Eight signs a new mom is struggling with postpartum anxiety/depression (and she doesn’t know it)

Behind the blissful baby showers and Instagram-worthy nurseries, there are hidden mental health struggles faced by many new moms - struggles that often go unnoticed, even by the mothers themselves.

This guide is dedicated to those who love these new moms, be it husbands, wives, mothers, mother-in-laws, aunts, grandparents, sisters, friends, or anyone standing in the wings with a caring heart.

You might notice that she is struggling before she does, or even before she is ready to admit that she is struggling. The pressure to navigate parenthood in the modern era is nothing short of excruciating. The choices seem endless, from choosing the right feeding method to selecting the perfect stroller and deciphering between attachment and positive parenting. Amidst the chaos of unsolicited advice, intrusive in-laws, and the relentless pursuit of perfection, a heaviness settles in—a heaviness often unnoticed by those surrounding the new mom. Underneath the visible challenges lie the invisible burdens of a mothers mental load, meal planning, sleep cycles, daily household duties, clothing choices, car seats, and the overwhelming work to find a daycare.

These environmental and circumstantial stressors, coupled with the physiological changes post-childbirth, create a perfect storm for a new mother's mental health. Hormonal shifts and chemical changes in the brain can cloud her ability to cope and think clearly, adding a layer of complexity to an already challenging chapter of life.

Eight telltale signs a new mom is struggling:

1. Over-cleaning. Over-cooking. Generally overdoing it (with a inability to rest or allow help from others).

2. Crying for long periods of time.

3. Outbursts of rage. Slamming things and yelling (at others or the baby).

4. Numbing out. Disengaged. More than regular amounts of screen time.

5. Difficulty bonding with baby. Mom feels or believes they haven't bonded.

6. Ignoring the baby and/or not wanting to feed or hold the baby (especially in the middle of the night).

7. Excessive worry, repetitive thoughts, intrusive thoughts (examples: not letting anyone else hold the baby, fixating on certain things, researching the same thing over and over again).

8. Unable to sleep or rest, even when the baby is sleeping.

It's normal for new moms to be exhausted, sensitive, and emotional in the fourth trimester (those first 12 weeks). However, if you don't see her mood picking up or an increased ability to cope or increased confidence in her new role, this could be a sign of something more serious, especially if she is using phrases like "I shouldn't be a mother, "or talking (even casually) of harming self, baby and/or suicidal ideation.

As the person watching and witnessing how the new mom in your life is coping, you need to trust your instincts about her moods, reactions and decisions for those first few weeks after birth. Trust your gut and check in with her if you think something is amiss.

Postpartum mental health risk factors to be aware of:

• Depression or anxiety during pregnancy

• History of mental health struggles/illnesses

• Recent personal loss/grief (mother, father or other close family or friend)

• Lack of social support (this includes actual lack of support and the mom's perceived lack of support)

• Low levels of support in the marriage (if applicable)

• Giving birth to preterm infant(s)

• Having multiple babies - twins, triples, etc.

• Experiencing the “wrong” support during birth that results in a traumatic birth

• NICU stay or interventions

What are you looking for?

Perinatal Mood disorders can be hard to spot. Everyone gets the "hard" parts of new parenthood, but not everyone gets Perinatal Mood Disorder.

Baby Blues - can start a few days or weeks after the birth. It is called Baby Blues because it comes "out of the blue" and can bring unexpected sadness and irritability, moments of crying, restlessness, and even anxiety. It's unexpected because you wanted this baby so damn much, and those first days often are not what you expected. These "blues" will taper off over the next couple of weeks. If they are lingering, then it's time to talk about postpartum depression/anxiety.

Perinatal Mood Disorders - can start days after birth, most frequently starting 8-12 weeks postpartum and can show up any time within that first year. There are five core perinatal mood disorders: postpartum depression, postpartum anxiety, postpartum obsessive-compulsive disorder, postpartum stress disorder and postpartum psychosis.

What you do when you notice a new mom struggling to cope:

• Sit with her, without distractions and really hear her.

  Being home with a baby is very isolating. The days are hard and long. Make sure to be mindful of eye contact, smiling, leaning in posture, nodding and allowing the new mom to speak. Say things like "Tell me more about that," "How did that make you feel," "I am hearing you," and "That sounds hard."

• Offer for her to have alone time (and don't take no for an answer)

  Almost every new mom will feel guilty about leaving their babies to take care of themselves. Discuss the ways she would feel comfortable taking time for herself. Empathize with her on how hard it is to do this and that she will have more energy and patience if she takes even 10 minutes of alone time.

• Notice and validate all the things she is doing well.

  If she isn't coping well, she will already be berating herself for all the things she isn't doing well or how she feels inadequate. Notice and validate all her efforts and tell her she is a good mom. She is doing an excellent job meeting the baby's needs and acknowledging how hard it is to care for babies. (PSA: Do not tell her to cherish these days, or this too shall pass - it will - but these statements are not helpful in these raw moments)

• Acknowledge that it's common (but not normal) to have shifting moods.

  Tell her it's ok to have conflicting, fleeting thoughts. In one moment, she will have sheer explosions of joy over this tiny human, AND in the same second, complete hatred or fear that something terrible will happen.

• Let her know she is not alone.

  You can remind her that 1 in 5 women experience a perinatal mood disorder. Assure her that she isn't doing anything "wrong" and offer her whatever support she needs.

• Support her in accessing professional support, mom groups or online support.

  To reduce the overwhelm in finding professional help, do the leg work for her and research the mental health professionals in your area that help women with postpartum mood disorders. Have an open discussion about what is available to her. Offer to drive her and accompany her with the baby (in the waiting room or car) so she is close by (especially important if she feels anxious and fearful of leaving the baby).

I’m Kayla, a survivor of postpartum anxiety/ocd and registered therapist in Canada. Are you interested in learning more about the services I offer? Book a consult here.

I am one of those people who can help.

Until next time,

Kayla Huszar, BSW, RSW, PMH-C

PS> The same goes for you, dads/wives/partners. You’re tired and adjusting too. You might not get the surge of hormones that new moms do but, if you are also having difficulty, or finding it hard to support mom alone, this is a sign for you to get support too!