Written by Kate Ferguson

Becoming a mother comes with extreme physiological changes, sleep deprivation and an entirely new role in life, yet it still comes as a surprise to people that postpartum women struggle with their mental health. My work is dedicated to raising awareness and offering support to mothers and their families as they navigate this transition to parenthood. 

Nearly 80 percent of new mothers experience down days, commonly referred to as “The Baby Blues.” But for an estimated 20 percent of moms, these feelings can signal that they are facing the most common complication for pregnant and postpartum women: a perinatal mood or anxiety disorder (referred to as a “PMAD”). PMAD’s can include a variety of disorders including postpartum depression, postpartum anxiety and postpartum obsessive-compulsive disorder, post-traumatic stress disorder and rarely, postpartum psychosis.  While giving birth is often the triggering event for a perinatal mood disorder, please note that symptoms can have onset any time during pregnancy, and also adoptive mothers as well as new Dads may notice they are experiencing symptoms.  

Symptoms can include:

Frequent crying

Sleep and appetite changes

Feelings of loneliness, sadness, helplessness

Frequent mood swings

Repetitive, sometimes scary thoughts that won’t go away

Anger, frustration, irritability

Difficulty bonding with baby

Anxiety, panic, excessive worry

Feelings of being trapped

Fear of being left alone with the baby

Sense of doom

Lack of interest in life, feeling sluggish, fatigued, exhausted

Difficulty making decisions or discerning what’s best for you or baby

Feeling overwhelmed

Feeling speeded up or wired

Thoughts of hurting yourself or those around you

I notice these symptoms when I hear women in my office say things like: “I feel like this was the biggest mistake of my life,” “every day feels like 100 hours and I just watch the clock,” “I wish I’d never had this baby…” Shame about having these thoughts and feelings can keep women from seeking help, but consider that these may be your symptoms talking. Having a new baby is hard, but it shouldn’t be miserable. Your life shouldn’t feel over, just profoundly changed.   

These symptoms can also manifest in a client’s indecision and feeling of being generally overwhelmed. My clients who obsess over following a suggested schedule, or who are struggling with breastfeeding or guilt over not breastfeeding. Who revisit and ruminate over decisions or have an exceptionally hard time adjusting if the day doesn’t go exactly as planned.  Sometimes this is just a Mom’s personality and isn’t a symptom, but if this resonates with you and you are having a hard time with basic functioning, consider that you may want to consult with a professional for additional help and support. 

Finally, women in the throws of postpartum anxiety can’t sleep. And sleep is hard to get with a newborn. So I like to ask: “Given the opportunity to sleep, can you sleep?” if the answer is “no,” and you are feeling speeded up, irritable, anxious, you might be experiencing anxiety that warrants treatment. The scenario can look like this: Baby fed and asleep at night, Mom in bed wide awake, exhausted, with racing thoughts or racing heart…not just one time, but again and again. 

Let me share some other information that can be helpful to know. 

What Factors Increase My Chance of Developing a PMAD?

  • Personal or family history of depression, obsessive compulsive disorder, anxiety or panic disorder, bipolar disorder or any other emotional illness including pregnancy or postpartum mood disorders
  • History of severe Premenstrual Syndrome (PMS)
  • Unplanned or unwanted pregnancy
  • Thyroid disease or other chronic illnesses
  • Lack of support from family or friends
  • High level of physical, emotional or financial stress
  • History of sexual, verbal, physical or mental abuse
  • Pregnancy complications and/or a traumatic delivery
  • History of infertility
  • Chronic sleep deprivation
  • Abrupt weaning from breastfeeding, breastfeeding challenges
  • History of miscarriages or pregnancy losses

What can I do to help myself avoid a PMAD or feel better if I think I have one?

  • FIRST: Self-help measures are important, but do not delay getting additional treatment if you need it.  The longer you wait to treat a perinatal mood disorder, the harder it is to treat. 
  • Ask for help. Being a mom is hard work. New and expectant mothers cannot do it all. Ask for help and support from loved ones. 
  • Educate yourself. Learn the factors that increase the risk of developing PMAD and be aware of the signs and symptoms. Knowledge is power.
  • Educate your loved ones about PMADs. Share the information you are learning here. It is very important that they are aware of the signs and symptoms.
  • Eat a balanced diet. Take your prenatal vitamins and make sure you are getting a variety of foods in your diet. Avoid high fat and high sugar foods.
  • Limit caffeine and AVOID alcohol completely (Alcohol throws gas on the fire of anxiety. Not popular to say, but important).
  • Exercise is important. A walk 3-4 days per week is beneficial for your mental health.
  • Get plenty of sleep. Take a nap when you can. Listen to your body and rest when it tells you to rest. I often recommend Mom’s on Call for this exact reason – It allows a predictability to the day (nap windows for Mom!) AND supports good rest for baby, which means good rest for Mom and Dad!
  • Take time for yourself

There are excellent resources (online support groups, information, reading) and also a directory of clinicians in your area that can be found on Postpartum Support International’s website www.postpartum.net .  Your pediatrician or OBGYN can also be a resource for local support (sometimes, not always).  

As I often say to those I’m talking with, I love you, keep going. As bad as you feel, I want you to know you are loved. There are people who care and want you to feel better. And keep going, because no matter what, you are worth the effort and work it may take to feel better.  


Kate Ferguson is the founder of Kate Ferguson Therapy and Associates in Atlanta, GA. Her website is www.katefergusontherapy.com and you can also follow her on Instagram @katefergusontherapy