The Struggle with Postpartum Mental Health Disorders
By Jasmin Portaz, M.A., LPC, ATR
April 30, 2026
The need for awareness, support, and compassion.
The recognition, understanding, and empathy toward postpartum mental health dangers and needs did not become prevalent in the United States until the late ‘80s-early ‘90s. Prior to this acknowledgement, the diagnosis used to explain nearly all mental health issues experienced by women or, more accurately, those assigned female at birth (AFAB) was “hysteria,” originally attributed to a “wandering uterus.” This diagnosis caused significant harm to a great many people, including treatments of forced “pelvic massage” to stimulate orgasms, hydrotherapy, hysterectomies, and psychiatric institutionalization. Unfortunately, “hysteria” was not removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1980. It is only within the last 40 or so years that the scientific community has come to acknowledge, and advocate for, the need for greater understanding, research, and intervention for non-male-born people. Even then, postpartum mental health issues have often been defined as nothing more than “baby blues,” an all-encompassing term that harshly and dangerously minimizes the severity and reality of the situation, leaving the underlying issues untreated or undertreated. There is clearly a need for more compassion, intervention, and understanding of the needs of those responsible for creating life.
POSTPARTUM DIFFICULTIES AND LACK OF SUPPORT
While mental health disorders and ailments can affect both the birthing and non-birthing parent at various times and in various situations associated with pregnancy, including the journey to get pregnant, pregnancy, post-loss, and postpartum, for now, we’ll focus on postpartum. At least 1 in 5 birthing parents suffer from some form of postpartum mental health struggle. Leading up to the birth of a child, there is great focus, care, and concern for the birthing parent, often by doctors, family members, partners, and other community members. Once the baby has arrived, the birthing parent gets one, sometimes two, postpartum checkups, unless more are needed or advocated for. Many people are not prepared for the hormonal and mental health difficulties associated with giving birth. Additionally, and possibly more importantly, those around the birthing parent are often unequipped to notice symptoms, seek appropriate help, and properly support them. The consequences of this can be disturbing, damaging, or even dire, with 23% of pregnancy-related deaths associated with postpartum mental health conditions, making them the leading cause of maternal mortality. Let’s take a look at some postpartum mental health disorders, signs, symptoms, and possible treatments.
POSTPARTUM DEPRESSION
Postpartum depression (PPD) was finally included in the DSM in 1994 as a specifier under the diagnosis of major depressive disorder (MDD). PPD is the most commonly recognized, diagnosed, researched, and perhaps understood postpartum mental health disorder. PPD affects 1 in 5 AFAB parents and 1 in 10 AMAB (or assigned male at birth) parents. This can lead to a myriad of symptoms, including sleep disturbances, lack of appetite, difficulties bonding with the baby, anger, irritability, or rage, lack of interest in activities that used to bring joy, lack of desire or ability to care for self, weepiness, feelings of guilt, hopelessness, and even thoughts of harm to self or baby. Symptoms usually begin within the first week postpartum
POSTPARTUM ANXIETY
Postpartum anxiety (PPA) does not currently have a formal diagnosis in the DSM. PPA is often unrecognized and therefore far too frequently goes untreated. Often, symptoms associated with PPA are disregarded and disrespected, with parents being made to feel shame, being told they are overreacting, having their boundaries disrespected, and feeling belittled or brushed aside. As with PPD, PPA is experienced by 1 in 5 AFAB parents and 1 in 10 AMAB parents. Symptoms for PPA include excessive and constant worry, nervousness, anxiousness, trouble relaxing, lack of appetite, inability to sit still, nausea, dizziness, diarrhea, sleep disturbances, feelings of anger, irritability, and intrusive thoughts about something bad happening. Symptoms usually begin immediately after delivery to six weeks postpartum.
POSTPARTUM PSYCHOSIS
Postpartum psychosis (PPP) has been added and removed from the DSM as a specifier multiple times and is currently (since 2013) under the diagnosis of brief psychotic disorder, bipolar l/ll, or MDD. PPP is a serious, extremely concerning disorder affecting approximately 1-2 of every 1,000 deliveries. Usually, symptoms are established in the first two weeks following birth, but they can also begin at any time within the first year of postpartum. Symptoms include paranoia, hallucinations, inability to sleep, hyperactivity, delusions, severe depression, lack of any emotion, difficulties communicating, and rapid mood swings. While all postpartum disorders should be diagnosed and treated with urgency, PPP is considered an emergency and requires immediate intervention and support from doctors and psychiatric professionals.
THOSE AT RISK
While those who have had previous diagnoses and mental health struggles are definitely at greater risk, there are many others who should be acutely aware and prepared. These groups of people include, but are not limited to:
Teens
Parents who have gone through the loss of a pregnancy or children
Single parents
Those experiencing financial instability
Those who struggled with fertility challenges
Queer and trans families
Parents of color
Military families
Those without social or familial supports
Parents with relationship challenges or a history of abuse
Unwanted pregnancies
Those with babies who spend time in the Neonatal Intensive Care (NICU)
Those struggling with disappointing or traumatic birth experiences
Parents of multiples
Those struggling with lactation and nursing
While none of these, even those with a history of mental health or familial mental health disorders, guarantees that a parent will experience any postpartum mental health struggles, those who identify with any of the above categories should be more aware and prepared for the possibility of mental health difficulties, while seeking support or having a plan for support.
EFFECTS ON PARENTS AND BABY AND HOW WE CAN HELP
While many mental health conditions go untreated, postpartum mental health issues far too often fall into that category due to society’s often flippant understanding and response to the postpartum needs of the birthing parent. 75% remain untreated leading to potentially serious impacts on both parents and baby. When someone is struggling with depression, anxiety, or psychosis, they may struggle to engage in basic self-care such as bathing, eating, sleeping, and reaching out for support. This lack of care can then be passed down to the most helpless of beings: newborn babies. Lack of proper care for newborns can have dire consequences, including adverse effects on mother-infant attachment, struggles with nursing and proper nutrition, longer stay in the NICU, behavioral, cognitive, and emotional delays, more trips to the emergency room, and in extreme cases, neglect, abuse, and even death.
Those around the parents can lookout for these symptoms, help by offering support for the parents to eat, sleep, shower, go on walks outdoors, share their experiences, offer to watch the baby, or simply be there so they are not alone. When symptoms are identified, doctors should be immediately consulted, children should be supported and possibly cared for by family, friends, or community supports, and parents should be treated with kindness, empathy, and understanding.
HOW THERAPY CAN HELP
Pregnancy, birthing, and parenting can be difficult even under the best of circumstances. Any person preparing for the birth of a child could greatly benefit from working with a therapist. If you are one of the people in a birthing person’s life, your therapist can help you identify needs and gather resources for them. As the birthing person, if you are able to begin this relationship before the birth, your therapist can help you identify struggles and needs, leading to early intervention and better possible outcomes. It is never too late to seek support, so even if you begin postpartum, even if it feels like all hope is lost, or like you simply can’t do this, your therapist can help. They can offer you the compassion and empathy you rightly deserve. They can offer tools and resources to help get you through even the toughest moments. And they can offer a safe space, just for you, where you can share scary or intrusive thoughts without feeling judged, unfit, or unsupported. You may not have all the support you need, but you can have the much-needed support of a therapist.
Warmly,
HELPFUL LINKS
American College of Obstetricians & Gynecologists - Summery of Perinatal Mental Health Conditions
American Psychiatric Association - Women's History Month: The Rise of Reproductive Psychiatry
National Library of Medicine - Postpartum Psychiatric Disorders
Postpartum Support International - Perinatal Mental Health: Signs, Symptoms and Treatment
World Health Organization - Perinatal Mental Health
National Suicide Prevention Lifeline - Call or text 988
Crisis Text Line - text HOME to 741741
If you are experiencing a mental health crisis, always seek professional help immediately. Please call 911 or the suicide prevention lifeline at 988 or go to your nearest emergency room for immediate care.
DISCLAIMER
The content of these webpages and blogs and information provided is for general informational and educational purposes only and is not intended as a substitute for professional medical or mental health advice, diagnosis, or treatment. Always seek the advice of your qualified health provider with any questions you may have regarding a medical or mental health condition. Seek professional help immediately if you are experiencing a mental health crisis or any other medical condition.