In immediate danger? Call 911. For a mental health crisis, call or text 988. The National Maternal Mental Health Hotline is free and staffed 24/7 at 1-833-852-6262. Postpartum Support International offers non-emergency support at 1-800-944-4773 (calls returned 8am–11pm ET).
Emergency: 911  ·  Crisis: call or text 988
Emerald Wellness (affiliated outpatient provider): (732) 444-2626
Early Recognition

Signs of postpartum depression & anxiety — recognize them early

Published  ·  Updated

The sooner postpartum depression and anxiety are recognized, the sooner treatment can start. The tabs below group the signs by condition. The psychosis tab is different: those signs need an emergency call, not a wait-and-see.

Emotional Signs

  • ● Persistent sadness or emptiness lasting more than 2 weeks
  • ● Feeling disconnected from your baby
  • ● Loss of interest in things you used to enjoy
  • ● Feeling like a "bad parent" or worthless
  • ● Crying frequently without clear reason
  • ● Feeling hopeless about the future
  • ● Thoughts of harming yourself or others: call 911 if anyone is in immediate danger or there is an urge or plan to act; otherwise call or text 988 now

Physical & Behavioral Signs

  • ● Sleeping too much or unable to sleep even when baby sleeps
  • ● Significant changes in appetite
  • ● Extreme fatigue beyond typical new-parent tiredness
  • ● Withdrawing from family and friends
  • ● Difficulty concentrating or making decisions
  • ● Feeling numb or "going through the motions"
  • ● Neglecting self-care or household responsibilities

Mental & Emotional Signs

  • ● Racing, uncontrollable thoughts
  • ● Constant fear that something will go wrong with the baby
  • ● Difficulty relaxing even when baby is safe
  • ● Inability to stop worrying
  • ● Feeling on edge or irritable constantly
  • ● Panic attacks (sudden intense fear, heart racing)

Physical Signs

  • ● Heart pounding or racing
  • ● Shortness of breath
  • ● Chest tightness or pressure
  • ● Dizziness or lightheadedness
  • ● Nausea or stomach upset
  • ● Unable to sleep despite exhaustion

Intrusive Thoughts (Common)

  • ● Unwanted, frightening thoughts about the baby being harmed
  • ● Disturbing images that pop into your mind against your will
  • ● Fear that YOU could somehow hurt your baby
  • ● Thoughts that feel completely contrary to who you are
  • ● Intense distress about having the thought

Compulsive Behaviors

  • ● Checking on the baby repeatedly
  • ● Avoiding situations related to the thought
  • ● Excessive reassurance-seeking
  • ● Mental rituals to "neutralize" thoughts
  • ● Hiding thoughts due to shame
💡
Important: Intrusive thoughts are NOT plans.

Having a disturbing thought does not make you a danger. In a study of 388 new mothers, those with unwanted thoughts of harming their baby, and those with OCD, were no more likely than other mothers to act aggressively toward their infant (Fairbrother et al., 2022). The horror you feel about the thought is part of OCD. Tell a provider, who can also rule out postpartum psychosis. It is treatable.

Warning Signs — Call 911

  • ● Hallucinations (hearing or seeing things not there)
  • ● Delusions (fixed false beliefs, e.g., baby is possessed)
  • ● Rapid, extreme mood swings within hours
  • ● Confusion or inability to recognize reality
  • ● Severe disorganized thinking or speech
  • ● Not sleeping for days without fatigue

What to Know

  • ● Occurs in about 1 to 2 of every 1,000 births
  • ● Usually begins suddenly, within the first 2 weeks after birth
  • ● This is a psychiatric emergency — do not wait
  • ● Highly treatable with immediate care
  • ● Most people recover from the episode with prompt treatment, usually in a hospital. The risk of another episode after a later pregnancy is higher, so plan ahead with a psychiatrist
🚨
This is a medical emergency.

Call 911 or take your loved one to the nearest emergency room immediately. Do not leave them alone. Postpartum psychosis is rare, serious, and highly treatable — fast action saves lives.

Sources

  • Screening and diagnosis of perinatal depression and anxiety: ACOG Clinical Practice Guideline No. 4, Obstet Gynecol 2023 (PMID 37486660).
  • Unwanted intrusive thoughts and the risk of harm: Fairbrother et al., J Clin Psychiatry 2022 (PMID 35235718).
  • How often postpartum psychosis occurs (five population-based studies reported about 0.9 to 2.6 cases per 1,000 women): VanderKruik et al., BMC Psychiatry 2017 (PMID 28754094).
  • Onset of postpartum psychosis in the first two weeks, and about 1 to 2 cases per 1,000 births: Friedman, Reed & Ross, Curr Psychiatry Rep 2023 (PMID 36637712).
  • Postpartum psychosis as a psychiatric emergency, why hospital care is usually needed, and the risk of another episode after a later pregnancy: Bergink, Rasgon & Wisner, Am J Psychiatry 2016 (PMID 27609245).
  • Recovery with treatment (98% of 64 women reached remission in one inpatient study): Bergink et al., Am J Psychiatry 2015 (PMID 25640930).

Also available in Español