Key takeaways: 

• Learn about the signs, symptoms, and causes of postpartum depression and anxiety.

• Discover the importance of seeking professional support for these conditions.

• Explore additional resources available for those affected.

Postpartum Anxiety vs. Postpartum Depression: Understanding the Differences

Becoming a new mom is a profound experience filled with a whirlwind of emotions; It’s supposed to be one of the happiest times of your life, but instead, you find yourself overwhelmed, filled with dread, or struggling to bond with your new baby. If you feel sad, lost and uncertain, you’re not alone—and the difference between these two postpartum mental health conditions can sometimes be hard to spot. You’ve heard of postpartum depression (PPD), but what about this constant, nagging worry that doesn’t seem to go away? Could it be postpartum anxiety (PPA)?

Hi, I’m Emily Zeller, a Licensed Marriage and Family Therapist (LMFT) who has worked with countless new moms and families navigating the rollercoaster of postpartum. I’ve seen firsthand how these conditions can deeply affect new mothers, fathers, and families.

The purpose of this blog post is to clarify the differences between postpartum anxiety (PPA) and postpartum depression (PPD), two mental health conditions that affect many mothers and new parents after giving birth. This post aims to help parents recognize the mood disorders they may be facing during the postpartum period. Understanding how symptoms like difficulty sleeping, obsessive and negative thoughts manifest is key to seeking appropriate care and support from a healthcare provider. With talk therapy and support groups, parents can better manage conditions like anxiety disorders and perinatal depression, improving their overall health and well-being.

What is PPA and PPD?

Postpartum anxiety (PPA) and postpartum depression (PPD) are common mental health conditions that can affect new mothers and nonbirthing parents after birth. PPA is marked by excessive worry, panic attacks, and obsessive thoughts, while PPD involves persistent feelings of sadness, difficulty bonding, and mood swings. According to the American College of Obstetricians and Gynecologists, around 15% of women experience postpartum depression, while about 10% may develop postpartum anxiety disorders. Risk factors include a family history of anxiety disorders or depression, sleep deprivation, and negative thoughts.

The term “postpartum” refers to any time within the first year following childbirth. While postpartum depression usually appears within the first two weeks to months after childbirth, some individuals may not notice symptoms until several months later. Each pregnancy and postpartum period is unique, bringing its own set of circumstances and expectations. It’s crucial to remain observant and seek assistance if necessary, even months after delivery.

What is PPA?

Postpartum anxiety (PPA) is a condition that affects many new moms in the postpartum period. Unlike the typical worries new moms may experience, postpartum anxiety disorders involve excessive worry that interferes with daily life. Panic attacks, intrusive thoughts, and constant fears for the baby’s safety are common. The exact cause of PPA is not fully understood, but it is believed to be influenced by hormonal changes after giving birth, sleep deprivation, and personal or family history of anxiety disorders or depression. Other risk factors include negative thoughts, a history of depression, and difficult childbirth.

Common symptoms of PPA include:

• Excessive worry about the baby’s health and safety

• Panic attacks or a constant feeling of dread

• Difficulty sleeping, even when the baby is asleep

• Intrusive thoughts or obsessive thoughts about potential dangers

• Physical symptoms such as a racing heart or shortness of breath

• Difficulty breastfeeding due to anxiety

• Feeling disconnected or difficulty bonding with the baby

What is PPD?

Unlike the "baby blues," which are short-lived, someone experiencing postpartum depression (PPD) experiences the following symptoms, but in more serious and long lasting form. PPD is a serious mood disorder that can persist for weeks or longer and significantly impact a mother’s ability to care for herself and her baby. It is often triggered by a combination of hormonal changes, sleep deprivation, physical symptoms from childbirth, and preexisting mental health conditions like a history of an anxiety disorder or depression. Other risk factors include family history, complications during delivery, and lack of support during the postpartum period.

Common postpartum depression symptoms include:

• Persistent feelings of sadness or feeling sad without clear reason

• Difficulty bonding with the baby

• Negative thoughts about oneself or one's ability to parent

• Sleep deprivation or oversleeping, unrelated to the baby’s schedule

• Difficulty breastfeeding or lack of interest in self-care

• Severe mood swings or irritability

• Withdrawal from family, friends, and activities

• Lack of interest or joy in the new baby or daily life

  Postpartum depression can affect both mothers and their partners. Research shows that up to 10% of new fathers may experience PPD, particularly when their partner is also struggling with it. Both men and women can benefit from a combination of psychotherapy and medication as part of their treatment plan.

  If you or someone you know is it’s important to seek help from a healthcare provider. With the right care, including talk therapy and support groups, recovery is not only possible but can also lead to a stronger bond with your baby and improved overall well-being. You don’t have to face this alone—support is available.

Understanding the impact of PPA and PPD

While both PPA & PPD can emerge after the birth of a baby, their effects can manifest in different ways. Here’s a look at how these conditions can play out in real life:

• Excessive Worry: One mom may feel an overwhelming sense of dread every time her baby cries, obsessively checking to make sure they’re still breathing—even if there’s no medical reason to be concerned. While checking on your baby’s well-being is normal, this mother may find herself checking 20, 30, or even 50 times a night, unable to sleep as a result.

• Intrusive Thoughts: Imagine a parent who is constantly flooded with distressing, unwanted thoughts, like the fear of accidentally dropping the baby. These thoughts are not reflective of reality but cause immense emotional pain and anxiety. Even though the parent would never act on them, they feel like they’re on a tightrope, trying to manage the weight of these scary ideas.

• Difficulty Bonding or Breastfeeding: A mother with PPD may feel disconnected from her baby, as if she’s watching herself care for her child from a distance. Her sadness may make breastfeeding or even holding her baby feel like an insurmountable task, leaving her questioning her worth as a parent.

• Panic Attacks: A mom dealing with postpartum anxiety might have sudden and intense panic attacks, often triggered by something as simple as being left alone with her baby. These attacks can make her feel physically ill, with a racing heart, difficulty breathing, and the overwhelming fear that something terrible is about to happen.

• Difficulty Sleeping: Sleep deprivation is a common part of new parenthood, but for moms with PPA, sleep may feel impossible even when the baby is resting. Their minds race, fixating on worries about the baby’s health, development, or their ability to parent effectively.

  A Closer Look: Case Study

  I once worked with a client I’ll call “Jill,” a first-time mom who was struggling with overwhelming anxiety just weeks after giving birth. She constantly feared something was wrong with her baby, despite multiple assurances from healthcare providers. Her anxiety was so intense that she avoided leaving the house, worried she might forget something crucial or that an accident might happen. At night, Sarah couldn’t sleep—even when her baby was peacefully dozing—because she felt she needed to be hyper-vigilant. Eventually, she reached out for help after recognizing that her mental health was suffering.

  Through talk therapy, Sarah began to understand the difference between natural maternal worry and the more intense, debilitating worry characteristic of PPA. By learning coping strategies and addressing underlying fears, Sarah gradually regained her confidence as a new parent. She also found support through a group of other mothers experiencing similar struggles, which helped her feel less isolated.

A therapist’s guide to seeking help for PPD and PPA

As a therapist specializing in women's mental health, I’ve worked with many new moms navigating the challenges of motherhood. Seeking help can feel overwhelming, but knowing where to start is key to healing. I’ll break down the steps to getting support, from recognizing the signs to finding the right health care options, such as talk therapy, support groups, and working with a trusted healthcare provider. You don’t have to go through this journey alone—help is available.

Why therapy is important

Therapy plays a crucial role in treating both PPA and PPD, offering a safe space for new moms to explore their feelings and develop strategies for managing their symptoms. Navigating the pregnancy and postpartum period can be overwhelming, especially when dealing with intense emotions like anxiety, sadness, or intrusive thoughts. Therapy helps individuals make sense of their experiences, process overwhelming emotions, and ultimately regain control of their lives.

Benefits of therapy for PPA and PPD include:

• Gaining insight into triggers and underlying causes of anxiety and depression

• Developing coping strategies for managing panic attacks, negative thoughts, and overwhelming worry

• Learning techniques to improve sleep, manage mood swings, and alleviate physical symptoms

• Strengthening the bond with the baby and addressing difficulty breastfeeding or difficulty bonding

• Accessing a judgment-free space to discuss the emotional toll of motherhood

Therapy empowers new moms to overcome PPA and PPD, offering essential tools for recovery and long-term well-being.

What to expect in therapy for PPA and PPD

When beginning therapy for postpartum anxiety or postpartum depression, it’s normal to feel unsure about what to expect. Therapy provides a supportive space where you can explore your emotions, thoughts, and behaviors in a way that leads to healing. In the initial sessions, your therapist will help you identify your specific concerns—whether it’s panic attacks, sleep deprivation, or feeling disconnected from your baby. Together, you’ll create a plan that focuses on your unique needs.

A typical session may include talking through your experiences, learning coping strategies to manage anxiety, and practicing relaxation techniques. Your therapist will help you understand how family history, risk factors, and personal challenges may be contributing to your current struggles. Over time, therapy can offer tools for managing negative thoughts, addressing difficulty bonding with your child, and improving your overall well-being during the postpartum period.

Couple or family therapy can be another helpful option when dealing with postpartum issues. This therapeutic setting encourages couples to share their feelings, fears, and experiences, fostering empathy and support during a challenging time. Plus, involving family members can help everyone learn how to cope together and create a solid support system for the new baby. By addressing individual and shared concerns, therapy helps build stronger relationships and a healthier home for everyone.

Finding a qualified therapist

Finding a qualified therapist who specializes in maternal mental health is crucial. The therapeutic relationship is vital for effective treatment, so taking the time to research and select a therapist who understands your experiences and challenges can make a significant difference. Here are some key factors to consider when choosing a therapist:

• Specialization: Look for a therapist who specializes in postpartum care, particularly in treating PPA and PPD. A therapist with a Perinatal Mental Health Certification (PMH-C) is specially trained to provide compassionate support and evidence-based interventions for individuals experiencing challenges related to pregnancy, childbirth, and the postpartum period.

• Approach to treatment: Inquire about their therapeutic techniques and whether they utilize evidence-based methods like cognitive-behavioral therapy (CBT) or mindfulness.

• Compatibility: It is crucial to feel a sense of connection and comfort with your therapist, as a positive therapeutic relationship can significantly enhance the effectiveness of treatment. Research published in the International Journal of Mental Health Systems emphasizes that a strong alliance between client and therapist is linked to better outcomes in mental health interventions.

• Location and availability: Consider whether they offer in-person sessions or teletherapy, and check their availability to accommodate your schedule. Online therapy offers new moms the convenience and flexibility to access support from the comfort of their home, making it easier to fit sessions into busy schedules; however, some individuals may prefer in-person therapy for the personal connection and immediate support that face-to-face interactions can provide.

Choosing the right therapist is a personal decision, and taking the time to find someone who meets your needs can greatly enhance your journey toward recovery. If you’re having trouble sorting through the various therapy options, it may be best to consult your medical provider for a referral.

More PPD and PPA resources

In addition to therapy, there are many resources available to help individuals experiencing PPA and PPD. These resources offer education, support, and community for new moms and new parents who may be struggling with the emotional and physical toll of postpartum anxiety and postpartum depression. Below are some valuable tools you can access to supplement your treatment:

• Postpartum Support International (PSI): Offers resources and support groups for women experiencing PPA or PPD. They also provide a Crisis Lifeline for immediate help.

• The National Institute of Mental Health (NIMH): A trusted source for information on anxiety disorders, mental illness, and treatments for conditions like obsessive-compulsive disorder and postpartum health issues. A systematic review or narrative literature review on different women's health issues and child development is available on this website.

• Centers for Disease Control and Prevention (CDC): Provides helpful insights on the prevalence and increased risk of developing PPD or PPA.

• The American Journal of Obstetrics and Gynecology: Features research and systematic reviews on women's experiences with postpartum health.

• Support groups for new moms: Connecting with other women can offer comfort and a sense of community when feeling isolated.

These resources complement therapy and can offer valuable support and education. However, they are not a replacement for professional mental health care and the guidance of a healthcare provider.

Final thoughts

No matter how isolated or overwhelmed you feel, please know that what you’re experiencing is real—and treatable. PPA and PPD can deeply impact not only your life but your child’s development and your family’s well-being. In my experience as a therapist, I’ve worked with women who often didn’t realize just how serious their feelings of sadness, anxiety, or doubt were at first. Through therapy, women often uncover effective coping strategies that empower them to manage their symptoms and regain their sense of self. Many report feeling more connected to their babies and partners, fostering healthier relationships and enhancing their overall well-being.

If you or someone you love is experiencing postpartum anxiety or depression, please don't wait to communicate your concern. Reaching out for support early on can be crucial in managing symptoms and enhancing the well-being of both you and your baby.

Whether you’re pregnant, juggling your third child, or in the midst of the newborn stage, you don’t have to face it all by yourself. I offer online therapy for women, couples, and families throughout Pittsburgh, Pennsylvania, Ohio, and Illinois through Zeller & Co. Therapy. Let’s work together to help you feel like yourself again, embracing both the challenges and strengths that come with motherhood.