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The day has finally arrived! You are meeting your new little bundle and starting this new chapter of life together! The excitement and rush of everything flies by in a flash and the next thing you know, you’re headed home. Your house is already prepared as you’ve researched all the must haves and best things to do. You’re ready to  start this journey of motherhood!

Over the next several weeks that initial excitement and bliss begins to waver and your mind turns to questions such as:

  • Why are they so fussy and crying all the time?
  • Are they getting enough to eat?
  • Why can’t I soothe them?
  • Is there something else wrong that I may not know about?

These and many other questions may keep you up at all hours of the night, aside from the frequent wakings for feeding. You notice your mood begins to shift, mainly between irritability and anxiousness, or you feel like you have no sense of control. Our team of therapists at Renewed Wellness understands these conflicting feelings you are experiencing.

 First and foremost, these feelings and questions are very normal and common, especially as a new mother or parent. Everything is new, and you are embarking on a completely new life as you exit those hospital doors.

 But what happens when thoughts and emotions go beyond this point?

How do you address symptoms positively and effectively as they arise?

How do you know when to seek additional help outside the support of family and friends?

Let’s start off by discussing the 4 different postpartum mental health categories that can be experiened through early motherhood:

Postpartum Blues

This takes place after birth and about 50%-85% of new mothers experience the ‘blues’. It is a condition that is considered mild and symptoms can include tearfulness, fatigue, sleep disturbances and physical exhaustion. The majority of women show a decrease in these symptoms as quickly as 4-5 days post-birth.

Postpartum Depression

Depression occurs within 10%-15% of new mothers and can take place directly after birth or as late as one year after delivery.

Postpartum Anxiety

This is a newer topic of discussion around postpartum mental health. Postpartum anxiety typically results from hormonal changes and can increase while attempting to respond to outside stressors. Some women experience panic attacks as well as obsessive-compulsive thoughts and actions in the postpartum period.

Postpartum Psychosis

This occurs in 1 to 2 out of every 1,000 new mothers. A psychosis state can be defined as “mothers being out of touch with reality, mentally”. It is characterized by hallucinations, delusions, confusion, extreme agitation, inability to carry on logical conversations, and inability to eat or sleep. Along with these, a mother will experience homicidal and suicidal ideations.

New mom cuddling her newborn baby in the hospital, representing the myriad emotions new mother's experience. Baby blues are common for new mothers. However, if your blues are intrusive and all consuming your postpartum mental health could need addressed. Therapy for postpartum mothers in North Carolina can help, learn more here.

Symptoms of Postpartum Blues

The most common signs of postpartum blues would be continuous crying and tearfulness. Emotional swings are not always directly linked to sadness; they can occur due to difficulties breastfeeding or insufficient milk supply, unwarranted advice, or too little or too much attention from your partner or family members.

Of those that experience postpartum blues, there is a 10%-25% chance of women becoming depressed.

Other symptoms that you may experience include but are not limited to:

  • excessive worrying
  • emotional sensitivity
  • mood swings
  • irritability
  • fatigue
  • confusion or poor concentration
  • difficulties learning new skills.

If these symptoms persist longer than 2 weeks and you find them more debilitating on a day-to-day basis, you may want to consult with your OB or mental health professional regarding evaluation for PPD and PPA.

 It is important during this time to be aware of your emotions and feelings, even if you may feel as though you do not have control over them. Being open with your partner or family can assist in decreasing some of these symptoms.

Symptoms of Postpartum Depression

Symptoms of postpartum depression typically emerge around 2-3 months postpartum but may occur at any point after delivery. Something to be mindful of is that mothers who experience miscarriage or stillbirth are also susceptible to postpartum depression. As symptoms continue and possibly heighten in severity, it is difficult to function daily and a downward spiral begins to occur, affecting mood, appetite, concentration, sleep-wake windows, and energy levels.

New mom struggling while her partner holds the baby representing the challenges of dealing with depression and postpartum mental health. You are not alone on this journey. Therapy for postpartum mental health in North Carolina can offer you the support you need.

There are several categories of symptoms one should take into consideration:

Emotional Signs

  • Loss of enjoyment in life or interests
  • Irritability and emotional outbursts
  • Hopelessness and helplessness
  • Suicidal thoughts
  • Feelings of shame
  • Emotional numbness or feeling trapped

Physical Signs

  • Sleep disturbances
  • Decrease in energy
  • Significant weight gain or loss
  • Headaches
  • Chest pain and heart palpitations
  • Loss of libido or low interest in sexual activity

Cognitive Signs

  • Feelings of worthlessness
  • Difficulty recalling information or difficulties with memory
  • Excessive fear or worry
  • Negative self-talk
  • Thoughts of harming the baby
  • Concentration issues

Behavioral Signs

  • Withdrawing from family or others; including towards the baby
  • Physical neglect towards self and baby
  • Inability to cope with daily routine
  • Neglect of surrounding environment

Symptoms of Postpartum Anxiety

This is a new topic and diagnosis that is being brought to light. There is not nearly as much research or studies to give solidified or concrete statistics; however, it remains a topic that needs to be discussed and shared, especially to mamas-to-be and new mothers.

It is shared that mothers who have experienced miscarriage or stillbirth have an increased risk in experiencing postpartum anxiety during future pregnancies. About 1 in 5 mothers will experience postpartum anxiety.

Many people have difficulty differentiating between anxiety and panic attacks. A panic attack can be seen and defined as a distinct episode of anxiety, but also accompanied by physical symptoms.

Although not an exhaustive list, some common symtoms women with postpartum anxiety experience are:

Panic Attack Symptoms

  • rapid heart rate
  • feelings of utter doom
  • hot flashes
  • inability to catch breath
  • feelings of faintness or dizziness.

Anxiety Symptoms

  • inability to relax
  • racing thoughts and thinking of the worst case scenario
  • difficulty focusing or forgetting
  • avoiding certain people or activities

 Women can also experience OCD symptoms or Obsessive Compulsive Disorder, which are intrusive and unwanted thoughts that are followed by the feeling of needing to do something in order to relieve stress, or to be able to move  on to another task. 

Symptoms of Postpartum Psychosis

Postpartum psychosis is extremely rare, however, it is something that should be discussed further to bring forth awareness and education. Postpartum psychosis typically appears days to weeks after childbirth. Major risk factors for postpartum psychosis are those with a history of postpartum depression or psychosis, a family history of depression, or the presence of bipolar disorder. Psychosis can look different depending on the mother’s past mental health.

Someone experiencing this may feel suspicious and even paranoid towards others and exhibit behaviors of bipolar disorder or manic-depressive disorder. In this stage one may be hyperactive, speaking extremely fast, have thought patterns that do not connect with one another, or have overly ambitious ideas. Anger or aggression is another symptom that may appear, both verbally and physically.

Extreme highs and lows are experienced.

Women usually experience depressive episodes of extremely low moments, manic episodes where they have an excessive amount of energy, and delusions. These erratic mood swings can be very detrimental towards mothers and infants. Those experiencing postpartum psychosis can act impulsively without thoughts of consequences. It is common for mothers who have postpartum psychosis to need consistent supervision from others due to risky behaviors as well as the possibility of inpatient hospitalizations.

New mom holding her baby looks sad, representing postpartum depression and anxiety faced by many new mothers. It is imperative to manage post partum mental health for both you and your baby. Online therapy in North Carolina can offer the resources you need.

Forms of Treatment

Now that we know a little more about the 4 categories revolving around postpartum mental health, let’s discuss some treatment options in the case that you or a loved one is experiencing any of these symptoms. As shared, postpartum blues usually resolve within the first 2 weeks post-birth. There usually isn’t a formal need for treatment; however, having positive support in place for mothers is crucial.

Medication or Pharmacotherapy

There are many different classifications of medications that can treat PPD and PPA. The main classifications for antidepressants are SSRIs, SNRIs, TCA, and MAOIs. Your healthcare provider or OBGYN will be able to help you determine the best medication for your specific situation.

Psychosocial Interventions

Therapy is a great resource for new mothers! It can be helpful whether participating in individual therapy, group therapy, support groups, or psychiatric hospitalizations. Some evidence-based treatment modalities that therapists may use for postpartum mental health are Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR), Interpersonal Psychotherapy (IPT), and Solution-Focused Therapy.


It is important to take time for yourself and allow your loved ones time for themselves. This can look different for each individual. Some ideas for self-care include sitting outside listening to nature while sipping a cup of tea, exercising, reading, socializing with friends, meditation, etc. The small period in which you can fill your cup can create a healthy environment for yourself, your baby, and those around you.


Awareness of signs, and symptoms, and how to effectively communicate your emotions to loved ones is imperative. If you find yourself being reactive, give yourself the time to collect your thoughts and sit with your significant other, doctor, or a support person to have constructive conversations about your emotions and feelings towards these transitions and changes.

If you have questions regarding any of the information shared, or find yourself experiencing these symptoms, please don’t hesitate to reach out to your therapist or your doctor. In the case of urgent need, please seek emergency services immediately.

A mom happily watches her baby crawl on the floor representing someone who has used therapy to improve their postpartum mental health. Online therapy for women in North Carolina can help you win this fight! Learn more here.

Start Therapy for Postpartum Mental Health in New Bern, NC

Therapy is a powerful tool and can be utilized by those experiencing postpartum depression, postpartum anxiety, the “baby blues”. Here at Renewed Wellness Counseling, Alyssa Hermanson specializes in therapy for postpartum mental health because we believe that you don’t have to do it alone. There are ways you can combat these emotions and be present for your baby, yourself, and your family. Alyssa can teach you how to overcome the demands in your life and help you tame the chaos in your mind. To get started with therapy at our counseling practice in New Bern, NC:

 1. Fill out this consult form.

2. Read about our skilled therapists.

3. Start the path to a renewed life.


Other Services at Renewed Wellness

At our New Bern, NC-based therapy practice, we offer more than just therapy for postpartum depression. Our therapists specialize specifically in therapy for military families, therapy for anxiety and stress chronic illness counseling, and addiction counseling. For those going through a life change, we also offer life transition counseling. In fact, we can help you wherever you are in the state with online therapy in North Carolina and South Carolina. Let’s work together to get you to a good place!


About the Author:

Alyssa is a Licensed Clinical Social Worker Associate with Renewed Wellness Counseling. Alyssa provides virtual mental health counseling to residents across North Carolina. Alyssa received her undergraduate degree from Pennsylvania State University and went to Temple University for her Masters in Social Work. Alyssa specializes in working with women experiencing postpartum mental health concerns. As a new mother, wife, and professional, Alyssa knows what’s it’s like to try to hold it all together while battling the stress of parenthood. Alyssa is available for virtual appointments or consultations by reaching out to