After giving birth, feeling uncertain about your role as a new mom is common, but the rush and range of emotions can truly feel like such a rollercoaster. Often, these feelings warrant the attention of a mental health professional, but understanding the differences between postpartum anxiety and postpartum depression can help new moms pinpoint exactly what it is they're experiencing and learn how to cope.
"There are commonalities between postpartum anxiety and depression, but one way to differentiate the two is how the energy is distributed," maternal mental health therapist Whitni Toson tells Romper. "Depression usually presents with symptoms of a low mood, feeling down, having little energy, loss of motivation or interest, hopelessness, and sometimes thoughts of death or dying. Anxiety usually displays different energy, where the energy is converted into excess worry, tension, feeling on edge or restless, overthinking or ruminating, and sometimes panic attacks."
When you're in the thick of the fourth trimester, sometimes it feels like your emotions just blend together, leaving you lost in a big, soupy fog. Toson says that experiencing both postpartum anxiety or depression "can create a cycle of feeling overwhelmed, then become hopeless, and repeat."
Deciphering exactly what it is that you're feeling can be difficult, so it's important to understand the signs and symptoms of both postpartum depression and postpartum anxiety, as well as when and how to seek help.
Differences In Signs & Symptoms
Both postpartum anxiety and postpartum depression fall under the umbrella of perinatal mood disorders. Although postpartum depression tends to be the condition that is most often discussed by doctors, the media, and moms themselves, postpartum anxiety can also be a prevalent part of some women's postpartum experience.
"Postpartum anxiety and postpartum depression share similar symptoms such as fatigue, an underlying feeling of fear, irritability and disrupted sleep for the new mother. It’s also possible to experience both postpartum anxiety and postpartum depression symptoms," licensed professional counselor Mike Gallagher tells Romper.
While the differences between the two conditions can be difficult to spot, there are things you can look at specifically to help determine what it is that you're experiencing.
"With postpartum anxiety one may experience racing thoughts, constant fear or feelings of dread, shakiness or trembling, nausea and vomiting, heart palpitations and light-headedness," Gallagher says. "Symptoms of postpartum depression include overwhelming sadness and hopelessness, anger, tearfulness and crying, and a lack of concentration. In more serious cases, postpartum depression can cause thoughts and behaviors of self-harm, suicide, and/or of bringing harm to the baby."
Experts note that both postpartum depression and anxiety can start anytime in the first full year following birth, so Toson says, "women must pay attention to their thoughts, mood, and behaviors" during this time. "If you notice any significant changes in your mood, thoughts, behaviors, or interactions with others, and these symptoms have been going on for more than two weeks, consult with your doctor or a mental health provider. Always seek immediate medical attention if you have thoughts of hurting yourself or others."
Treatment Options For Postpartum Anxiety & Depression
"Treatment for postpartum anxiety and postpartum depression may include medication and psychotherapy, among other wellness approaches," Gallagher tells Romper."Because presenting symptoms can be different between postpartum anxiety and postpartum depression, medication and therapy techniques may change, too. However, cognitive behavioral therapies are usually the frontline approach and have shown efficacy to treat depressive and anxious symptoms."
Treatment will also vary depending on the severity of your symptoms, but overall, having a good support system in place while receiving treatment is key.
"Usually, with respect to cases of anxiety, one-on-one therapy and support groups can be incredibly helpful to keep the symptoms at bay. Making sure a mother has a good support system and is able to do things she enjoys while healing and bonding with her child are important," neuropsychologist Dr. Sanam Hafeez tells Romper. "In severe cases of postpartum anxiety or postpartum depression, medication may be prescribed. The type of medication used for either postpartum depression or anxiety depends on the symptoms the patient is experiencing. Many cases need therapy paired with medications that help cope with irritability, mood swings, and sadness, which are symptoms of depression."
Why Postpartum Support & Screening Is Critical
"Many women tend to be embarrassed or ashamed of dealing with postpartum depression or postpartum anxiety. The stigma is something mental health professionals have been trying for a long time to help women overcome," Hafeez tells Romper. "Every woman is different and needs to pay close attention to her feelings after she gives birth. Postpartum depression and anxiety are related to chemical imbalances and should not be cause for shame."
Reaching out for support if you notice that you feel symptoms of postpartum depression or anxiety is of the utmost importance. Although most OB-GYNs will screen new moms for perinatal mental health problems at their six-week checkup, it may be sooner than this that your symptoms arise. So, it is crucial to find support when you need it.
"If a new mother has continuous days of feeling anxious and/or depressed, it is essential to consult her doctor so that there is an established notice to observe how long the symptoms last and their intensity," Hafeez says. "Feelings of anxiety, sadness, irritability, loss of appetite, difficulty bonding with your newborn, and all the rest are cause for concern, and especially if they last later than two weeks or start after two weeks of giving birth."
If you or someone you know is experiencing depression or anxiety during pregnancy, or in the postpartum period, contact the Postpartum Health Alliance warmline at (888) 724-7240, or Postpartum Support International at (800) 944-4773. If you are thinking of harming yourself or your baby, get help right away by calling the National Suicide Prevention Lifeline at 1-800-273-8255, or dialing 911. For more resources, you can visit Postpartum Support International.
Dr. Sanam Hafeez, PsyD., a neuropsychologist in New York City, faculty member at Columbia University
Whitni F. Toson, M.A., LPC, a maternal mental health therapist that specializes in Perinatal Mood and Anxiety Disorders in Texas