Postpartum Distress: When it’s more than just the baby blues

For most women, expecting a baby is a joyous experience, but for some, the reality of motherhood can be a rude awakening. Research shows a woman is more at risk for emotional illness during and after pregnancy than any other time in her life.

Most moms have heard of the “baby blues,” or postpartum depression, but the ‘blues’ are not the only challenges a woman may experience after child birth. Postpartum distress includes a range of symptoms and conditions, including:


1. Baby Blues: Between 50-80 percent of new moms experience the “baby blues” within the first three weeks of delivery. This hormonally-driven roller coaster of emotions is normal and does not require medical or psychological intervention.

2. Postpartum Depression (PPD):  In addition to depressed mood, a mom with PPD may feel overwhelmed, guilty and disconnected from their baby and everyone else in their lives, suffer from intense anxiety and have thoughts of death, dying or suicide.

3. Postpartum Anxiety: Women with postpartum anxiety often experience racing thoughts, an inability to relax or sit still and persistent fears and worries about parenting. Many women experience physical symptoms like lack of appetite, stomach cramps, headaches, shakiness, nausea or panic attacks.

4. Postpartum OCD: Postpartum OCD includes anxiety symptoms and scary thoughts related to the baby. Many women find themselves afraid of things in their home and surroundings that could harm them or the baby, and may constantly check things (e.g., locks, oven, baby breathing).

5. Postpartum Psychosis: Although rare, postpartum psychosis is a serious condition with rapid onset that requires immediate medical intervention. Symptoms include delusions, hallucinations, irritation, hyperactivity, paranoia and difficulty communicating.

The Path to Wellness

Psychotherapy is an excellent recovery tool during this difficult time. A therapist trained to work with perinatal mood and anxiety disorders can provide non-judgmental support to help find a way out of the depression. For some women, medication can accelerate recovery. Local support groups for postpartum mothers can also be a wonderful form of support. These groups are typically led by PPD survivors who share their experiences of distress, coping and recovery to help others understand they are not alone in this struggle.

Postpartum Support Virginia ( is an excellent local resource for women seeking more information on postpartum distress. In addition to providing valuable information, it maintains a current list of support groups and referral options for treatment professionals, and the “Moms on Call” program provides one-on-one support, encouragement and information about where to go for help.  

Often, women don’t reach out for help for fear of being perceived as “crazy,” of being labeled a “bad mom” or of the belief that someone will take away her baby, but a support system is crucial to recovery. Moms experiencing postpartum distress do not have to suffer in silence. Self-care is important for all women, but it becomes critical in the postpartum period.

Dr. Elizabeth Hatchuel is a licensed professional counselor and owner of Evolve Clinical Services, a private mental health practice in Old Town Alexandria, VA. She specializes in the treatment of depression, anxiety, perinatal mood and anxiety disorders and maternal mental health. For more information, please visit, follow her on Twitter @EvolveClinical, or contact her at [email protected]

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