPPD” (Baby After PPD) survivors with a positive message.

Grace Parson

She blogs at Arms Wide Open and Tweets at @OurArmsWideOpen

Grace and her husband have been married for eight years and have a 3 ½ year old son and had a baby boy born in October, 2011. She is an American from Oregon who has been living in Mexico since 2006. Meet my friend, Grace.

I suffered from postpartum depression and postpartum anxiety most severely from December 2008 to September 2010. I’d like to share about my experiences with postpartum strategies that have helped keep me healthy so far with my second baby, communication with your partner, medication during pregnancy and self-care. I hope that we reach moms in the midst of PPD, giving them hope of recovery and healing. I also hope that moms contemplating having another child will be encouraged and empowered to move forward. You can be well!

Kate Ferguson

Kate has two children is married and lives in the USA. She experienced PPA/PPD after her first pregnancy. Here’s Kate, my friend in real life, too.

I had risk factors and I asked for help, but it was hard to find. Too hard. Professionally and personally that changed the trajectory of my life. For baby two I prepared and managed to have a healthy pregnancy and postpartum period. Six months after my second baby and feeling well, I returned to a job I left in the midst of the postpartum depression turmoil. My job involves helping PPD moms through therapy and advocacy. It’s all very full circle and satisfying. I want to raise awareness of risk factors and encouragement to seek help. And, it’d be nice to have an emphasis on all the different ways we chose to tackle pregnancy after PPD and how valid each was/is (each woman is different, and what she ultimately does for wellness will be unique both in decision and effective care/treatment). I hope to be able to reach women who think that they just hate being a mom as well as those lost ones who don’t know what is wrong and aren’t being helped. I always wanted three children. With my eyes wide open, I am wading in again: my next baby is due May 3, 2012.

Suzanne Stanard

She blogs at Pretty Swell Blog , is on Facebook and Twitter .

Suzanne is married with two children. She survived postpartum depression and anxiety with her first baby and she is just out of the trenches with baby number two. She lives in North Carolina. ’m pleased to introduce Suzanne.

One of the biggest lessons I learned with my first baby is how important it is to reach out for help if you think something is wrong. I waited longer than I’d like to admit, but once I took that first step the relief was immediate. I was fortunate not to experience PPD/A the second time around largely because I did some important things to prepare (and we all knew the signs to look for). I really hope that through this series we can reach moms who’ve survived a perinatal mood disorder and might be afraid to try for another child out of fear. It IS scary. But it also can be wonderful.

Yuz Rozenblum

Yuz lives in Melbourne, Australia. She’s been married for four years, had three pregnancies, has two children both born at 36 weeks weighing just over 2kgs and both with feeding issues, the second child worse than the first and has since been diagnosed with laryngomalacia (floppy larynx). Yuz, in her own words, which always seem to garner laughs and sometimes even tears.

My daughter was born unexpectedly at 36 weeks. We were separated after the birth and she remained in hospital five days following my discharge. I was officially diagnosed with PPD (called postnatal depression or PND, in Australia) as well as PPA (PNA) when she was five weeks and was admitted to a parent infant unit in a psych facility (which I have affectionately called the nuthouse) when she was eight weeks and was there for three weeks. I went back to the nuthouse weekly for the next nine months and was part of their outreach program where a staff member came to my house every fortnight to check up on how I was doing at home. We decided to have another baby mid 2010 and I was pregnant soon after. Our son was born in at 36 weeks via a scheduled c-section due to a complicated pregnancy (bi-partite placenta, placenta previa & vasa previa the latter giving my son a 20% change of surviving if my membranes ruptured unexpectedly). I was admitted to hospital at 34.5 weeks, got to the scheduled c-section day at 36 weeks and we were both discharged together five days later. After a week and a bit with only a 50g weight gain my son was readmitted to hospital and was there for nine weeks where he was (finally) diagnosed with laryngomalaia (floppy larynx) at 11 weeks (or 7 weeks corrected). I stayed with him for the duration of his admission. The reason I am so passionate about sharing my story is to assure other postpartum depression (postnatal depression) survivors that having a positive experience is possible. Having a perinatal mood or anxiety disorder is not your fault; you didn’t ask for it and most importantly it’s not forever. Even though it was a difficult time for us the second time round, it was not because of my mental state. My love and bond for my son never wavered. On a practical level, I want to be available to share where and how to get the help you need in Australia. We have wonderful resources and a fantastic medical system that makes it easy to seek and get the help you need without taking out another mortgage. On an emotional level, I want to implore mums to plan ahead so that you can give yourself the best chance at having a better experience. The driving force which led me to plan well in advance was my daughter. I didn’t want her seeing me slip and for her to have an even more difficult adjustment period on top of getting used to having a sibling. My other driving force was husband and sparing him having to look after a toddler, a newborn and an unwell wife.

Meet the Interviewer, Amber Koter-Puline :

She is on Facebook, blogs at Beyond Postpartum and Postpartum Healing , and is on Twitter .

Amber Koter-Puline is a part-time working mother of two. Amber suffered a severe postpartum reaction after her first child in 2007. Since recovering with proper treatment and care her passion is supporting and educating expectant and new mothers about the postpartum period and being a first time mother. Amber facilitates new mothers and postpartum support groups in the Atlanta metro area. She lives in Atlanta with her sons and husband.

Amber writes at Beyond Postpartum and when pregnant with her second son decided to create a network of moms who could support one another through pregnancy, trying to conceive or adoption after surviving a perinatal mood or anxiety disorder. She was greatly blessed by this experience and is thrilled to be the “interviewer” in this series of blog posts!

Follow Along with the Interview

• Postpartum Depression Survivor Series, Day 2
• Postpartum Depression Survivor Series, Day 3: The Husbands
• Postpartum Survivor Series Day 4: What Happened After The Next Baby
• Postpartum Depression Survivor Series, Day 5: Coming Together Around A New Baby

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41 comments.

So inspirational. I have had PPD with all 6 of my kids so I know where these ladies are coming from. I'm still battling this horrible demon and my youngest is 5.5 months.

katherine – thank you for letting us share our stories!

Ladies – much love and gratitude for the blessing of you all in my life.

It's so nice to read about the positive and real experiences from other mothers who have suffered from PPD in the past. My husband and I are thinking about having another baby (our first "baby" is almost 2!) and it's nice to know that there are other families out there who have endured. I was a bit nervous at first, even talking about the prospect of giving birth and there being a chance that I could go through the depression again. But this website is such a tremendous source of encouragement and hope.

Good for you for seeking out resources and thinking ahead. There are lots of ways to prepare for and even prevent the severity of PPD in the future. We can't control everything, but the places where we can make adjustments and plan ahead can make all the difference. Peace and best wishes, Amber

So many…so so SO many woman with PPD need to read these stories. They are so important.

I need to read them.

Bookmarked and saved for a "rainy" I may want another baby day

PS. The smiles on all of these faces are absolutely genuine…right from the heart. Love.

This is the answer to my prayers. I've been struggling with the decision of whether or not to have another child. I suffered from severe PP OCD with my first and still have some struggles. I'm so excited to hear these stories so I can make a better informed decision when the time comes.

If you choose to do it, you will get through it. Use your resources! We're all here for you.

Do you know what mental health medications are safe during pregnancy?

Patricia, here is a good resource for you: http://www.mothertobaby.org/otis-fact-sheets-s13037

Ask your doctor. Not the internet.

Really great…this is such a tough issue. I've had PPD twice now, and we've talked a lot about whether or not we should have another baby knowing that it is almost certain I would have it again, and what we can do to try to make it easier if we do have another. Thanks to these brave ladies for sharing their stories!

So glad to have the opportunity to be sharing this journey with these incredible women and to be here, where there is such a great readership, to offer hope and encouragement to those who are expecting or who are considering more children after surviving PPD. We really want to put ourselves out there for all of you…please feel free to ask questions throughout the week or to reach out to us for support!

I'm so glad to hear that this topic is resonating with so many mamas. Hving another baby after surviving PPD is one of the hardest decisions I have ever had to make. I always knew I wanted more than one child & also knew I wanted my baby to have a sibling but had to weigh this decision up with the chance I might have slipped again. The difference is second time is that you already have experience of being a mum – nothing is new or foreign. And you are well armed with info, can word up friends & family to help you & look out for your triggers & basically go into it armed. It's possible to have a better experience but planning is the key. Looking forward to sharing the rest of the weeks interview with you all & as Amber said, if you have any questions, we're here to help. Yuz xxoo

This is such a great idea — thank you to Amber, Katherine, and the women who participated!! 🙂

this is beyond inspiring! thank you for sharing your stories and your progress with us.

I'm so excited to learn about this series. Sometimes I get pangs for baby #2, but then I think, "I cannot possibly go through PPD/PPA again. Forget it." So I definitely will read the series with an open mind. Thank you, all of you, for sharing!

It's a difficult decision and there is no right one for everyone. But, we're here for you to talk to about it…anytime!

Thank you, Katherine, for opening your home to us this week! Honored to be part of this. xo.

My home is your home. – K

It blesses my heart to see women being encouraged from this series. We are here for you all! These ladies in the series have been the greatest encouragement to me the past year!

Such a wonderful, inspirational idea! I am looking forward to it! I think a lot about the "what ifs" surrounding Baby #2 in the future and it helps me to hear stories of women who have been where I am and had a completely different experience the next time around.

Love that you are doing this series and interviewing survivors of Perinatal Mood Disorders! I suffered with PPA/OCD with my first child almost 12 years ago and nothing like this was available. All that you're sharing is SO helpful to moms going through a PMAD. I also went on to have a 2nd child, 2.5 years after the first, and with much planning and preparation, didn't have a reoccurance. Thank you for sharing your stories!

Love this series. I know and love many of these mamas, and I know their strength, so it's great to see that here. Those of us contemplating another after PPD need to hear these stories, so thank you.

Hello, My name is Jennifer. I am 29 years old. My daughter was born in November 2007. Shortly after I had her, my husband noticed that I wasn't acting like myself. I wasn't sleeping, wasn't eating, having crazy thoughts. I never wanted to harm myself or my daughter thank God, but he knew something just wasn't right so he took me to the hospital. I was admitted to the psychiatric ward for almost 3 weeks, for post-partum psychosis. This is very rare and very scary. The nurses and doctors did not even know I had it at first. It took my best friend doing research of my symptoms on the internet and printing them out and bringing them to the hospital before they actually put two and two together. The closest thing that I can say it was like was like having amnesia. There are things that I don't even remember doing. i had to be told to eat, shower, etc. it was really really hard. I had to be on medicine for quite some time, and it took a while before they got it regulated. I am much better now, still have mild depression some days, but I do not take meds- thats my choice. i really want to have another child but my husband is afraid that the same thing will happen again. It upsets me so bad because i always wanted at least two children and I am very happy that we have our daughter, but I feel as if what did i do to deserve to have what happen to me happen? How can i know if it will hapen again? There needs to be more awareness! I hope this may help others by reading my post. Thank you

Thank you for your honesty. PPP is real and is rare, but you are not alone. There is a Facebook group dedicated to it and there are several stories of it here at PP. Seek both professional and peer support resources if you choose to have another child. They will help make sure you are all safe and well. Peace.

My son is nearly 41/2 and i am dieing inside for baby number 2 i had pnd for 3 years, and we got pregnant last year and it came back but after all that i lost the baby:(, i keep trying to relive having another baby and i feel like i can do it but all the anxity comes back straight away once i build myself to doit, sometimes i just think i should just move on but i so badly want another baby ……….. i am really stuck:(

Can you recommend (or link to another post) ways to prepare for “next time” to minimize the severity of potential PPD/PPA? How can it be prevented?

I thank you for your stories. They are very encouraging. I’m still struggling with having a 2nd child because it was so bad after my first. Almost losing my life, my husband and my son. I’m so much better now but I dont want to risk having anyone go through that again. Any advice?

Miranda, my best advice is to do what you feel is best for you. Each mom is different. Some of us choose to have more children and some of us don’t. It’s certainly possible, if you want to. But there is no right or wrong answer. It might be helpful to have some sessions with a therapist to talk this through if you’re feeling conflicted and not sure which decision to make. ~ K

Miranda, there are many of us that have travelled the road again. Some of us didn’t get PPD the second time because of all the planning we did before & during our pregnancies. Some of us did get PPD again, but it was never as bad as the first time (I am sure there are cases of it being the same or more severe, but not to my knowledge as help & support has been set up). I’ve also started a closed FB group supporting those of us that had PPD & went on to have another baby. There is a comprehensive support action plan, resources etc there that can be accessed at any time. If you’d like me to add you to the group, request to join here or send me a friend request for me to add you. xoxo https://www.facebook.com/groups/316213795134745/ https://www.facebook.com/yuzrozenblum No pressure to join – just know you’re not alone & there’s plenty of support no matter what decision you make. Yxo

I think this is inspirational as well. I’ve been thinking about having another baby for about six months. I feel like I could enjoy things and tackle being a new mother again in a much healthier way. I took me a few years to get well. I had severe ppd and ppa. My daughter is 5 now . We’ll see. It feels right. Thank you for sharing. I’m glad more women are being open rather then hiding. We have to support one another. Nydia

I just found out that we are expecting our 2nd child (our son is 3) and I suffered with ppa after having him. I still have anxiety issues and am on medication to help make it more controllable. I know I am more educated and have better resources then I did when this first hit me out of no where but I am still very nervous. I just want things to be different this time around.

Sonya – It’s perfectly normal to be concerned about all of this the second time around. You’re not alone. The best thing you can do is stay on top of your mental health (it sounds like you’re already doing that!) and get resources and supports in place now for the things you might need during your pregnancy and postpartum period. Like you said, you have so much knowledge this time around and that will surely serve you well.

This is so great to read, I’ve struggled so badly with PND with both my beautiful children. But I hid my feelings as feared what may happen, thanks to a wonderful husband and my own mother I got through some horrible months. I would love another baby, as would my husband, but feel so desperately sad and fearful that I don’t know if I could do it, especially as I never seeked out help. Reading others stories is so healing. Thank you ladies

Way to go the warrior mommies in this series. But shame on you for making it look way too simple. PPD can escalate each pregnancy, so for severe cases, like mine, it’s comparing apples to oranges and giving false hope.

Hello Berry, thank you for your input. It is very important to us to consider those that have a different experience. We also recognize and support mothers who decide not to have more children, and those who cannot. Sharing these particular experiences is in no way meant to belittle the experiences of others. This isn’t the possibility for everyone, but it can be for others. Each post here may not fit all stories and all mothers, but we do our best to honor and respect a wide variety of women and experiences through what we share here.

I saw Emily writes appear on “the cafe” a few days ago, it inspired me to start writing about my experience with severe postnatal depression, I’ve started to write a bit about what I went through, it’s pretty rough reading, but heartbreakingly honest and cathartic. Anyone searching for a real, uncensored story of SEVERE postnatal depression please check it out https://postpostnatal.wordpress.com/

I’ve done everything this second baby to not have ppd and I still do. The treatment curbs it to where I only have angry outbursts once in a while rather than feel suicidal. I am thankful that with help that I am not suicidal this time. What scares me most is having my 3 year old see mommy angry more than how the baby is doing. Have I scarred her for life? I’m trying so hard and failing.

What a truly inspirational and honest account of the journey these women have gone through with their PPD/PPA/PPP/OCD etc. There are so many variables with these conditions and no right or wrong for any woman. I would love to have another child, but I am still in limbo with whether I want to put myself, my husband and most importantly my child (now 2.5yrs) possibly through it again. Although I feel so much better now than I did in those early months of motherhood (I was quite frankly a sleep deprived, anxious wreck), the scars are still there and I am not sure a woman ever completely gets over PPD (does she?). Certainly in my experience I feel I have changed since my experiences and I am not sure I can ever get ‘me’ completely back again. I expect any mother feels that way, PPD or no PPD. More sleep might make things feel better, of that I have no doubt 😉 (my little one is a VERY bad sleeper and always has been… & I am still BF’ing – no judgement please!!). But reading these wonderful stories really does help me get some rationale behind my thoughts of potentially embarking on another pregnancy. My husband says we will get through it and is in full support of us having another child, but as us survivors all know all too well, this is our body, our mind and unltimately our wellbeing that would be affected most, should PPD (or in my case PPA most significantly) rear its ugly head again. Lots to think about and consider… Thank you ladies. xx

I had ppd afyer my first and want to have another one. i asked tge doctor about it he said on that sane day he was quitting but if he were to be my doctor he’d lower my meds byt i was so upset he was qiitting. this is at county mental health. so now i have to wait six months to see a nrw doctor and i am praying he is going to understand that i want a second child. things have definetely changed in my life and my husband and my family think i can handle another baby. my counselor didn’t nescessarily say but said to ask the doctor. from what I’ve read it seems possble to be on certain meds and be pregmant. so far I’ve read very encouraging stories. so I’m waiting to gibd out more from a new doctor but my famiky is willing to pay a private doctor if needed. i just hppe the best qitg this new doctor

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• On being a postpartum depression survivor who had another baby - [...] wisdom and advice to other survivor moms who might be hoping for another child. Here’s the first installment. Each…
• Yuz takes off the mask | PPD to Joy - [...] at the top helping to pull up those below. I started participating in discussions, joined groups (BAPPD – the…
• The Baby After PPD Survivor Series - [...] Day 1 http://postpartumprogress.com/7-postpartum-depression-survivors-share-their-stories-of-having-more-c... [...]
• My Post on PPD to Joy - [...] my posts on Postpartum Progress last month, Yael asked me to write a guest post on her blog about…
• You’re not alone | Not Just About Wee - [...] focus on my recovery & not what people thought of me. It was Valentine’s Day 2012 where I first…
• Paternal Depression - help for dads suffering | Not Just About Wee - […] I’ve posted the series on Postpartum Progress on those of us that formed a group when we were having…
• On being a postpartum depression survivor who had another baby | pretty*swell - […] wisdom and advice to other survivor moms who might be hoping for another child. Here’s the first installment. Each…

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• 6 Things To Avoid If You Have PPD Or Anxiety
• 6 Tools To Help You Feel Understood Thru PPD & Anxiety
• 6 Things That Affect How Long It Takes to Recover from PPD
• The 6 Stages of Postpartum Depression & Anxiety
• 6 Surprising Symptoms of PPD & Anxiety
• The 6 Rights of Every PPD Mom

Meet Katherine

Katherine Stone is the creator of Postpartum Progress. She is a survivor of postpartum anxiety & OCD. Follow her on Twitter at @postpartumprog or on Instagram at @katherine_stone.

Postpartum Disorders

The 3 phases of my postpartum depression journey.

I was diagnosed with postpartum depression (PPD) when my daughter was 9 months old, but struggled during the entire first year of her life. Before I sought help and got treatment, I experienced different moods, emotions and thoughts I didn’t understand. Only when I was hospitalized, diagnosed and put on medication did I no longer blame myself for how I had been feeling. My journey with PPD was long, grueling and not something I would wish upon any new mother. My journey with PPD had three parts that changed me, confused me and sadden me to this day.

Part I: Despair

Two weeks after my daughter was born, a deep sadness began to roll through my body. So deep it was like I could feel it in my bones. Nothing gave me joy, and nothing made me happy, not my daughter’s first smile or precious cuddles with her. Happiness seemed unattainable, and the sadness washed over me constantly throughout the day.

I didn’t understand why I was so depressed. I had just gone through an amazing experience of the birth of my daughter, and I felt broken for not experiencing the joy a new mother should experience. I believed she deserved better and deserved a happy mother who would appreciate special moments with her. I believed the sadness would never go away , and I let it swallow me up for the first nine months of my daughter’s life.

Part 2: Rage

When my daughter was 5 months old, I wasn’t feeling sad anymore, but instead there was an emotion much worse and much more dangerous — rage. Everything in my world made me angry, and most of the time it was my daughter who fed my irrational anger. I let the rage come over me every day and rule my mood. I was too tired to fight it and too irrational to realize it was wrong.

Along with rage came hate, which was targeted at my daughter. I felt like I hated her for changing my life, for taking away my sleep and for dissecting my sanity. One day, while I was trying to put my baby down for a nap, she fought and she screamed until I snapped. I yelled at her, at the top of my lungs, to be quiet. She stopped crying for just one second before tears welled up in her eyes and she looked at me with shock and fear. I had scared my daughter, and in that moment, I no longer hated her but hated myself. I finally realized hating my daughter was not right, I didn’t mean it and something was going on inside my head I didn’t understand.

Part 3: Recovery

The moment I snapped was the moment I knew I needed help. I admitted myself to the psychiatric unit of the local hospital, desperate for answers and for someone to tell me I really, truly, was not a bad mother who didn’t love her child. I stayed in the hospital for eight days, where I attended both individual and group therapies, learned a variety of coping skills, was put on medication and was finally diagnosed with PPD.

Admitting myself to the hospital and admitting there was a problem was the first step in my recovery. To this day, I am still taking more steps. To recover from the first two parts of my journey with PPD, I still attend therapy, take my medication and practice the coping skills I learned in the hospital. My recovery means a lot to me because I’m recovering for my daughter. She needs me and needs me to be better so that I can take care of her. I work toward my recovery every day because she deserves a me who is happy, healthy and who loves her.

My journey with PPD and the first two parts of that journey were heartbreaking for me, and still are when I think back on them. However, my recovery keeps me going, and keeps me positive. I do everything I can to find happiness every day because I missed out on it for so long.

I make sure to cherish special moments with my daughter since I missed so many the first nine months of her life. Right now, the most important things in our life are my recovery and her happiness. I am able to attain both through my use of therapy, medication, coping skills and the unwavering love I have for my daughter. I live for the last step of my PPD journey and put the first two parts of that journey where they belong, in the past.

Madelyn is a 24-year-old single mother of a beautiful 1-year-old genius. She enjoys coffee, maxi skirts, scary movies and long naps. She’s currently trying to break into the blogging world and help break the stigma of mental illness. She battles Bipolar I Disorder, Borderline Personality Disorder, Postpartum Depression and ADHD.

How to Tell Someone You Think You Have PPD

Medical review policy, latest update:, why should you tell someone you have ppd, read this next, how to tell a partner, family member or friend you have ppd, how to tell a doctor or medical professional you have ppd, more tips on asking for help with ppd  .

No new mom is an island, and that's even more true for those who are struggling with PPD. Opening up about your symptoms can be hard, but it's the best thing you can do to start feeling better. So don't wait. 

What to Expect the First Year , 3rd edition, Heidi Murkoff.  WhatToExpect.com, Postpartum Depression (PPD) , April 2021. WhatToExpect.com, Postpartum Depression (PPD) Screening Test , April 2021. WhatToExpect.com, Can Dads Get Postpartum Depression? , April 2021. WhatToExpect.com, Your Postpartum Checkups - When You'll Go and What to Know , June 2021. WhatToExpect.com, The Parent-Baby Bond: What if It Doesn't Happen Right Away? , September 2021. WhatToExpect.com, Postpartum Symptoms and Solutions , September 2021. WhatToExpect.com, Postpartum Recovery Timeline , March 2021. American College of Obstetricians and Gynecologists, Postpartum Depression , December 2021. American Psychiatric Association, What Is Postpartum Depression? , October 2020. Mayo Clinic, Postpartum Depression , September 2018.  National Institutes of Health, National Institute of Mental Health, Taking Control of Your Mental Health: Tips for Talking to Your Health Care Provider . U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Depression During and After Pregnancy , 2019.   Cleveland Clinic, Postpartum Depression , January 2018. Crystal Clark , M.D., M.S.c., Associate Professor of Psychiatry and Behavioral Sciences at Northwestern University and Immediate Past President of Marcé of North America, Chicago, IL.

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More Stories of Hope and Healing

Get Help Now. Call  1-833-TLC-MAMA ( 1-833-852-6262 ) for 24/7 free confidential support for pregnant and new moms. If you are in mental health distress or have a suicidal crisis, call or text the Suicide and Crisis Lifeline at 988 for free and confidential support. Trigger Warning: Mentions of mental health distress, self-harm, and suicide .

Start a healing journey PPD is common and there is help if you are experiencing symptoms or supporting someone who is - explore resources here. Find Support for PPD Support Someone With PPD Explore PPD Resources

Read more stories of hope and healing:

Adriana’s story, lisette’s story.

• Patience’s Story

Carriann’s Story

• Stacy’s Story
• Divya's Story

Jasmine’s Story

I first experienced PPD when I was weaning my daughter – it was shocking, unexpected. I didn’t know that PPD could happen so late. The simplest of things were hard – waking up, getting out of bed, dressing my daughter. I felt frozen and uncomfortable in my own skin. I didn’t know how to move forward.

When I got to the point that every day was harder and harder to get through, I knew I needed help. I found a therapist, but PPD didn’t come up. Then I found a peer support group for women with PPD, and it literally saved my life. Being part of a community of women who were experiencing the same challenges that I was, gave me hope and faith that I could get better.

My PPD healing journey has been long and beautiful. I just wanted to feel better – but it didn’t happen overnight. Once I found support, help and a community, I got stronger and a little better each day. It has not been a straight path, but when I struggle, I know where to go for love, support, and help.

Back to list of Stories of Hope and Healing .

COVID was a backdrop for my pregnancy and postpartum experience. I had lots of scary thoughts during pregnancy and was constantly worrying. I became overwhelmed and would shut down or disconnect. After giving birth, I was depressed, found breastfeeding difficult and felt like a failure. My scary thoughts worsened and when I asked for help at 4 weeks postpartum, I was told that I had the Baby Blues and that it would get better. At 3 months I went back to work, was sleep deprived and the commute was hard – I was very angry and irritable and had suicidal thoughts. I was terrified that the anger and thoughts would lead to something worse. As a woman of color, I was worried that sharing my worst feelings and thoughts could mean having my child taken away.

Finally, I couldn’t ignore how much I was struggling. After 6 months I contacted my healthcare provider again who referred me for therapy, but the wait was too long, and the system had no code for PPD as a diagnosis. I felt so isolated. I searched social media and found Postpartum Support International (PSI), began attending support groups, and realized that I was no longer alone in my struggles. I found a therapist and between the therapy and support groups, things started to slowly get better, but I was still struggling. I had tried to avoid medication – partly because of my Latina culture and partly because I thought that I couldn’t be a ‘real mom’ on anti-depressants. When my suicidal thoughts got worse, I found the courage to ask my doctor for medication – the medication was essential and lifesaving for me.

Within 2 months on antidepressants, continuing support groups, and therapy, I felt like I had come out of the dark hole I had been living in and became the best version of myself ever! I worked hard in therapy to overcome the traumatic experiences of my childhood and my childbirth. I found joy in motherhood that I had not imagined. My experience with PPD, recovery, and now helping other women, have completely changed the trajectory of my life. I am passionate about peer support groups and helping parents not to suffer in silence like me.

Patience's Story

My PPD symptoms came on when my youngest was around 3 months old and my oldest was 2.5 - my husband who is in the military just deployed, and it was during COVID. I felt extremely alone and like I was suffocating - because I was physically isolated and alone. Every day, I woke up and said: "just try to keep yourself and the kids alive." I wasn't eating, was angry, and agitated. It went on for too long, and I realized that these were symptoms of PPD.

Months before my husband left, I tried to be proactive and contacted a therapist, but it didn't go well. Isolated and alone, I finally accepted my parents' offer to move in with them. We stayed with them, and they cared for me and the kids - that gave me the time, space, and support to get out of the dark space I was in. Throughout this time, I reached out to other women in my circle who struggled - that community support was important. It was invaluable.

At first, I felt some guilt because I'm a perinatal mental health therapist. I know the signs, I know the symptoms. But that doesn't make me exempt from experiencing symptoms of PPD. Now, when I look back, I feel like an overcomer, not just a survivor. I feel empowered to share my story with others. At the time I wanted help my way and on my terms. But that was unrealistic. It's okay to accept the "good enough" help even if it is not ideal - good is way better than no support. I'm proud to share and more importantly, celebrate what I overcame!

My PPD journey began June 20, 2015. I was miscarrying my first child and was completely shattered. Shortly after I was pregnant again and was anxious and fearful the entire pregnancy, waiting for a doctor to tell me there was no heartbeat. That never happened and on May 6, 2016, my first son was born. Everyday intrusive thoughts flooded my mind, I kept imagining the worst-case scenario, and was terrified to leave him for a second, while also wanting to just be alone and sleep the day away. My husband seemed so much more emotionally equipped at parenting and it seemed to come easy to him. Once my husband went back to work 2 weeks after our son was born, I struggled. I struggled with breastfeeding, I struggled with getting out of the house, I struggled with any type of self care. This went on for months, I wasn't myself, but I was trying my hardest to mask all of these emotions, because I was ashamed.

After months of struggling, crying by myself in the shower, and avoiding friends, I finally joined an online support group for newly post partum moms and moms who were grieving a loss. Sharing my feelings and journey with other women empowered me, showed me that I wasn't alone. Their support and encouragement convinced me to share how I was feeling with my husband, all of the shame started to vanish, and he immediately supported me through the struggles. He insisted on me getting out in the fresh air each day, showering each day, and we alternated nights so that we shared the around the clock baby duties. This helped immensely, and I really started to enjoy motherhood. Everyday isn't perfect or easy, but now I don't feel alone, I don't feel ashamed, I can speak up and advocate for myself.

My healing journey has had its ups and downs, my husband and I lost two more babies to miscarriage and birthed three other healthy full-term babies over the last 6 years. These losses have caused me fear and uncertainty during my pregnancies, but now I don't suffer in silence. Both my care team and my husband have done a wonderful job at recognizing when I'm anxious or fearful and they've been a constant support over the last 7 years.

Motherhood and postpartum is not linear, I think all mothers struggle sometimes, but having support, sharing my feelings and taking care of myself, has made an incredible difference in my life and allowed me to enjoy this incredible role of mother. Seeing my children smile, grow and look up to me makes me so proud and they encourage me each day.

Back to list of Stories of Hope and Healing

Stacy's Story

I was 31 when my first child was born. As a licensed mental health counselor and an older mom, I felt well-equipped for motherhood's emotional rollercoaster. I first noticed things were off about 2-3 weeks after my daughter was born. I started to have scary, intrusive thoughts and severe anxiety. The “What if “ fears reduced my already limited sleep, and the anxiety would make it hard to breathe. People told me this should be the happiest time of my life, and I was miserable. My husband noticed things weren't right and urged me to get help.​

I was afraid to tell anyone what was going on, so I started researching what was happening to me. The more I researched, the more I recognized the symptoms were PPA/OCD. My OB offered me medication, but I wasn't comfortable taking it. On our Reservation, there were limited resources or accessible information for Native American women like me. I was afraid to let anyone know what was happening. I didn't want to look like a “bad mom.” I ended up not seeking help. I became pregnant again, and it started all over again once my second child was born. Instead of suffering in isolation, I leaned into my support system and advocated for myself by telling them what I needed. My circle of support included my husband, my sister, and my parents, plus I had my mental health colleagues. I gave myself permission to ask for help.

I wanted my kids to have a whole mom and have good memories of me being fully present. My journey has been complicated, but I turned my misery into my mission - learning, getting training, becoming a PMH-C therapist, advocating, and networking with other moms - that nurtures me to spread awareness and has been a huge part of my healing journey. I want to shed light on postpartum mood disorders, especially within minority groups, and advocate for more culturally sensitive information and treatment options.

Divya’s Story

A few weeks after my daughter’s birth, I found myself very on edge. My mind was racing and I couldn’t stop thinking about every bad thing that could happen. I worried about whether she was breathing. Then I would check—and check again. I kept telling myself it would get better as she got a little older, but my anxiety just got more out of control. My husband noticed it getting in the way of my ability to sleep. It was also interfering with my ability to enjoy my baby. I tried to convince myself—and my husband—it was all okay; that I could handle it by myself. But another complicating factor was my own guilt.

I’m a child of immigrants. I was raised to believe when things are hard, I just need to try harder, I was taught to be grateful for what I have. My parents struggled, suffered, and sacrificed for me—so I felt guilty for being anxious instead of just being thankful for having a healthy baby. The guilt made my anxiety even worse. I was finally able to talk to a therapist and get a handle on my feelings. She was wonderfully supportive and a survivor of perinatal mood and anxiety disorders herself. It was incredibly helpful to have my experience validated and see that you can come out on the other side.

I’ve worked hard to understand and un-learn old patterns of guilt and self-blame. I’m now a perinatal psychotherapist working with adult children of immigrants, examining how narratives of struggle and sacrifice interfere with our ability to give ourselves compassion and grace during the postpartum period. I’m grateful for the opportunity to share my story so children of immigrants—and all new parents—can understand they’re not alone, and that help is available.

I had a hard time getting pregnant, so I made it a priority to take care of my health and to be prepared. Being a healthcare provider, I thought that I had all the resources and support I needed, but so many things were surprisingly hard. Breastfeeding was unexpectedly hard, and I felt pressure to do everything well, even while not sleeping and becoming increasingly anxious and developing insomnia. Finally, it became hard to even move from the bed to the couch; days blurred, and I felt hopeless and asked myself "Why did I want this?" It felt like I was failing… At six weeks postpartum, I saw my OB who prescribed antidepressants, but I didn’t want to take them. Finally, my husband begged me to take the medicine and see someone – that was the real beginning of addressing my PPD. He accompanied me to see a psychiatrist, and I finally felt seen. She developed a medication plan with me for sleep and depression, and I started to take them. I continued with the psychiatrist and began to feel better after starting therapy too. I went through a few therapists but finally felt like I connected most with an Asian American therapist. Eventually I tapered off all of my medications, but when we started to think about if I even wanted another child, I found a therapist with perinatal specialty (PMH-C) and have continued with her ever since.

The PPD experience has changed my life – I value my mental health so much more and I try to pay it forward now by helping other moms not suffer as hard as I did. Volunteering for Postpartum Support International was healing in a way; writing and sharing about my experiences has also been therapeutic.  The whole journey has also helped me to realize how I want to parent and how important it is to take care of a mother's mental health. I believe that we must address the guilt about taking care of ourselves. Depression lies to you about your worth – you lose your sense of self-worth. You have to believe that you are the best thing for your baby - under all of the rest, that is the truth. The best gift you can give your child is a mother who is well--mentally and physically.

Start a healing journey

PPD is common, but there's help available for you if you are experiencing PPD and for those who support women with PPD.

• Click here to view our Finding Support for Postpartum Depression webpage, it’s filled with tips and resources for navigating and healing from PPD.
• Click here to download Supporting Someone with Postpartum Depression for more tips on how you can support someone experiencing PPD.
• Click here to view our webpage of shareable PPD media assets and educational materials.
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Hormones and PPD: My Journey Continues…

October 14, 2019

I’m not sure why exactly, but sharing this post is somewhat more uncomfortable than some of my previous posts. In an effort of transparency and the hope of helping someone else, I write the continuation of my journey with postpartum depression and anxiety.

I wasn’t sure at first how my hormones were related to my postpartum depression, but I realized that it’s a piece of my postpartum journey. There are no two identical experiences with PPD and there are still no definitive causes of PPD, so these are the factors that contributed for me.

• History of anxiety and previous symptoms of PPD
• Traumatic birth
• Uncertain life circumstances
• Hormonal depletion and imbalance

Could it be Your Hormones?

This current chapter in my journey started with a friend asking me if I had had my hormones checked. She shared her experiences of needing to take hormones to stabilize her mood and improve her depression and anxiety. I was appreciative that she shared her experience, but I didn’t feel it had any similarity to my situation. I had a baby and then I had depression and anxiety, therefore it was postpartum depression. No need to look any further. I ultimately conceded that I would go see “the hormone doctor” if it would make my family happy, but I knew nothing would come of it.

I went to my first appointment and was surprised at how emotional the appointment was for me. I had to share what precipitated me coming to the appointment, and describing everything from my perinatal symptoms to Declan’s birth, and then the aftermath, was overwhelming. I was given a prescription to get my blood drawn and set up a follow up appointment weeks down the road.

My Results…

When I finally came to my results appointment I was so nervous. I didn’t know what to expect, but I was so worried there was something else wrong with me, and I just wasn’t sure I could handle wrapping my mind around another deficiency. The doctor was very nice and candid and quickly shared that I had depleted levels of all my hormones and while depleted, they were also imbalanced. She felt that this would explain a laundry list of my symptoms from the insomnia, constipation, depression, anxiety, low sex drive, to the mental fogginess. She prescribed a bunch of herbal supplements (Pregnenolone, Ashwaghanda, Magnesium Citrate, Active B Complex, Vitamin D, and Saw Palmetto) in the hopes of replenishing my hormone stores and balancing them at the same time.

I suppose I should’ve felt good, great even, that I had an answer and a plan. But it just made me feel more uncertain and overwhelmed. None of my physicians agreed on the cause of my symptoms or the best way to treat them. Who was I supposed to listen to? And if I chose the wrong one, how much time would I loose working towards actually getting better? I felt lost in the middle of a maze that I didn’t know the way out of. I felt unsure about everything. Was it my hormones all along? Can I still say I had postpartum depression? Do I have both? And if so, how do you treat them concurrently? Those were just the surface questions. In the deep and darkest corners of my mind, I wondered why it had taken this long to come up with this answer. How much time had I lost not going down this path? Why hadn’t God intervened sooner?

Ultimately, I decided I had nothing to loose by starting the herbal supplements.

Another big piece of her recommendation was to have my Mirena IUD removed. I had a Mirena IUD after Rocco was born and another after Declan was born. I loved it. I felt great, I had no problems with it, no period to mess around with, and I never had to remember to take another pill. I had read articles about the “Mirena crash” and negative side effects of Mirena, but mostly blew it off, assuming the women making those claims were a little off their rocker. But my physician said based on my lab work, I was the worst candidate for this type of iud and should have it removed as soon as possible. Apparently there are different generations of progesterone and I need to be taking a birth control with a first-generation progesterone and estrogen. I didn’t like the idea but felt like there was no point in doing this half-assed, it was either all or nothing. So I set up my appointment and had my iud removed and started taking Junel birth control pills right after.

Waiting…

So now I wait. Wait for all the supplements and medications to do their jobs. I will have my blood work redone after three months to see if they have made any difference.

Postpartum Depression

I have written a previous post about PPD, Raising Awareness: What is Postpartum Depression? , but felt it appropriate to add more information relevant to the underlying causes of PPD given this new turn on my journey.  In research, PPD is defined as:

• Depression that began before or during pregnancy;
• Depression that occurred in the context of childhood trauma history, traumatic labor and delivery, thyroid dysfunction, psychosocial stress, or sleep deprivation;
• Depression that occurred with OCD, PTSD, generalized anxiety disorder, or personality changes.

Unfortunately, despite centuries of women having children and ongoing research, no definitive underlying cause for PPD has been identified.  Risk factors are acknowledged, but at this time, causes are only hypothesized.  Additionally, expert opinions vary as to the timing of the onset of PPD.

• According to the American College of Obstetrics and Gynecologists (ACOG), perinatal depression, aka, postpartum depression (PPD), includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery.
• The Diagnostic and Statistical Manual of Metal Disorders, Fifth Edition (DSM-5) states that a major depressive episode or major depression qualifies as peripartum if onset occurs during pregnancy or in the 4 weeks following delivery.

There is no clear definition of when postpartum depression can occur, even among experts.  In terms of duration,

• 38% of women with postpartum depression experienced chronic symptoms
• 50% of women experienced postpartum depression for over 1 year
• 30% were still depressed up to 3 years after giving birth

Reproductive Hormones

The female reproductive system is primarily regulated by five hormones, each with specific roles.  The two most relevant to mood are estrogen and progesterone.  It has been suggested that reproductive hormones may play a role in PPD because of the association between the rapid changes in hormone levels that occur at delivery and the onset of depressive symptoms.  Additionally, reproductive hormones play a major role in basic emotional processing, arousal, cognition, and motivation, and regulated the biological systems involved in major depression.

• Estrogen- affects the brain (mood), bones, heart, skin, and other tissues.  Symptoms associated with low estrogen include: hot flashes, night sweats, trouble sleeping, mood swings, dry skin, migraines, depression, difficulty concentrating, fatigue, and vaginal dryness.  If left untreated, low estrogen can lead to infertility.  The main form of estrogen in the body is estradiol which interacts with the brain similar to antidepressant medications.
• Progesterone- regulates neurotransmitter synthesis, release, and transport.  Neurotransmitters can affect a wide variety of both physical and psychological functions, including heart rate,  sleep, appetite, mood, and fear.

There is evidence that suggests that hormone instability in the perinatal period could contribute to mood dysregulation in PPD.

Thyroid Hormones

Thyroid hormones have been proposed as a bio marker of PPD because of the relationship between thyroid dysfunction and depression. Estrogen increases T4 (thyroxine) levels. So, thyroid dysfunction may contribute to PPD for some women.

Lactation Hormones

The hormones oxytocin and prolactin involved in lactation have also been implicated in PPD. Failed lactation and PPD commonly co-occur. Not only do these hormones regulate lactation, but they also influence maternal mood and behavior. Estrogen and progesterone modulate oxytocin expression in the brain. Lower levels of oxytocin during the third trimester are associated with increased depression during pregnancy and the immediate postpartum period.

Hypothamus-Pituitary-Adrenal Function

Hypothamic-pituitary-adrenal (HPA) axis dysfunction has been implicated in PPD as well. Hyperactivity of this axis resulting in high levels of cortisol, is one of the most consistent findings among individuals with depression. In pregnancy, the HPA axis is dysregulated and doesn’t normalize until 12 weeks post delivery.

Immune Dysregulation

Immune dysregulation has also been suggested to contribute to the development of PPD. The immune axis is regulated by estradiol. During pregnancy anti-inflammatory cytokines are increased and are responsible for immunosuppression to promote pregnancy maintenance. Delivery causes a rapid shift in the immune system from anti-inflammatory to a pro inflammatory state. Patients with depression have been shown to have higher levels of proinflammatory markers.

Evidence of a genetic vulnerability to PPD has been suggested by multiple studies.

Answering Questions

I have people ask me all the time, “How are you feeling?” I know they want an honest answer, but I also know they want the answer to be positive. Either way, I don’t really know how I’m doing. I’m not worse, I’ve certainly improved since this all started. I’m not 100% or in a place I’d want to stay, so how do you answer that? I’m getting there?

I do feel more myself than I have in a while, but I still have bouts of depression where I feel down, worthless, or apathetic. I still have anxiety over things that never used to worry me like driving a car, or worrying about our escape plan if our house catches fire. I still feel the pangs of guilt and failure as a mother and wife and even occasionally still wonder if they would all be better off without me. So with all that said can I really say I’m doing well? But I feel like my time has run out on saying that I’m still struggling. All I can do is hope I won’t struggle much longer.

• Schiller et al. The Role of Reproductive Hormones in Postpartum Depression . CNS Spectr. Feb 2015; 20(1): 48-59 .
• What is Estrogen?
• What are the Symptoms of Low Estrogen in Women and How Are They Treated?
• How Long Does Postpartum Depression Last?  Medical News Today.

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October 15, 2019 at 7:22 am

Rachael, just in case someone near and/or dear to you doesn’t say this, I want you to see it in writing. Time has NOT run out on you saying you’re still struggling. And your boys will never be better off without you. I went undiagnosed with late onset postpartum anxiety. I figured it out after Alexis’ death when I began researching PMADs. My daughter will be 11 next month and I still have moments when I get consumed with anxiety for her and her brother. Thankfully I’ve learned ways to acknowledge when it’s happening and to work (deeply pray) through it, but it still happens. 🎼”If you could see where Jesus brought me from to where I am today. Then you would know the reason why I love Him so.”

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Navigating Postpartum Depression at Work

There’s no one-size-fits-all approach, but these seven strategies can help.

More people are starting to become aware of the basics of postpartum depression (PPD) and how common it is in the weeks and months after giving birth. But most people don’t know that PPD can strike up to a year after giving birth — long after most maternity leaves are finished — and that the stress of returning to work is a risk factor for exacerbating PPD. Failing to understand PPD before and during return to work can be dangerous to your wellbeing and your career. This article will help you understand some small steps you can take to lower your risk and return to work with confidence. These include: calling on your village for support, embracing who you are, avoiding social media, reclaiming sleep, educating yourself, returning to work slowly, and recognizing when your return to work plan needs a change. There is no one-size-fits-all approach to addressing the spectrum of PPD, but making these investments in your own postpartum physical and mental health are investments in your career and well-being.

Sarah was well-versed at the fine art of excelling. A Division 1 collegiate soccer player, she transitioned with ease into the highly-competitive corporate world after graduation, working for a well-respected global IT company. Moving from an entry-level events planner to senior manager within five years, Sarah was well-known in the organization for tending to urgently needed adjustments in real-time. Then, in August 2018, she was excited to learn she was pregnant. The next spring, Sarah and her husband welcomed a baby girl named Amelia Jeanne, or AJ for short.

• Julia Beck is the founder of the It’s Working Project and Forty Weeks . Ms. Beck, a passionate strategist, storyteller, ideator, and connector, is based in Washington, D.C. She can be found on social media  @TheJuliaBeck .

Partner Center

PostpartumDepression.org

Helping Women with Postpartum Depression

What is Postpartum Depression?

Postpartum depression (PPD) is a serious mood disorder. Women who develop PPD have feelings of intense sadness, worry and exhaustion following childbirth.

Postpartum depression (PPD) is a severe mood disorder that causes mothers to have feelings of intense sadness, worry, exhaustion, worthlessness, and even anger after their new baby is born. Sometimes confused with “baby blues,” postpartum depression affects almost 15% of women after childbirth. If you or your loved one struggles with suicidal thoughts, contact the National Suicide Prevention Lifeline at (800) 273-8255.

Learn about Postpartum Depression

Do I have PPD?

There is no single universal way doctors diagnose postpartum depression. However, various signs, symptoms, and assessments can confirm if you are suffering from PPD and reveal the severity of your condition. If you are wondering if you might have postpartum depression, learn ways you can get diagnosed.

How PPD is Diagnosed

Can PPD be Treated?

Postpartum Depression is a treatable women’s health condition. A combination of therapy and antidepressant medications can be useful in helping you manage your PPD symptoms and overcome your condition. With treatment, you can make it through this challenging period and fight back against PPD.

Learn About PPD Treatments

How Can I Get Support?

Postpartum depression is a confusing and often debilitating disease. Treatment can help you manage symptoms, but emotional support options (like support groups) or psychotherapy (such as Cognitive Behavioral Therapy) can help you cope with the mental and emotional turmoil that comes with PPD.

Learn About PPD Support

About Postpartum Depression (PPD)

Postpartum depression (PPD) creates feelings of anxiety and depression. PPD also hinders a mother’s ability to care for her child after birth. Understanding the symptoms of postpartum depression can help you determine whether you need to seek medical or social support.

Postpartum depression (PPD) is a serious mood disorder that affects new moms after childbirth. Postpartum depression creates feelings of sadness, anxiety, depression, and exhaustion. PPD is more common amongst women with a family history of depression or pre-existing mental illness, such as chronic depression or bipolar disorder.

Learn About PPD

What Causes Postpartum Depression?

Postpartum depression has physical and emotional causes. The drastic changes in hormone levels a mother experiences following childbirth, birth complications/traumatic birth experiences, and genetic predisposition are common causes of PPD. Preexisting mental disorders can also lead to an increased risk of postpartum depression.

Causes and Risks of PPD

Signs & Symptoms of Postpartum Depression

If you believe that you or a loved one is suffering from postpartum depression, it is helpful to learn about the signs and symptoms. Common side effects of PPD include changes in personality, mood, and behaviors—from mood swings and trouble sleeping to major depression and suicidal thoughts.

Signs & Symptoms of PPD

Types of Postpartum Depression

Postpartum depression does not always equate to sadness. There are multiple types of perinatal depression with varying degrees of severity, such as postpartum panic disorder, or postpartum psychosis. Each type has unique risk factors, signs, symptoms, treatments, and progressions.

More About PPD Types

Get Answers to Your Postpartum Depression Questions

Support for family members and friends.

It can be extremely difficult to watch someone struggle with postpartum depression. You may feel shocked, confused, or helpless. These are natural reactions when the mental and emotional well-being of your loved one is at stake. Learn how you can help your loved one and get the support you need.

It can be extremely painful for partners to watch their loved one struggle with postpartum depression. Numerous support resources are available to spouses and partners who are struggling to cope with their loved one’s condition.

More Info For Partners

Parents may feel overwhelmed as they work to determine the best way to help their daughter who is struggling with PPD. Parents can show support by offering to help, staying in touch, and more.

More Info For Parents

Siblings may find it difficult to cope if their sister is experiencing postpartum depression. Understanding the disorder and knowing the resources available to mothers can help siblings offer support.

More Info For Siblings

It is normal for friends to feel concerned for their female friend after a PPD diagnosis, as well as worry about what they can do to provide support. Staying connected can help friends support the new mother and her child.

More Info For Friends

Find More Helpful Resources for Supporting Your Loved One

Get Resources

Treatment and Recovery

Postpartum depression treatments generally include a combination of therapy with a psychiatrist or psychologist and prescription medications such as antidepressants. Learn about available treatment options and long-term recovery.

Therapy is just one aspect of effective postpartum depression recovery treatment. Therapy is essential to recovery because it helps mothers address and manage the symptoms and underlying causes of their condition.

More About Therapy

Medications significantly help reduce and manage postpartum depression symptoms. Antidepressants are often prescribed by a licensed health care provider to treat PPD. Many antidepressant medications are safe to use even while breastfeeding.

More About Medication

Long-Term Recovery

It is important to remember that recovering from postpartum depression takes time, but it is almost always possible. Long-term recovery may involve ongoing treatment, family support, coping skills, and regular self-care.

More About Recovery

Psychologist vs Psychiatrist

Both psychologists and psychiatrists provide mental health support such as talk therapy to mothers struggling with PPD. However, the approaches and limitations of these mental health professionals are different. Learn about the pros and cons of both.

Psychologists vs Psychiatrists

Learn More About How PPD is Treated

Why We Created PostpartumDepression.org

PostpartumDepression.org was founded and inspired by Chris and Jenna Carberg. In just two short days following the birth of their daughter Elsie, Chris began to see changes in his wife’s mood and behavior. Following a serious postpartum depression diagnosis, the couple has made it their mission to encourage women and educate families.

All website content has been reviewed by Dr. Kimberly Langdon, and we regularly make updates to provide the newest information about postpartum depression, anxiety, panic, and psychosis.

Read Our PPD Story

Postpartum Depression Quiz

There are ways to help predict whether or not you are at risk of developing postpartum depression. Postpartum depression and its many types are serious conditions. It is important to recognize signs, symptoms and risk factors as soon as possible.

Quote from Gwyneth Paltrow, Actress “When my son, Moses, came into the world in 2006, I expected to have another period of euphoria following his birth. Instead, I was confronted with one of the darkest and most painfully debilitating chapters of my life.”

Announcing Planned Documentary on Postpartum Depression: More Than Blue

Announcing Planned Documentary on Postpartum Depression:

More than blue.

Illuminating the Faces and Voices of Postpartum Depression across America

As of March 2024, have closed the interest form for More Than Blue. We received hundreds of interest forms from those who were interested in sharing their story as part of the documentary, and we greatly appreciate the time people took to share their story with us. We have been in touch with people whom we believe could best help us tell this important story, and we anticipate finishing production in the late spring. We look forward to sharing more information with you in the months to come.

While the last two decades have brought increased awareness about the need to screen and adequately treat postpartum depression (PPD), a major documentary film that illuminates the lived experiences of those suffering or who have recovered from PPD has yet to emerge. In partnership with multi-award winning documentary production company Ark Media , we are proud to announce this important project: the creation of a feature-length documentary for national broadcast that will tell a more  complete story of PPD through the voices and faces of a diverse group of women across America. With this film, we will catalyze a new era of understanding of PPD and its treatment, inspiring transformation at the level of the individual, couple, family, community and health care system in order to get women the care they deserve.

The heart and soul of More Than Blue will be the stories of real women living through postpartum depression, as well as those who have recovered or who are recovering. We are now identifying a group of courageous women who wish to participate.  We will film these women across a period of months in an effort to capture many aspects of their “postpartum story”, from onset of symptoms to the sometimes bewildering search for effective support and treatment, to the joy and relief of recovery. As women tell their individual narratives, we will capture the experiences of others involved in the postpartum experience: partners, friends, clinicians and other providers of care and support.

Interested in telling your story or know of others who wish to share their PPD journey? We seek those who may be interested in participating in the documentary in some capacity. We are not looking for firm commitments on filming at this point, but wish to begin a confidential conversation, and to answer any questions people who might wish to participate have about the project. By joining with us, you will help to enhance understanding of PPD in the general public, while also helping to lift the stigma and shame that so often surrounds what is still the most common complication in modern obstetrics. For more information on how to participate, please press here .

Lee S. Cohen, M.D. Director, Center for Women’s Mental Health, Mass General Producer, More Than Blue

Barak Goodman Director, More Than Blue

Charlotte Cooley Producer, More Than Blue

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