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  • Writer's pictureAMP Therapy Center

The Unspoken Truth About Postpartum Depression

Postpartum depression is much more commonly talked about than it used to be, whether from a friend's social media post, a Hollywood star blogging or commenting on their experience in an interview, or from the news. It's more widely talked about than it used to be. Although, as a whole, I don't believe it is fully understood, accepted, or normalized in society as it could be. What most people don't know, or might not realize, is how pregnancy and postpartum can impact a mom's mental health in many different ways, not just "postpartum depression". We, as a society and culture, don't always talk about the hard parts of pregnancy or becoming a mom. It's easy to recognize the joyous and wonderful aspects of motherhood, but what about the scary stuff no one really talks about?


Perinatal Mood and Anxiety Disorders are REAL. They effect 1 in 7 women, which is a whopping 20%!! Did you know that?? For the ladies in the back, 20%!! A perinatal mood and anxiety disorder is THE MOST COMMON pregnancy complication, yet there is often much shame, guilt, or even embarrassment when experiencing perinatal mental health distress. This leads to more isolation and feeling alone. Some common thoughts might be, "I can't possibly tell anyone what I'm thinking and feeling. I can't believe I feel this way. I'm such a bad mom for thinking or feeling like this. No one would ever understand. I feel so alone in this. It's so dark and I feel so stuck. It'll pass. I'll get over it. Just put your head down and keep going. Make sure everyone else is taken care of first. Then, I'll make time for myself." Sound familiar??


"The hardest part for me was acknowledging the problem. I thought postpartum depression meant you were sobbing every single day and incapable of looking after a child. But there are different shades and depths of it..." -   Gwyneth Paltrow

My goal here today is to hopefully shed some light on the unspoken truths about postpartum depression and perinatal mental health, that no one talks about. Because the more we talk about this stuff, the more understood and normalized it becomes. And the more normalized and understood it is, the less guilt and shame show up. The less guilt and shame, the less scary it becomes. The less scary it is, the easier it is to talk about. The easier it is to talk about, the more moms feel confident seeking help (whether professional or not). The more moms seeking help, the less suffering moms!! You get my drift?? LET'S START TALKING ABOUT THE HARD STUFF.




Perinatal Mental Health is MORE than just Postpartum Depression

Okay, let's define Perinatal Mental Health, so we are all on the same page, because it is so much more than just Postpartum Depression and so different than the Baby Blues. Postpartum Depression is just one aspect of mental health distress that can be experienced after your baby is born, postpartum. But this type of mental health distress, along with the other perinatal mood and anxiety disorders (I will define in just a second), can show up at ANY point during pregnancy and up to ONE YEAR postpartum. Let me say that again. The distress symptoms of a perinatal mood or anxiety disorder can START during pregnancy all the way to 12 months after your baby is born.


So, what are the perinatal mood and anxiety disorders if it's not just depression? Perinatal Mental Health describes any behavioral, emotional, or mental distress during your fertility journey, including a pregnancy loss: Perinatal Mood and Anxiety Disorders (PMADs) include Depression, Anxiety, Panic, Posttraumatic Stress (PTSD), and Obsessive Compulsive (OCD). To clarify, Perinatal Psychosis is NOT included in a Perinatal Mood and Anxiety Disorder that we are talking about here. Each of these has their own set of signs and symptoms that can start at any point during pregnancy or up to one year postpartum. They are different than the Baby Blues which are just postpartum, start a few days after delivery and last ONLY 3 - 4 weeks, never longer. Baby Blues are NOT a perinatal mental health disorder and will resolve on its own as hormones balance, sleep is restored, and your body begins to heal physically.


"My family expected me to be so happy. I didn't understand myself - why was I so upset all the time, so worried, so fearful, so angry..."

Perinatal Mental Health Signs, Symptoms, and More!

Perinatal Mental Health Etiology
  • Change in mood occurring daily, intensely, and getting in the way of your basic needs

  • Disturbance to sleep and appetite

  • Feelings of guilt, shame, or hopelessness

  • Crying and sadness, constant worry, or racing thoughts

  • Loss of interest or finding pleasure in things that you used to enjoy

  • Feelings of anger, rage, or irritability

  • Scary negative and unwanted thoughts

  • Intrusive thoughts of harming yourself or your baby

  • Physical symptoms like dizziness, tightness in your chest, nausea, or hot flashes

  • Flashbacks, fears, or recurring nightmares


Intrusive Thoughts

Let's talk about intrusive thoughts. Have you heard that term before? It basically refers to any unwanted, negative thought that shows up in your mind. It is common in any Perinatal Mood and Anxiety Disorder, not just Postpartum Depression. It's much more than just scary thoughts about harming yourself or harming your baby (like we often hear in the news). 90% of ALL new parents will experience intrusive thoughts. They may vary in frequency (how often), intensity (how much they get in the way of your day), and duration (how long they last), but they are very common to motherhood, regardless of experiencing a Perinatal Mood and Anxiety Disorder. Just know, you are not alone. And you are not a bad mom for having these thoughts.


So, if this is something that the majority of new parents experience, what does it look like? sound like? feel like? There is a difference between what we call ego-SYNtonic intrusive thoughts and ego-DYStonic intrusive thoughts. Ego-syntonic thoughts are those that are in synch with what you believe to be true or real. The thoughts make sense to you. These are intrusive thoughts that DO increase the risk of harm to self, baby, or others. They are often in line with a perinatal psychosis episode and typically require hospitalization due to the emergency and risk of harm. These are not the intrusive thoughts I'm talking about. Remember, perinatal psychosis is NOT a Perinatal Mood and Anxiety Disorder, it is in its own category of perinatal distress and is VERY rare. I'm talking 0.1 - 0.2% of moms will experience perinatal psychosis. Now, Ego-DYStonic intrusive thoughts are where I want to focus your attention. These are intrusive thoughts that do NOT make sense to the mom. They are very scary, very distressing, and don't feel in line with who the mom is or her values. They are common, normal, and DO NOT cause any risk of harm to mom, baby, or others. These are the type of intrusive thoughts that most new parents will experience and can vary in frequency, intensity, and duration, which will also affect the level of distress they can cause a new mama. GOOD MOMS HAVE SCARY THOUGHTS: a great depiction through comics and beautiful artwork of intrusive thoughts MANY, many moms experience.


The transition to motherhood can be an overwhelming time, and distress is normal. It's okay to seek support. Seeking professional help does not make you less than. Does not make you a bad mom. Does not mean you are weak. Instead…it’s the opposite. It takes a lot of strength and courage to ask for help and be vulnerable. By making sure YOU are well, you are making sure YOUR baby's mom is well. That's not selfish.

How To Get Help and How to Give Help

  1. Learn more so you can recognize when someone you love is struggling or when you find yourself struggling

  2. TALK ABOUT THE HARD STUFF

  3. Know it's not their/your fault; they/you are not to blame; and with help, they/you can be well

  4. Clarify and communicate what being "helpful" means; is your idea of being helpful the same as theirs and vice versa?

  5. Share with your support system how you are feeling, or encourage them to share with their support system - including friends, family, or coworkers

  6. Seek or encourage professional help: talking with your baby's Pediatrician or your OBGYN can be a great place to start!

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