You did something enormous. You grew and delivered a human being. And somewhere between the hospital discharge and the first sleepless week at home, instead of feeling the joy everyone keeps telling you to feel, you're anxious, weepy, overwhelmed or maybe a little numb.
Postpartum depression and anxiety are far more common than most people realize, and far less talked about than they should be.
The Numbers
In Canada, almost one in four mothers who recently gave birth, 23%, reported feelings consistent with postpartum depression or an anxiety disorder. That's not a small number, it could be your friend experiencing these symptoms or the woman next to you in prenatal class, or maybe its you feeling symptoms od postpartum depression or anxiety. A national survey of over 6,500 Canadian women found that 13.8% had symptoms consistent with postpartum anxiety, while 17.9% had symptoms consistent with postpartum depression. And those numbers only capture what gets reported. Many women don't disclose what they're going through, partly from exhaustion, partly from stigma, partly because they assume what they're feeling is just a normal part of being postpartum. It isn't. Or at least, it doesn't have to be.What's Happening in Your Body
The postpartum period is one of the most significant hormonal shifts a human body can experience. During pregnancy, your estrogen and progesterone levels climb steadily for nine months, they're part of what sustains the pregnancy and, interestingly, they also contribute to cognitive function, memory, and mood regulation. When the placenta is delivered, estrogen and progesterone levels drop sharply, reaching pre-pregnancy levels within just five days. In only Five days, after nine months of building up. Estrogen has mood-regulating effects, and its abrupt decrease can lead to feelings of depression and anxiety. The drop in estrogen and progesterone levels after birth is also linked to a rapid decrease in serotonin, the neurotransmitter involved in regulating mood, happiness, and sleep. A decrease in dopamine, the "reward" neurotransmitter, may also occur postpartum, which can contribute to a flat, joyless feeling known as anhedonia. Research has found that sharp changes in maternal hormone levels are correlated with depression, and that depression is correlated with anxiety, which is in turn associated with elevated cortisol levels, the body's primary stress hormone. In other words: your body is doing an enormous amount right now. The way you feel is, in part, a direct physiological response to that.The Sleep Part
Everyone knows new parents don't sleep. What fewer people talk about is what that actually does to the brain. Research has found that the chance of developing postpartum depression in women with poor sleep quality was 3.34 times higher than in women with good sleep quality. Sleep deprivation disrupts the balance of neurotransmitters, impairs emotional regulation, and makes it significantly harder to manage stress, all of which creates a compounding effect on top of the hormonal changes already happening. The relationship between sleep deprivation and postpartum depression is also bidirectional: depression often causes sleep problems, and sleep problems make depression worse. Once that cycle starts, it can be hard to know which came first.The Part About Visitors and Saying Yes When You Mean No
This one doesn't get enough attention. Grandparents want to come over, friends want to meet the baby and everyone has good intentions, and the last thing you want to do is disappoint the people who love you. So you say yes and tidy the house to the best of your abilities, put on a smile and make conversation. You answer the same questions about feeding and sleep and weight gain. And once they leave, and you're more exhausted than before they arrived. Research consistently shows that low postpartum social support is among the strongest predictors of postpartum depression, but the nature of that support matters. Support that reduces your load is protective, while social obligations that add to it are not. High life stress and stressful life events have been identified as two of the most consistently replicated risk factors for postpartum depression across decades of research. And the early postpartum period is full of them, the pressure to host, to perform happiness, to be grateful, to have it together, all while running on almost no sleep and a completely reconfigured hormonal system. Protecting your rest and your comfort in those early weeks is one of the most important things you can do for yourself.Symptoms of Postpartum Depression
Postpartum depression doesn't always look like what you might expect. It's not always crying on the bathroom floor (though sometimes it is). The symptoms of postpartum depression can include:- Persistent low mood or feeling emotionally flat
- Difficulty bonding with your baby, or feeling like you're going through the motions
- Withdrawing from people you usually want to be around
- Feeling hopeless, worthless, or like you're failing as a mother
- Changes in appetite, eating much more or much less than usual
- Difficulty concentrating or making decisions
- Exhaustion that goes beyond ordinary new-parent tiredness
- Intrusive or scary thoughts that feel out of character
Symptoms of Postpartum Anxiety
Postpartum anxiety is actually more common than depression in the early postpartum period, and it often goes unrecognized, partly because some degree of new-parent worry can seem completely understandable. But there's a difference between normal concern and anxiety that won't let you rest. The symptoms of postpartum anxiety can include:- Racing thoughts that won't slow down, especially about the baby's safety
- Difficulty relaxing even when the baby is sleeping
- Feeling on edge, irritable, or easily startled
- Physical symptoms like a tight chest, rapid heartbeat, or shortness of breath
- Avoiding certain situations out of fear something will go wrong
- Needing constant reassurance that your baby is okay
- Trouble sleeping even when you have the opportunity
What Can Actually Help
The good news is that postpartum depression and anxiety are treatable. A few things worth considering if you're noticing these symptoms: Talk to your doctor or midwife. Postpartum mood disorders are medical and they're not a sign of weakness or bad mothering. Your care provider can screen for what's going on and connect you with support. Protect your sleep where you can. This doesn't mean sleeping when the baby sleeps (easier said than done). It means being honest with your partner, family, or support network about what you actually need. Letting someone else take a night feeding so you get a longer sleep stretch can have a really positive impact. Start saying no to things that drain you. You are allowed to postpone visits and ask people to keep it short because you don't owe anyone access to your home or your energy right now. Consider therapy. Talking with someone, particularly a therapist who works with maternal mental health, can make a significant difference. You're giving yourself the same level of care you'd give anyone else going through something this hard. Connect with others who get it. Isolation makes everything worse. Whether that's a postpartum support group, an online community, or a friend who went through something similar, knowing you're not the only one navigating this can take some of the edge off. The postpartum period asks a lot of you; more than most people prepare for, and more than most people will admit to out loud. If you're struggling right now, that doesn't mean something has gone wrong with you but rather that your sleep is disrupted, your hormones are recalibrating, and you're being asked to function through all of it. That's a lot. And it makes sense that some people need support to get through it. If you've been wondering whether what you're feeling is more than just the adjustment period, a conversation with someone who understands maternal mental health is a good place to start. You don't need to have a diagnosis to reach out, you just need to be struggling.We’re here if you need help
Want to connect with a therapist who specializes in postpartum mental health? At The Dot, we offer free consultations for anyone in Canada considering therapy. We’ll go through your questions and concerns and help you find the right therapist for what you’re dealing with. Does everybody need therapy? No. But if you’re curious about working with someone who specializes in EMDR and trauma, that curiosity is worth pursuing. Book Your Free Consultation Visit our therapist match form to let us match you with the right therapist for your needs.
