The Subtle Signs Of PPD That Often Get Overlooked

When you imagine postpartum depression (PPD), there’s a good chance the image that comes to mind is something like this: A woman in a drab outfit opens some gray curtains and peeks out at all the people outside looking happy. Laughing. Dancing. Maybe eating perfect salads. She’s forlorn, she looks miserable, and quite honestly, she’s probably nothing like you.

And that’s the problem. The image popular culture gives us of PPD is the mom who’s persistently gloomy, who gives up on her appearance, who has no motivation. But because most of us know it’s normal to have some — as the kids say — “big feelings” in the days and weeks after giving birth, it’s not always easy to know if what you’re feeling is just the baby blues or something more serious. The main difference: Baby blues tend to last a week or two. When the feelings persist longer than that, it’s worth a conversation with a healthcare provider.

The reality of PPD can be strikingly different from what you’d expect. Most new moms are actually highly motivated to get up, keep everything running, and somehow do it all perfectly. To recognize the symptoms, it’s important to identify signs you could easily miss if you’re expecting to feel like a sad lady with a cartoon cloud over her head. Ahead, four subtle signs of PPD you might brush off — but should be paying attention to.

1. You’re Feeling All Sorts Of Angry

Women who’ve experienced PPD are often blindsided by the pure white-hot rage. According to Elizabeth O’Brien, a psychotherapist, consultant, and educator who specializes in perinatal mental health and trauma, “What’s underneath the rage is anxiety and depression — but what surprises them is that they’re highly functioning. They’re like, ‘I don’t know what happened to me. I’m not identifying this controlling behavior as anxiety. I’m not identifying with depression classically because I’m dressed, getting things done, taking care of my baby. But I’m really angry and irritable.’”

These ragey feelings are often directed at a partner, a mother, or a mother-in-law. Partners describe feeling blindsided by the change in demeanor (“What happened to my wife?”), and women may not immediately connect it to a mental health issue. After all, they’re functioning fairly well — they just feel furious all the time. And quite frankly, there are legitimate reasons to be angry sometimes. Doomscroll on your phone, watch the news for 15 minutes, and the list gets long real quick. But persistent, outsized rage directed at everyone you love most is a symptom of PPD.

2. Your Body Is (Loudly) Trying To Tell You Something

Headaches that don’t quit. No appetite or the complete opposite, like eating without feeling satisfied. A level of exhaustion that a nap can’t even touch. PPD-related fatigue is different from run-of-the-mill new-parent tiredness in one very notable way: It doesn’t improve with rest. It’s easy to dismiss these physical symptoms as just part of the new-baby deal — and sometimes they are. But when they’re constant and show up alongside mood changes, they could indicate something more serious. As O’Brien puts it, “the postpartum period is probably the most vulnerable time in a woman’s life.” And your body often knows this before your mind catches up.

3. You’re Beyond The Point Of Overwhelmed

For high-achieving women, it can be incredibly disorienting to go from running meetings and managing projects to suddenly being unable to choose a yogurt flavor. Difficulty concentrating, trouble making even simple decisions, and a general cognitive fogginess are all recognized symptoms of PPD. Everyone knows the mental load of new motherhood is a lot, but it’s different when it feels like your brain has just gone completely offline. Rather than treating it as a character flaw, consider it a possible sign of PPD.

4. You’re Not “Sad” — You’re Just Kind Of… There

This is the one that really doesn’t match the sad-lady commercials. Instead of feeling the anticipated sadness and tearfulness, you’re experiencing flatness, as if you’re unable to feel joy, interest, or love. You’re simply going through the motions and feeling almost nothing. You plan every single detail of this baby’s arrival — pick the nursery colors and the homecoming outfit, master the incredibly complicated car seat — so it’s confusing to feel oddly detached from all of it. If you step back and watch yourself parenting from a distance, wondering why nothing feels like it’s “supposed” to, it’s easy to start telling yourself you’re just being ungrateful. If you’re experiencing this, bring it up to a professional. As O’Brien observes, women often come in saying “something’s wrong with me,” and they’re right. They just don’t know yet that what’s wrong has a name.

Returning To Yourself Is Possible

The good news about these and other more easily recognized symptoms of PPD is that they’re all temporary and treatable. O’Brien recommends starting with the body first. She says, “I always approach women in this time period from a biopsychosocial lens: How are we first supporting the body? Is she getting enough sleep, proper nutrition, and protein? Is she dehydrated? Even mild dehydration increases anxiety.”

Samantha Caola, a Maine-based licensed clinical professional counselor who specializes in perinatal mental health, is equally direct about sleep. She says, “Sleep is everything. Carve out time for it — coordinate with a partner, a doula, a family member, a friend, or a neighbor. This isn’t meant in jest; it’s so important to your mental well-being and functioning and is typically the starting place for the development of a postpartum mood disorder.” (Yes, this is yet another motivation to give up your late-night screen time.)

Finding The Right Support

If the body-first basics aren’t moving the needle, that’s ok — it’s just data you can take to the next step. Professional support is available and very much worth pursuing. Because PPD comes with hormonal components and unique physical experiences, look for a therapist who specializes in perinatal mental health. Even a skilled general therapist may be unfamiliar with specific symptoms or treatment modalities.

If you’re unsure of where to start, Postpartum Support International has a therapist directory where you can filter by location and perinatal specialization, as well as online support groups and a helpline.

The woman peering out the dark curtains doesn’t look like you. But that doesn’t mean you don’t need or deserve support. It just means you need to know what to look for — and now you do.

Presented by BDG Studios