Understanding Postpartum Depression: Symptoms, Support, and Hope

In my 25 years of labor and delivery experience, I’ve had countless conversations about postpartum depression symptoms with moms and their families.

It’s important to understand that postpartum depression can happen to anyone, regardless of background, social status, support network, or just about any other factor you can name. That said, certain elements do increase your risk.

What I want you to know is this: Postpartum depression is real, it’s treatable, and it’s absolutely not your fault.

Now, let’s talk about what postpartum depression is and what to do if you notice postpartum depression symptoms in yourself or someone you love.

What Is Postpartum Depression?

It’s completely normal to feel emotional and overwhelmed in the early days after birth. The “baby blues” are real and usually peak a few days postpartum before tapering off within a couple of weeks. You might feel weepy, exhausted, or a little fragile. That’s your body and mind adjusting to a massive hormonal shift, new responsibilities, and very little sleep.

Postpartum depression, however, is a mood disorder that can begin any time in the first year after giving birth. It often shows up as sadness that won’t lift, persistent low motivation, loss of interest in things you used to enjoy, and feelings of hopelessness.

Postpartum depression differs from postpartum anxiety, which tends to feel more panicky and include a racing heart, looping or intrusive thoughts, and a sense of being on edge. Both may occur together, but depression usually feels like being stuck in a low place, and you just can’t get out from under the weight of it.

Common Postpartum Depression Symptoms

Most providers, including Haven, use the Edinburgh Postnatal Depression Scale during postpartum visits to assess for symptoms of postpartum depression. These are some of the key factors we look for:

• Are you still able to laugh or find joy in what used to bring you joy?
• Do you blame yourself when things go wrong, even when it’s not your fault?
• Do you feel anxious, scared, or panicky for no clear reason?
• Are day-to-day tasks or emotions just too much right now?
• Have you been feeling so unhappy that it’s hard to sleep, even when you’re tired?
• Do you cry often or feel deeply sad or miserable?
• Have you had any thoughts about harming yourself or your baby?

Any one of these can qualify as a postpartum depression symptom, especially if it’s happening frequently or interfering with daily life. If you find yourself checking “frequently” on multiple questions or living in the middle ranges of “sometimes” or “often,” please reach out to start a conversation with your midwife or provider.

Regarding the final question, if your answer isn’t “never,” that’s a red flag regardless of your other responses and deserves immediate attention.

A Note on Postpartum Psychosis

While we’re discussing postpartum depression symptoms, I want to briefly mention postpartum psychosis. This condition is very rare but extremely serious, typically occurring in the first month postpartum.

Postpartum psychosis affects a person’s sense of reality and involves hallucinations, paranoia, and/or delusions. It often occurs alongside underlying mental health diagnoses like bipolar disorder or schizophrenia. This condition frequently includes thoughts of harming yourself or your baby.

If you or someone you love shows signs of becoming detached from reality, this requires immediate intervention. Call for help today — not tomorrow — with no delay. A person experiencing postpartum psychosis will usually need someone else to help identify symptoms, since their detachment from reality prevents them from noticing the warning signs.

What Increases the Risk of Postpartum Depression?

Again, anyone can experience postpartum depression, but several risk factors increase the likelihood. Some are biological, some emotional, and some situational. Here are some of the most common:

Biological Factors

• Hormonal changes after birth
• History of thyroid imbalance
• Nutrient depletion, especially low B12 or vitamin D

At Haven, we check vitamin B12 and D levels at your first OB visit because deficiencies can increase the risk for mood disturbances later on.

Psychological Factors

• Personal history of depression, anxiety, or other mental health disorders
• PMDD or severe PMS
• Low self-esteem
• High self-criticism

Social and Situational Factors

• Lack of support from partner, family, or friends
• Marital or relationship struggles
• Financial strain
• Major life changes (job loss, moving, etc.)

Birth and Early Parenting Challenges

• Complications during pregnancy or labor
• Birth that doesn’t go as planned, like an unexpected transfer, a cesarean section, or simply more interventions than expected
• NICU stay, or caring for a baby with greater needs
• Difficulty with breastfeeding, including issues like mastitis
• Colicky babies who cry frequently and are difficult to soothe
• Unplanned or unwanted pregnancy

From my own observations, I’ve also noticed that moms who aren’t quite prepared for the intensity of the postpartum period seem more prone to developing postpartum depression symptoms. Those early weeks can be consuming, and without adequate mental (and practical) preparation, moms may experience a more difficult transition.

Supporting Moms: What Dads, Family, and Friends Can Do

If you’re reading this as part of a new mom’s support network, know that your awareness and involvement can be life-changing.

First, it’s important to understand that postpartum depression is real and can happen to any mom — even if she has a stable family, loving partner, and strong support system.

Next, learn to recognize the postpartum depression symptoms outlined above. If you notice something feels “off” with the new mom in your life, even if you can’t put your finger on exactly what, talk with her or, if you have the ability, loop in her healthcare provider.

Finally, remember that practical support can make a huge difference in mom’s mental and emotional well-being.

For example, sleep deprivation magnifies the difficulty of everything else. With that in mind, help mom prioritize sleep and rest. This might mean taking the baby out of the house after she nurses, handling night feedings when possible, or arranging care for older children. The magic sleep number for mental health stability is 5 hours, so helping mom get that amount of continuous sleep when possible can make a world of difference.

Also, I recommend helping to plan practical postpartum support like this before baby arrives. Who will help mom get her rest? Will you prepare freezer meals ahead of time, or will someone bring meals over? Don’t wait to plan until two weeks postpartum, when you have to scramble.

Getting Help for Postpartum Depression Symptoms

Postpartum depression doesn’t have just one treatment option.

Here at Haven, for instance, I often recommend trying EnBrace HR, a prescription supplement that addresses genetic B12 methylation issues. Since B12 has a direct link to dopamine production, this deficiency can contribute to mood symptoms.

If this isn’t sufficient within a short time, I may start a conversation about counseling and medication. In our practice, we never begin medication without a counseling component to provide foundational mental health support. (We often recommend Ready Nest Counseling and She Blooms in the Nashville area!)

If your story does involve medication, remember that there’s no shame in using all the tools at your disposal to feel better — for your baby and yourself.

No matter what, know that you don’t need to do this alone. At Haven, we see all our clients one to two weeks postpartum where we check in on mental health, and again at six weeks where we screen for postpartum depression. Even if you’re with another provider, all OB practices check in at six weeks postpartum, and most will see you sooner if you’re having difficulties.

Remember to be honest when they ask how you’re doing, and don’t minimize your feelings. You don’t need to push through, feel ashamed, or wait until things worsen to get support.

Postpartum Depression: You’re Not Alone

Whether you’re a new mom worried about postpartum depression symptoms or someone supporting a new mother, remember that seeking help is a sign of strength.

Women sometimes feel a sense of shame around postpartum depression, as if they’ve done something wrong to cause it. But, hear me: Postpartum depression isn’t your fault. It isn’t a failure. It’s simply a reality of the human condition.

Postpartum depression affects mothers with seemingly perfect circumstances as well as mothers facing obvious challenges. The transition to motherhood is profound and complex, and there is absolutely no shame in needing support.

If you’re someone who typically handles everything independently, seeking help might be especially hard. But you don’t need to prove you can do it all alone. Accepting help and treatment isn’t giving up — it’s giving yourself and your baby the best chance at thriving together.

If you’re someone struggling with postpartum depression or anxiety, please know there is support. There is healing. There is hope.