Postpartum Mental Health
This blog contains excerpts from handouts created by Dr Andrea Nelson, PhD. Andrea is a Registered Psychologist supporting the perinatal units at the Foothills Medical Centre.
Having a baby is a major life transition. While the postpartum period can bring joy and connection, it can also bring exhaustion, uncertainty, worry, and a wide range of emotions.
Postpartum mental health concerns are common, and recognizing the signs early can make a meaningful difference for parents and their families.
Depression affects up to 15% of women and 10% of men.
About 10% of adults have an anxiety disorder in Canada, and this risk increases to 17% in postpartum women.
An estimated 3.9% of people around the world will have post-traumatic stress disorder at some point in their lives. The risk of PTSS increases with high-risk pregnancies and traumatic births up to 18.5%.
Experiencing some difficult emotions after having a baby is common. However, when symptoms are persistent, distressing, or begin to interfere with daily life, relationships, or your ability to care for yourself, it may be time to reach out for support.
What are the symptoms of postpartum mental health concerns?
Postpartum depression, anxiety, and post-traumatic stress can look different from person to person. Sometimes the symptoms are obvious, while other times they can be difficult to recognize—especially when exhaustion and adjustment to life with a newborn are already part of the picture.
POSTPARTUM DEPRESSION
Depression can affect how a person feels, thinks, and functions. It can make it difficult to care for yourself or your baby and can affect your ability to experience pleasure or connection.
Some symptoms to watch for include:
Feeling very sad, hopeless, or empty
Losing interest or pleasure in things you normally enjoy
Changes in appetite or weight
Difficulty sleeping, or sleeping much more than usual
Difficulty concentrating or making decisions
Feelings of guilt, worthlessness, or inadequacy
Feeling disconnected from your baby or from the experience of becoming a parent
One parent described their experience this way:
“I didn’t have a sense of joy regarding [my baby]... just sadness and fear and guilt and more sadness.”
POSTPARTUM ANXIETY
Anxiety involves anticipating a future or potential threat. Some anxiety is a normal part of becoming a parent, but it can become a problem when worry is persistent, distressing, difficult to control, or interferes with everyday life.
Postpartum anxiety can show up in many different ways.
Actions
Doing things to try to control or avoid upsetting thoughts and feelings
Performing rituals or habits that temporarily reduce anxiety
Avoiding people, places, or tasks that trigger anxiety
Excessive cleaning, checking, or preparation
Repeatedly seeking reassurance
Spending long periods researching baby-related concerns
Feelings
Feeling scared, panicky, nervous, irritable, overwhelmed, or jumpy
Feeling numb or frozen
Thoughts
Excessive worry or repeatedly expecting the worst
Worrying about harm coming to your baby
Underestimating your ability to cope or access resources
Overanalyzing decisions or actions
Finding it difficult to switch off anxious thoughts
Physical symptoms
Quick or shallow breathing
Racing heart
Upset stomach
Muscle tension
Jitters or feeling on edge
Difficulty sleeping
One parent described the intensity of postpartum anxiety:
“Deep down I felt completely out of control. I would lie awake at night in a panic imagining her living with awful handicaps. How would we be able to take care of her? What if she was a vegetable? What if she… died?”
POST-TRAUMATIC STRESS DISORDER
A pregnancy, birth, or postpartum experience can sometimes feel traumatic. This may happen after a medical emergency, unexpected outcome, frightening experience, loss of control, or other event that felt overwhelming or unsafe.
Post-traumatic stress symptoms that continue for more than a month may indicate PTSD and may benefit from professional support. Symptoms can include:
Re-experiencing
Having upsetting memories, dreams, or flashbacks about what happened
Experiencing strong emotional or physical reactions when reminded of the event
Avoidance
Avoiding memories, thoughts, or feelings related to what happened
Avoiding places, people, conversations, or situations that remind you of the experience
Changes in mood and thinking
Experiencing strong feelings such as fear, anger, guilt, shame, or horror
Finding it difficult to experience positive emotions such as love, satisfaction, or happiness
Losing interest in activities you used to enjoy
Feeling numb or detached from others
Having negative thoughts about yourself, other people, or the world
Arousal and reactivity
Feeling irritable or angry
Feeling jumpy, anxious, or constantly on edge
Feeling as though you are always in danger
Having difficulty concentrating or sleeping
Engaging in risky or dangerous behaviours
One parent described repeatedly revisiting their birth experience:
“I did find myself going over the day before his birth, over and over again. I tore myself apart wondering what I could have done differently. If only I hadn’t done this, if only I had done this…”
Strategies to support your mental health postpartum
There are many things that can help protect and support mental health during the postpartum period. What works will be different for everyone, so focus on small, realistic steps rather than trying to do everything at once.
Make space for yourself. Balance time with and without your baby in whatever way feels right for you.
Move your body. Even a short walk or some gentle activity each day can help support your mood.
Prioritize rest and sleep. Fatigue can make symptoms of depression and anxiety more difficult to manage. Accept help with the baby when you can and rest when opportunities arise.
Eat regularly. Aim for a balanced diet and regular meals or snacks. If you don't feel hungry, small snacks or nutritional supplement drinks can be helpful.
Pay attention to your emotions. Notice difficult feelings such as fear, sadness, anger, powerlessness, guilt, and shame, while also making room for feelings of love, joy, and happiness. You don't have to feel grateful or happy every moment to be a good parent.
Stay connected. Reach out to your partner, family, friends, or community. Isolation can make difficult feelings harder to manage.
Notice patterns. Writing down your feelings, physical sensations, thoughts, and actions can sometimes help you identify patterns and triggers.
Seek professional support when needed. Evidence-based therapies can be very effective in treating postpartum depression, anxiety, and trauma. (see What treatments are helpful? below).
What treatments are helpful?
It isn't always easy to know whether what you're experiencing is depression, anxiety, trauma, or something else. Talking with someone you trust can be a good first step. You can also speak with a healthcare professional, such as your doctor, midwife, social worker, or psychologist.
Different therapies can be helpful for different concerns:
Cognitive Behavioural Therapy (CBT) focuses on understanding and changing patterns of thinking, emotions, physical sensations, and behaviours. It can help improve mood, address unhelpful anxiety, and process traumatic memories. (PPD, PPA, PTSD)
Interpersonal Therapy (IPT) focuses on relationships and adjusting to the changes that come with becoming a parent. (PPD)
Acceptance and Commitment Therapy (ACT) focuses on identifying what matters most and learning to make room for difficult thoughts and emotions while moving toward those values. (PPA)
Cognitive Processing Therapy (CPT) focuses on examining beliefs about the causes and consequences of traumatic events and developing a more balanced understanding of what happened. (PTSD)
Eye Movement Desensitization and Reprocessing (EMDR) is a trauma-focused therapy that uses bilateral stimulation, such as eye movements, while working with traumatic memories. (PTSD)
Medication may also be an option. Antidepressant medications can be prescribed by a doctor, and there are options that can be used while breastfeeding. Your healthcare provider can help you weigh the potential benefits and risks. (PPD, PPA, PTSD)
The most important thing to remember is that you don't have to wait until things feel unbearable before asking for help.
Resources and Support
ONLINE RESOURCES
CANADIAN PSYCHOLOGICAL ASSOCIATION
CENTRE FOR CLINICAL INTERVENTIONS
Understanding Depression Video
Depression Information and Worksheets
POSTPARTUM SUPPORT INTERNATIONAL
Strategies to manage anxiety in future pregnancies
ANTIDEPRESSANT SKILLS WORKBOOK
COUNSELLING AND SUPPORT
Perinatal mental health services are offered through community mental health clinics. Your physician can refer you, or you can self-refer (403 943-1500)
Community organization that offers a variety of free supports and services to families, including women with post-partum depression. No referral required.
COMMUNITY COUNSELLING AGENCIES
Provide free or sliding scale fees according to your ability to pay.
Carya - specialized programming for families with children
Catholic Family Services - no association with Catholic faith necessary
You don't have to do this alone
Mental health challenges during pregnancy and after having a baby are common, and getting help is a sign of strength—not a sign that you're failing as a parent.
If you're concerned about how you're feeling, talk to someone you trust and connect with a healthcare professional. Early support can make a meaningful difference for you, your baby, and your family.
