As a therapist, I’ve spent years helping others navigate their mental health challenges. But when I became pregnant, I found myself in unfamiliar territory. I wasn’t prepared for the wave of anxiety that followed me through my pregnancy and postpartum period. Even with my professional training, the emotions I experienced felt overwhelming and, at times, isolating.
Perinatal mental health (mental health during pregnancy and the postpartum period) is a critical yet often overlooked topic. Many parents-to-be face challenges like anxiety, depression, and intrusive thoughts, yet stigma and lack of awareness often prevent them from seeking support. It’s understandable since they’re likely not sleeping well, hormones are probably all over the place, there are physical changes going on… I could go on and on.
In this blog post, I’ll share some of my personal experiences, along with insights into the common struggles many expectant and new parents face from a podcast episode I recorded with Amanda (a therapist) and Twilight Florido Burgad (a psychiatric nurse practitioner)—both providers specialize in this crucial period. Whether you’re currently pregnant, navigating postpartum, or supporting someone who is, this post is here to remind you that you’re not alone—and that there’s help and hope.
Let’s explore what perinatal mental health is, how it can show up, and what steps you can take to prioritize your well-being.
Here’s the podcast interview with Amanda and Twilight about perinatal and postpartum mental health:
What Is Perinatal Mental Health?
The perinatal period pregnancy covers pregnancy all through the first year of your baby’s life. This is a vulnerable and transformative time for parents, fundamentally altering their life and often their mental and physical health too. It makes sense that people struggle during this time!
Signs of Postpartum Depression and Anxiety
Postpartum depression or anxiety looks a lot like normal depression or anxiety, although its onset is during that perinatal period. Symptoms of postpartum depression usually include:
- Feeling sad or feeling like you’re not a good parent (especially if these feelings persist beyond the two-week baby blues period)
- A sense of overwhelming guilt,
- Feeling unable to cope with emotions
- Feeling disconnected from themselves
- Feeling tired or unable to get out of bed (although, this is a hard one to decipher because you’re probably not sleeping a ton)
- Lack of appetite or eating more than usual (again, this might be a tough one because lactating can cause some new eating habits)
Symptoms of Perinatal or Postpartum Anxiety
There is an increased risk of clinically significant anxiety during the perinatal period, with symptoms like racing thoughts, worrying about the baby’s safety, or having intrusive thoughts that might be distressing and lead to behaviors like not wanting to go down stairs for fear of dropping the baby.
In the initial weeks after I gave birth, I experienced intense anxiety around whether my baby was breathing while he was sleeping or if my cat or a blanket might suffocate him. While this is a common fear, I did find some relief as time went on (and especially after I started sleeping a little more). When I was struggling with these intrusive thoughts it helped me to verbalize them with close friends who were also parents—it made me feel like I wasn’t alone and their reassurance was what I needed at the time.
Common Mental Health Challenges During Pregnancy
Perinatal anxiety is the most common type of mental health issue during this time. Personally when I was pregnant, I experienced a lot of anxiety. Many of my friends had gone through miscarriages, physical health issues, and even stillbirths, so in the early days of my pregnancy, these thoughts consumed me. I found some relief after the very first doctor’s appointment where I heard the heartbeat, but I continued to have waves of anxiety that I needed to find new ways to cope through.
Tips for self-care during pregnancy:
- Listening to pregnancy or non-pregnancy meditations.
- Staying active by doing yoga, walking, or swimming (as long as it’s ok with your doctor).
- Connecting with others in similar life stages or that are becoming parents through Facebook groups or prenatal classes.
- Writing or reciting encouraging mantras, like “One day at a time,” “I can do this,” or “My body is amazing.”
- Visualizing encouraging things, like your partner holding a baby at the end of the pregnancy, your children meeting the baby for the first time, or a peaceful birth.
- Saying no to things that tire you or that don’t contribute to your peace.
- Seeking therapy if you’re noticing that it’s difficult to control your worry or if you’re feeling more down and hopeless or extended periods of time. There are lots of therapists that specialize in pregnancy and perinatal mental health at Ellie Mental Health!
Beyond Postpartum Depression
Most of us have heard of postpartum depression, but it is just one of several perinatal mood disorders. There are other conditions like postpartum psychosis that are crucial to recognize and address. warns, must be treated as a psychiatric emergency due to its potential risks.
Symptoms of Postpartum Psychosis
The following are the most common symptoms of postpartum psychosis—but keep in mind that this diagnosis is fairly rare. They typically develop within two weeks of giving birth, but they could come on later.
- Delusions: Believing things that are true, when they’re not
- Example: Believing that your baby was swapped with a different baby
- Hallucinations: Hearing, seeing or feeling things that aren’t actually there
- Example: Hallucinating that someone is telling you to harm your baby
- Rapid mood swings
- Example: Feeling euphoric or really happy and switching to hopelessness or depression
- Difficulty focusing or make sense of your words
- Paranoia: Feeling suspicious of others
- Example: Believing that your mother is going to kidnap your baby
- Risk taking and impulsivity that is out of the ordinary
- Difficulty sleeping
- Thoughts of harming yourself, your baby, or suicidal ideation
If you or someone you love is experiencing these symptoms, please don’t ignore it. Postpartum psychosis is serious and should be treated right away by contacting your doctor or going to an emergency room. Typical treatment is a combination of medication and therapy.
Can Men Get Postpartum Depression?
Absolutely! In fact, research indicates that approximately 10% of new fathers encounter postpartum depression, with symptoms often peaking between 3 to 6 months after childbirth. For dads, this can look like irritability, fatigue, changes in sleep and appetite, difficulty bonding with the baby, and feelings of inadequacy
Can Adoptive Parents Experience Postpartum Depression?
Yes! Adoptive parents may experience a form of postpartum depression often referred to as post-adoptive depression, which shares many symptoms with PPD, including:
- Emotional changes: Feeling overwhelmed, anxious, or emotionally distant from the child. A lot of adoptive parents I work with share that the time following placement often just feels like “babysitting” because there’s not a lot of attachment there yet.
- Fatigue and sleep disturbances: You’re pooped. All of the time. Sleep issues are a very common issue in adopted kids—regardless if they’re infants or not. An adoptive family I worked with years ago shared that she had to sleep on the floor of her daughter’s room for a whole year before the kid felt comfortable falling asleep on her own. There can also be nightmares or night terrors because of trauma.
- Feelings of inadequacy: Adoptive parents have to go through an enormous amount of trainings, background checks, and the entire homestudy process to “prove” that they are fit to be parents. You often feel like you’re under a microscope and every choice you make will be judged. Combine that with the secondary grief and separation that the birth parent and child may be experiencing, and it’s easy to feel like you’re not enough.
- Isolation: It’s a new dynamic and it can be lonely. Adoptive parents don’t always receive the same support biological parents do. While baby showers and meal trains are becoming more common for adoptive parents, it is unfortunately not always a given for every parent.
- Unrealistic expectations leading to disappointment: As an adoptive parent, you’ve spent years preparing to be a parent and proving that you’ll be a great one… what happens when you struggle? In my experience, adoptive parents are less likely to speak up when things feel off or when they’re not measuring up to the rosy picture we had in our heads out of fear or pressure.
- Fear and anxiety: Depending on your state and program, there may be a period of time after the child is placed with you where the birth parent, agency or state can take the child back. This might be due to a birth parent changing their mind and deciding to parent, the birthparent getting legal custody through court after an involuntary removal of the child, or if a different placement option comes up that fulfills the rules of the Indian Child Welfare Act or the Sibling Bill of Rights. There can be a lot of unknowns until it is legally finalized.
If you’re interested in learning more about Post Adoption Depression, I highly recommend checking out Karen J. Foli’s research and book.
Normalizing the Postpartum Experience
It’s very common to experience the “baby blues” while you’re adjusting to parenthood, and counseling for new parents can be very helpful. The “baby blues” is when you’re feeling anxiety, overwhelm, sadness, irritability, crying, reduced appetite, and inability to sleep. It typically starts after delivery and can last up to two weeks.
We need to normalize the difficult emotions and experiences parents may face during this time period, while also highlighting what to do when things are feeling more serious. As Twilight emphasizes, it is essential for parents and clinicians to understand that having “scary thoughts” can often be a part of adjusting to parenthood. Amanda further adds that acknowledging and normalizing these experiences can prevent isolation and help new parents seek necessary support.
The Importance of Social Support
Social support is paramount during the perinatal period. Twilight advocates for building a strong support network well before the baby arrives, underscoring the importance of leaning on family, friends, and community resources. Programs like those offered by Postpartum Support International (PSI) provide valuable support and education for new parents.
Amanda Davis Scott shared: “Talk about what can happen, how common these things are, perinatal mood and anxiety disorders, what you can do to protect yourself, protect your sleep, utilize your resources and support around you so that you don’t run into the problem of expecting too much out of yourself or extending yourself too thin.”
Twilight added: “Not everybody is going to need medication. Not everybody is going to need therapy, but social support is the one essential that everybody needs during that time.”
No-one gets a parenting instruction manual, but that’s okay. The team of experts from Ellie Mental Health can guide you in your postpartum mental health journey. Find a perinatal therapist near you today.
Parent Self-Care and How to Support New Parents
Both Amanda and Twilight stressed the importance of parental self-care in the podcast episode. This includes eating healthy food, sleeping when you can, and mental health support. They encourage parents to shed societal pressures of perfection and to seek help without guilt.
When you become a new parent or you add another kid to your family, it can sometimes feel like you’re drowning and take some time to adjust. This adjustment period can feel even harder when you’re struggling with your own mental health too. Self-care looked different in those early days for me—it needed to be quick, require less energy, or just be simpler. It looked like:
- Sleeping or lounging around in cozy pajamas
- Going for a quick coffee run all by myself
- Dancing with my baby
- Going for a short walk (with or without the baby in the stroller)
- Using meal kids and grocery delivery instead of needing to run errands
- Rewatching favorite shows during the endless hours of feeding (Friends and Mr. Monk were my go-tos in the early postpartum days)
- Taking lots of warm baths
- Facetimes with other moms that I knew would get it
- Getting a new water bottle since I was suddenly thirsty all. the. time.
- Taking my older daughter on our own little dates
In the whirlwind of new parenthood, self-care can get pushed to the backburner (which is understandable—you’re suddenly caring for a whole new little person), but it’s important to prioritize even the smallest things for your mental health.
Think about some things that help you feel a little bit more like yourself (maybe it’s going for a walk with a friend or trying all of the Costco samples on a Sunday afternoon) and then don’t be afraid to ask your support system for help to make it happen.
If you, dear reader, are a support person to a new parent, be proactive! Buy the new parent comfy pajama pants, bring over dinner one night (pro tip: bring paper plates or offer to do the dishes afterwards), or offer to watch the kids while they catch up on some sleep.
In another blog post about how to support a new parent, therapist Anna King recommends asking questions like, “I’m running by Starbucks, can I pick something up for you?” or “I really struggled adjusting to parenthood at first. How do you feel like you’re doing?” Be direct and pro-active, rather than just waiting for the new parent to ask for help.
Final Thoughts
Parenthood is a life-changing experience, but it’s not always the picture-perfect journey we see on social media. If you’re struggling with your mental health during pregnancy or postpartum, I want you to hear this loud and clear: you’re not alone, and it’s not your fault.
As a therapist (and a mom) I’ve been there. Those overwhelming feelings, the anxiety, the intrusive thoughts… they can make you feel like you’re the only one going through it. But trust me, so many parents face these challenges, even if we don’t always talk about it.
The good news? You don’t have to navigate it alone. Whether it’s finding a therapist who specializes in perinatal mental health or even just sharing your feelings with a friend or partner, there’s help out there.
If you’re a support person, don’t underestimate how much simple acts of kindness matter, like offering to pick up coffee or holding the baby while they nap.
You’re doing better than you think, and it’s okay to ask for help. Parenthood is tough, but you don’t have to go through it on your own. There’s so much support and hope waiting for you.
