How to Tell If What You're Feeling Might Be Postpartum Depression

I’d lived with anxiety for years, and experienced perinatal anxiety during my first pregnancy. So when I had my second child, I knew I was at a higher risk for postpartum mental health challenges. What I didn’t expect was how hard it would be to recognize when it was happening to me—especially when I hit nearly six months postpartum.

That’s part of what makes postpartum depression (postpartum depression) so difficult to identify—it doesn’t always look or show up the way you expect it to. Yes, it can involve intense sadness and frequent crying. But it can also feel like anger, numbness, constant worry, guilt, irritability or simply not feeling like yourself. The tricky part is that you can be going through the motions of everyday life—caring for baby, going to work, taking care of household chores and even socializing outside of the home—while struggling more than anyone around you realizes.

“We often mistake functioning for wellness,” says Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center and author of Good Moms Have Scary Thoughts. "A mother may be doing everything she’s ‘supposed’ to do while privately feeling anxious, numb, hopeless, overwhelmed, disconnected or consumed by self-criticism.”

Becoming a parent changes nearly every part of your life. So how can you tell the difference between the exhaustion and emotional upheaval of new parenthood and postpartum depression? Below, experts and parents who’ve experienced the condition firsthand break down what it can actually feel like, signs and symptoms of postpartum depression to watch for and how to get help.

Key Takeaways

• Postpartum depression can look like more than sadness. Signs and symptoms of postpartum depression may include anger, irritability, numbness, guilt, anxiety, hopelessness or feeling disconnected from yourself or baby.
• Postpartum depression can be hard to spot—especially when someone is functioning normally from the outside. Partners and loved ones may notice changes in mood, behavior or daily functioning before the person experiencing them fully recognizes what’s happening.
• The “baby blues” and postpartum depression are not the same thing. How long symptoms last, how intense they feel and how much they interfere with daily life can help distinguish the two.
• Postpartum depression can begin at different points in the postpartum period. Symptoms don’t always begin immediately after birth, which is why knowing the signs matters.
• Postpartum depression treatment is available, and you don’t have to wait until you’re in crisis to ask for help. Therapy, medication and other options can help. The right next step depends on your symptoms and individual circumstances.

Postpartum Depression vs. Baby Blues: What’s the Difference?

The main difference between postpartum depression and the baby blues is that postpartum depression tends to stick around longer and interfere more with everyday life.

The “baby blues” are incredibly common and may leave you feeling weepy, anxious, overwhelmed or more emotional than usual. They typically begin a few days after birth and ease on their own within about two weeks. But postpartum depression often lasts longer and feels more intense. “If low mood, anxiety or emotional flatness lasts beyond two weeks, or if it’s intense enough to interfere with sleep, eating, bonding with baby or basic functioning, that’s no longer the blues,” explains Dr. Sarah Oreck, MD, a board-certified reproductive psychiatrist and cofounder and CEO of Mavida Health. “Baby blues can feel like weather that passes. Postpartum depression feels like a climate—it settles in and doesn’t lift as easily on its own.”

But two weeks isn’t a deadline you have to reach before asking for help. If what you’re feeling is unmanageable or making it difficult to get through the day, reach out to your provider, even if you’re only a few days postpartum.

Signs and Symptoms of Postpartum Depression

Postpartum depression doesn’t always look like someone crying all day or being unable to get out of bed. In fact, some of the signs can be surprisingly easy to chalk up to exhaustion, hormones or the enormous adjustment of having a baby. And postpartum depression doesn’t look the same for everyone. Here are the signs and symptoms of postpartum depression experts say to watch for, and what moms who’ve experienced them say they can feel like.

Physical and emotional signs in birthing parents

Postpartum depression can affect you both emotionally and physically, and persistent sadness is only one possible sign. Dr. Oreck says some of the symptoms that are easiest to overlook include:

• Anger or irritability. This might look like snapping at your partner, feeling constantly on edge or getting frustrated at minor things.
• Numbness and emotional disconnection. Dr. Oreck says she’s seen parents describe feeling as though they’re simply “going through the motions” of caring for baby. They may lose interest in things they previously enjoyed or withdraw from other people.
• Guilt and worthlessness. These feelings go beyond typical mom guilt and can be exacerbated by societal pressure to be a perfect mom.
• Changes in appetite and sleep. Some might assume it’s just the case with early parenthood, but these changes aren’t always due to baby’s schedule.

Brianna Wood, MA, LMHC, a therapist specializing in perinatal mental health based in Maple Valley, Washington, says it’s worth paying attention when difficult feelings linger or become overwhelming. "While it can be typical to take time to get into a rhythm with baby…the duration and intensity of these symptoms matter,” she says.

Postpartum depression can also occur alongside postpartum anxiety, postpartum OCD and other mental-health struggles, which can make the experience even more difficult to neatly identify. If something feels off, you don’t need to figure out exactly which diagnosis fits before bringing it up with your provider.

Also, remember that unwanted, scary thoughts about baby are common with postpartum depression and anxiety and are worth mentioning to your provider. Hallucinations, delusions or thoughts of acting on harm to yourself, baby or anyone else need immediate medical attention.

Signs partners and family should look for

Sometimes the person experiencing postpartum depression isn’t the first one to recognize it. A partner, family member or friend might notice the following signs:

• You’ve become more withdrawn
• You seem unusually flat or disconnected
• You’re increasingly irritable or angry
• You’ve lost interest in things that once brought you joy

Keep in mind that outwardly keeping up with everyday life doesn’t necessarily mean everything is okay. “A mom can look okay and not be okay,” points out Kleiman. “Don’t wait for her to ask for help—shame, guilt and fear can make asking incredibly difficult.”

That was something Jon Gustin, creator of @thetireddad, experienced when his wife developed postpartum depression after their first baby. “She wasn’t herself,” he recalls. At first, he struggled to determine whether what he was seeing was postpartum depression, sleep deprivation or simply the enormous adjustment of becoming a parent. Looking back, he wishes he had understood sooner that he couldn’t fix what she was experiencing. “She needed professional help, and I should’ve jumped at that sooner,” he says.

If you’re worried about someone, Kleiman recommends asking how they’re really doing, listening without immediately trying to reassure them or fix the problem and taking what they tell you seriously. And please reach out to your provider immediately if your partner is having hallucinations, delusions or expresses thoughts about harming themselves, baby or anyone else.

Real moms answer: What does postpartum depression feel like?

For many moms, postpartum depression didn’t feel the way they expected it to, and that made it harder to recognize.

For Kaitlyn B., a mom of four in Indiana who experienced both postpartum depression and postpartum anxiety, it felt like losing control. She remembers sobbing at the same time every night, feeling terrified when other people held her baby and becoming consumed with worry about baby’s safety. “To me, I was trying to manage something that felt so completely out of control,” she says. It wasn’t until her husband told her how worried he was that she realized she needed help.

Stephanie S., a mom of three in New York, remembers postpartum depression as more than sadness. “I cried daily,” she says of her experience after her youngest was born. “I felt empty and rageful.” At the same time, she was maintaining a family and a job and says she “had to pretend” she was okay in front of the people around her.

Nicole, a mom of three in New York, experienced depression and anxiety after having her babies. Along with crying and guilt over not feeling as happy as she thought she should, she remembers extreme anxiety, irritability and, after her third child, intrusive thoughts. “To feel like you’re drowning but also alone is the worst feeling,” she says.

For Samantha P., a mom of three in New York with a history of OCD, her postpartum experience included postpartum depression, postpartum anxiety and postpartum OCD. She expected depression to look like sadness, but instead found herself overwhelmed by fears about baby’s safety. “I thought I’d be depressed, not scared of everything,” she recalls. Eventually, recognizing that what she was experiencing went beyond the baby blues helped her seek support.

How Common Is Postpartum Depression?

If you’re experiencing postpartum depression, you’re far from alone. According to the Centers for Disease Control and Prevention (CDC), about one in eight women who recently gave birth report symptoms of postpartum depression. And while certain factors can increase your risk (more on those below), postpartum depression can happen to anyone, including someone who’s never experienced depression or anxiety before.

Postpartum Depression Timeline

There’s no single timeline for postpartum depression. Symptoms may emerge within weeks of giving birth, but they can also appear months later, which means feeling okay early on doesn’t necessarily mean you’re in the clear.

When does postpartum depression start?

Most episodes of postpartum depression begin within the first several weeks after birth. Dr. Oreck says she commonly sees symptoms emerge between two and six weeks postpartum, but she’s diagnosed postpartum depression as late as 9 to 12 months after delivery. In some cases, symptoms may surface around transitions such as weaning, returning to work or your first period after baby.

Don’t dismiss a change in how you’re feeling if baby is no longer a newborn. Research from the CDC supports screening for depression throughout the first year after birth, since symptoms can emerge later in the postpartum period. So if you start feeling unlike yourself even months later, it’s worth bringing up to your provider.

How long does postpartum depression last?

There’s no set timeline for recovering from postpartum depression. How long symptoms last can vary depending on their severity, your individual circumstances and whether you receive treatment.

For some people, symptoms can persist well beyond the first few postpartum months. In one National Institutes of Health (NIH) study that followed women for three years after giving birth, a small group experienced persistently high levels of depressive symptoms throughout that period.

That said, Dr. Oreck says very mild cases may sometimes improve as hormones stabilize and sleep gets better, but “for most people, waiting it out means staying sick longer than necessary.”

There’s no reason to wait for symptoms to become severe before reaching out for help. “The earlier you start treatment, the faster and more complete the recovery tends to be,” says Dr. Oreck.

Treatment Options and How to Get Help

Treatment for postpartum depression often includes therapy, medication or a combination of the two, depending on your symptoms and individual circumstances.

• Therapy. Therapy treats postpartum depression by providing a safe space to discuss your thoughts and feelings. Through techniques like Cognitive Behavioral Therapy (CBT), it can help you rebuild your confidence, develop practical coping skills and process the intense emotional and biological changes of parenthood.
• SSRI medications. Dr. Oreck says antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat the condition.
• Emerging medications. There’s also zuranolone (Zurzuvae), the first oral medication approved by the FDA specifically to treat postpartum depression. It’s taken over 14 days and, Dr. Oreck notes, may begin working more quickly than traditional antidepressants.

A healthcare provider can help you weigh these and other treatment options and determine what’s appropriate for you.

Next steps to get help

Think you or your loved one might be experiencing postpartum depression. Here’s what to do.

• Reach out to a provider. The first step is reaching out to a professional who can help assess what you’re experiencing.
• Hotline options. If you don’t know where to start or have a trusted provider to turn to, you can also reach out to the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) for free, confidential support 24/7. Postpartum Support International (PSI) also offers a HelpLine at 1-800-944-4773, as well as resources for finding perinatal mental health support.
• Flag when it’s an emergency. Some symptoms require immediate help. If you’re thinking about harming yourself or baby, call or text 988 or seek emergency medical care. Hallucinations, delusions, paranoia, confusion or symptoms of mania can be signs of postpartum psychosis, which requires emergent medical attention.

What Causes Postpartum Depression and Who Is at Risk?

There’s no one single cause of postpartum depression. Hormonal changes, genetics, life stress and the physical and emotional demands of giving birth and caring for a newborn can all play a role.

Common risk factors

Some common risk factors for postpartum depression include:

• A personal or family history of depression
• Anxiety
• Bipolar disorder
• Having experienced postpartum depression in a previous pregnancy
• Limited support, relationship or financial stress
• A traumatic birth or NICU stay
• Certain medical issues, including thyroid problems

Having a risk factor doesn’t mean you’ll develop postpartum depression, and having none doesn’t mean you won’t. “I’ve treated plenty of patients whose first-ever mental health episode was postpartum depression,” says Dr. Oreck.

Can You Prevent Postpartum Depression?

There’s no guaranteed way to prevent postpartum depression, and developing it isn’t a sign that you did—or didn’t do—something during pregnancy or after birth. But if you know you may be at higher risk, talking with your provider during pregnancy can give you a chance to put support in place before baby arrives.

For people at increased risk of depression, the U.S. Preventive Services Task Force recommends that clinicians provide or refer them for counseling interventions, including approaches such as cognitive behavioral therapy (CBT) and interpersonal therapy (IPT).

If you’ve experienced depression, anxiety or postpartum depression before, consider bringing that history up with your OB or mental health provider during pregnancy so you can discuss what additional support or monitoring may make sense for you.

To Sum It Up

Postpartum depression doesn’t always look the way you’d expect. Signs and symptoms of postpartum depression can hide behind a functioning exterior, show up as anger or numbness instead of sadness, and start weeks or even months after birth. If you’re feeling off, don’t wait—postpartum depression treatment is readily available. “Start with whoever is easiest to reach quickly—your OB, midwife or primary care provider,” advises Dr. Oreck. “You don’t need to wait for your six-week postpartum visit or upcoming appointment.”

How We Developed This Article

Postpartum depression is a common condition that many moms struggle with—and they don’t need to go it alone. To learn more about postpartum depression symptoms and treatment, we spoke with two therapists and a psychiatrist, all of whom specialize in new moms’ mental health. We also interviewed moms who’ve experienced postpartum depression, as well as a dad who supported his loved one through it, to better understand what postpartum depression can look and feel like.

After editing, this article was vetted through fact-check and reviewed by our ob-gyn medical adviser. Learn more about how we ensure the accuracy of our content through our editorial and medical review process.

About the author: Christine Carpenter is a contributing writer and editor for The Bump whose passion for writing was reignited after the birth of her first child at the height of COVID. She began writing about motherhood with the hope of shedding light on perinatal mental health and helping women feel less alone. She lives in New York with her two young boys.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.