The Mother Behind Motherhood
Understanding Postpartum Depression & Anxiety
Written by Dr. Erica Brown, NMD
There is a quiet expectation placed on the postpartum season – that it should feel joyful, natural, and full of bonding moments. And while those moments absolutely exist, they can also exist alongside exhaustion, overwhelm, intrusive thoughts, sadness, irritability, or a constant feeling that you’re somehow falling behind.
The truth is, postpartum is not just about healing physically after birth – it’s a full-body transition. Your hormones shift rapidly, your nervous system is under constant demand, your sleep disappears, your identity changes, and suddenly everyone is focused on the baby while you’re trying to figure out how to feel like yourself again.
Postpartum depression (PPD) and postpartum anxiety (PPA) do not reflect a lack of strength or gratitude–they reflect the immense physical, emotional, and hormonal demands of the postpartum season. These experiences are common, real, and deserving of thoughtful support.
Let’s talk about what postpartum depression and anxiety actually look like, why they happen, and why these experiences deserve more conversation and support.
The Conversation We Need to Normalize
Postpartum depression (PPD) and postpartum anxiety (PPA) are among some of the most common complications after childbirth. About 1 in 8 women experience postpartum depression within the first year after delivery. Anxiety is just as common, if not more, in some cases.1, 2 And for some women, they begin weeks or even months after birth.6
Depression and anxiety also often overlap, creating a layered experience that may include low mood, racing thoughts, guilt, exhaustion, intrusive thoughts, irritability, and a persistent sense of overwhelm or urgency.3 Many women assume this is just part of being a new mom, and because of that, they wait far too long to ask for help.
Beyond the “Baby Blues”
It’s normal to feel emotional in the first couple of weeks after delivery. The “baby blues” are incredibly common and can include tearfulness, mood swings, and feeling more emotionally sensitive than usual. This is largely driven by the massive hormonal shift that happens after birth and typically improves within about two weeks.
Postpartum depression and anxiety are different. They tend to last longer, feel heavier, and interfere more with daily life.
Postpartum depression may look like:
Feeling persistently sad, numb, or disconnected
Losing interest in things you normally enjoy
Feeling guilty, inadequate, or like you’re failing
Difficulty bonding with your baby
Feeling hopeless, overwhelmed, or emotionally flat
Postpartum anxiety may include:
Constant worry or racing thoughts
Intrusive or distressing “what if” thoughts
Trouble sleeping even when the baby is sleeping
Feeling physically tense, restless, or on edge
A constant sense that something bad is about to happen
Because many of these symptoms overlap with “normal” new motherhood (fatigue, disrupted sleep), they are often overlooked or minimized–both by patients and providers.
The Bigger Picture Behind Postpartum Mental Health
Postpartum mental health is not caused by a single factor. Usually it’s a combination of several things happening at once.
Hormonal shifts
After delivery, levels of estrogen and progesterone drop rapidly. This is one of the most abrupt hormonal shifts the body experiences. These hormones directly influence mood, stress resilience, sleep, and neurotransmitters like serotonin and GABA.
Sleep deprivation
Sleep disruption is expected in motherhood, but chronic fragmented sleep can significantly impair emotional regulation, stress tolerance, blood sugar balance, and increase risk for both depression and anxiety.
Stress
The postpartum period places high demand on the hypothalamic-pituitary-adrenal (HPA) axis. Your body is trying to recovery from pregnancy, labor, healing, feeding a baby, and often returning to normal life far too quickly. That constant “on” feeling can keep the nervous system stuck in survival mode and the chronic stress can amplify vulnerability to mood disorders.
Inflammation & Nutrient Depletion
Pregnancy and breastfeeding are incredibly demanding. Iron, B vitamins, magnesium, omega-3s, vitamin D, and protein all play important roles in mood regulation and energy. Deficiencies may contribute to fatigue, mood changes, and cognitive symptoms.
Psychosocial Factors
This one matters so much more than is generally talked about. Many women are trying to navigate postpartum while carrying invisible mental loads, relationship shifts, work stress, and the pressure to “bounce back.” Lack of support, identity shifts, and prior mental health history during this time are strong predictors of postpartum depression.4
Reframing the Conversation
One of the most important conversations we can have around postpartum mental health is this:
This is not a character issue.
It is not a sign that you’re ungrateful.
It is not a sign that you’re failing.
It is not a sign that you’re a bad mother.
It is often a reflection of a body and nervous system under significant demand.
When we stop asking, “Why can’t I handle this?” and start asking,”What support does my body need right now?” everything changes. This shift alone can be incredibly healing.
A Final Reminder for the Postpartum Season
Postpartum is one of the most vulnerable and transformative seasons of life. It can be beautiful and hard. Joyful and exhausting. Connected and lonely–all at the same time. If postpartum depression or anxiety is part of your story, it does not define your motherhood. It simply means you deserve support.
If symptoms are lasting longer than 2 weeks, interfering with your ability to function, or making it difficult to care for yourself, it’s time to ask for support. And if there are ever thoughts of harming yourself or your baby, immediate care is essential. You don’t have to wait until things feel unbearable–early support leads to better outcomes–and often faster healing.5
If this resonates with you, scheduling a free 15-minute consult is a simple place to start. We can discuss potential treatment options, and explore what next steps may help you feel more supported and less overwhelmed.
Healing is possible. Support is available. And you are not meant to carry this alone.
References:
1. Stats MH. Depression Statistics for Postpartum (0-12 months) 2026 | Mental Health Stats. Mental Health Stats. Published 2026. Accessed April 27, 2026. https://mhstats.org/postpartum/depression/?utm
2. Feldman N, Hibara A, Ye J, et al. Postpartum anxiety: a state-of-the-art review. The lancet Psychiatry. Published online January 2025:S2215-0366(25)00197X. doi:https://doi.org/10.1016/S2215-0366(25)00197-X
3. Wang Y, Wang Y, Huang W, Deng J, Gu J. Association of maternal postpartum depression, anxiety, and stress symptoms: a network analysis. BMC Psychiatry. 2024;24(1). doi:https://doi.org/10.1186/s12888-024-06412-9
4. Amer SA, Zaitoun NA, Abdelsalam HA, et al. Exploring predictors and prevalence of postpartum depression among mothers: Multinational study. BMC Public Health. 2024;24(1). doi:https://doi.org/10.1186/s12889-024-18502-0
5. Dennis CL, Singla DR, Brown HK, et al. Postpartum Depression: A Clinical Review of Impact and Current Treatment Solutions. Drugs. 2024;84(6). doi:https://doi.org/10.1007/s40265-024-02038-z
6. Tai Raina Hunter, Brandon Alexander Chiew, McDonald S, Adhikari K. The Prevalence of Maternal Depression and Anxiety Beyond 1 Year Postpartum: A Systematic Review. Maternal and child health journal. Published online June 11, 2024. doi:https://doi.org/10.1007/s10995-024-03930-