# Emotions and Mental Health Concerns After Birth ![](https://assets.bmc.org/transform/2d8f8eb1-3f1f-481e-8de5-0d4a8e6a9d39/iStock-1361756859?io=transform:fill,width:1000px&format=webp) Many parents feel sad, worried, or overwhelmed during pregnancy or after having a baby. It is not your fault if you have any of these feelings. There are lots of reasons you might feel sad or worried, including: - Changing hormones, which can cause depression in some people - Being tired from being awake with your baby at night - Stress from caring for your new baby **Perinatal mood and anxiety disorders (PMADs)** are mental health problems that start or get worse during pregnancy up to one year postpartum. They’re common among parents but can make it hard to take care of yourself, your home, or your baby. If you have any of the feelings or symptoms listed below, talk to your healthcare provider. With the [right help and support](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for your Mental Health | Boston Medical Center"), you can start feeling better. ## Is It Just “Baby Blues” or Postpartum Depression? ### Baby Blues **Baby blues** are very common and happen because of changes in your hormones after birth. Up to 80 percent of people have baby blues after giving birth. Baby blues include mild changes in feelings. During this time, you may: - Feel more emotional - Cry more easily This is very normal! Most of the time you will feel better two weeks after your baby is born. In the meantime, you can try these [self-help tips](/bump-beyond/postpartum-experience/mental-health/mental-health-after-your-babys-birth "Bump & Beyond: Caring for Your Mental Health After Your Baby’s Birth | Boston Medical Center"). ### Postpartum Depression **Postpartum depression** can have many symptoms. **The feelings last two weeks or more.** You may feel or notice: - **Feeling very sad** or down most days - **Not enjoying things** you used to enjoy - **Blaming yourself** or feeling **worthless** - **Sleeping too much** or **not sleeping** even when tired - **Not wanting to eat** or forgetting to eat - **Worrying so much** it’s hard to focus or get things done - **Not wanting to get out of bed** or care for yourself - **Finding it hard to care for your baby** - **Thoughts of hurting yourself or your baby** - **Rarely: seeing or hearing things** others do not (voices, whispers, messages) Postpartum depression can start any time in the first year after having a baby, but is most common in the first one to six months after your baby is born. [Get Help Now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center") [Download: Recognizing Baby Blues vs. Postpartum Depression (PDF)](https://www.bumc.bu.edu/obgyn/files/2024/07/Perinatal-Mental-Health-3.pdf "BMC OB/GYN: Baby Blues and Postpartum Depression Handout (PDF)") ## Other Common Mental Health Problems Just because these conditions are less obvious, it doesn’t mean they are less serious. If you are experiencing these, you deserve to get help and support. If you already have a diagnosis of one of these conditions, your symptoms can get worse during the period after you have your baby. ##### Perinatal Anxiety Perinatal anxiety is common during pregnancy and in parents who just had a baby. It can happen by itself or with feelings of sadness or depression. You may have: - Anger or irritability - Constant feelings of being “on edge” or nervous - Constant worries - Difficulty sitting still or relaxing - Fears that something bad could or will happen - Panic attacks (racing heart rate, chest or throat tightness, sweaty palms, shortness of breath) - Physical symptoms like nausea, dizziness, sweating, or upset stomach - Racing thoughts - Sleep and appetite problems ###### Learn More - [UBC Faculty of Medicine Infographic: Perinatal and Postpartum Anxiety](https://parlab.med.ubc.ca/infographic-on-anxiety-in-pregnancy-the-postpartum/ "Perinatal Anxiety Research Lab (PARLab) Infographic: Anxiety in Pregnancy and in the Postpartum | University of British Columbia Faculty of Medicine (parlab.med.ubc.ca)") - [Postpartum Support International (PSI) Entry for Perinatal Anxiety](https://postpartum.net/perinatal-mental-health/#Perinatal-Anxiety "About Perinatal Mental Health: Perinatal Anxiety | Postpartum Support International (postpartum.net)") [Get Help Now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center") ##### Obsessive Compulsive Disorder (OCD) **Obsessive compulsive disorder (OCD)** is when people have unwanted, repeated thoughts (obsessions) that can be scary or upsetting. To feel better, people might do certain actions or tasks over and over to protect against those thoughts (compulsion). During pregnancy or after having a baby, these thoughts and actions often focus on the health and safety of the baby. OCD can make it hard to do your daily activities. You may feel or notice: - Doing things over and over to feel safer, like cleaning a lot or checking the baby many times - Scary thoughts or pictures in your mind (obsessions) that repeat and won’t stop, often about your baby. These are called intrusive thoughts. - Being afraid of the thoughts themselves - Not wanting to be alone with your baby because you worry you might act on these thoughts These thoughts are unwanted. Having them does not mean you will act on them. ###### Learn More - [UBC Faculty of Medicine Infographic: Postpartum Harm Thoughts](https://parlab.med.ubc.ca/infographic-on-postpartum-harm-thoughts/ "Perinatal Anxiety Research Lab (PARLab) Infographic: Postpartum Harm Thoughts | University of British Columbia Faculty of Medicine (parlab.med.ubc.ca)") - [Postpartum Support International (PSI) Entry for Perinatal Obsessive Compulsive Disorder (OCD)](https://postpartum.net/perinatal-mental-health/#OCD "About Perinatal Mental Health: Perinatal Obsessive Compulsive Disorder (OCD) | Postpartum Support International (postpartum.net)") [Get Help Now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center") ##### Post-Traumatic Stress Disorder (PTSD) **PTSD** is a mental health condition that happens after experiencing or witnessing a traumatic event. Childbirth post-traumatic stress disorder is PTSD that happens after giving birth because you had a hard or difficult birth. You may feel or notice: - Nightmares about what happened - Unwanted memories or feeling like it is happening again - Wanting to avoid reminders of what happened, like staying away from people, places, or things that bring it up; not wanting to think or talk about it - Strong emotions, including feeling numb, guilty, angry, or ashamed - Body and sleep changes, like feeling easily scared or jumpy, always being on guard, having trouble sleeping, and finding it hard to pay attention ###### Learn More and Get Help - [BMC RESTORE (REcovery from Stress and Trauma through Outpatient care, Research, and Education) Center](/restore-OLD "Department of Psychiatry: RESTORE Center | Boston Medical Center") - [MGH Postpartum Traumatic Stress Disorders Research Program](https://www.massgeneral.org/psychiatry/research/dekel-lab "Department of Psychiatry: Postpartum Traumatic Stress Disorders Research Program (Dekel Lab) | Massachusetts General Hospital (massgeneral.org)") - [Postpartum Support International (PSI) Birth Trauma Support Groups](https://postpartum.net/group/birth-trauma-support/ "Birth Trauma Support | Postpartum Support International (postpartum.net)") - [PSI Entry for Perinatal Post-Traumatic Stress Disorder (PTSD)](https://postpartum.net/perinatal-mental-health/#PTSD "About Perinatal Mental Health: Perinatal Post-Traumatic Stress Disorder (PTSD) | Postpartum Support International (postpartum.net)") [Get Help Now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center") ##### Substance Use Disorders Perinatal **substance use disorders (SUDs)** include trouble with alcohol, prescription medications, or drugs such as cannabis, opioids, and cocaine during pregnancy and after having a baby. If someone in your life has an SUD during pregnancy or after having a baby, you might notice them: - Missing health visits before or after birth - Not going to work or not caring for the baby - Having big changes in mood, energy, or behavior (being very upset, very tired, or having mood swings) - Pulling away from family or friends - Not eating well, or not gaining enough weight - Showing signs of being drunk or high (slurred speech, trouble walking, being very sleepy) - Having symptoms after stopping alcohol or drugs (shaking, sweating, feeling nervous, stomach problems) ###### Learn More and Get Help - [BMC Project RESPECT](/departments/obstetrics-and-gynecology/obstetrics/project-respect "Department of Obstetrics & Gynecology: Project RESPECT | Boston Medical Center") (for support with all SUDs) - [BMC VAPI (Vaping Associated Pulmonary Illness) Clinic](/programs/tobacco-treatment-center/electronic-cigarettes) (for support with vaping and smoking) [Get Help Now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center") ##### Bipolar Disorder **Bipolar disorder** is a mental health condition that causes big changes in mood. You may cycle between feeling very sad or low (**depression**) and feeling very “up” or full of energy (**mania** or **hypomania**), and act in a way that is different than usual for you. **Symptoms of Depression** - You may feel very tired or sad. - You may not enjoy things you usually like. - These “down” feelings last two weeks or more. **Symptoms of Mania** - You may feel very excited or “up.” - You may have lots of energy, talk a lot, or sleep very little (even if you’re tired). - People close to you may say you’re acting differently. - These “up” symptoms last four or more days in a row. ###### Learn More - [Postpartum Support International (PSI) Entry for Bipolar Mood Disorders](https://postpartum.net/perinatal-mental-health/#Bipolar "About Perinatal Mental Health: Bipolar Mood Disorders | Postpartum Support International (postpartum.net)") [Get Help Now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center") ##### Postpartum Psychosis **Postpartum psychosis** is a rare but serious mental health condition that usually happens in the first month after having a baby. It can happen later too. It happens more often to first-time parents, people with bipolar disorder, or to people with family members who had postpartum psychosis. **Postpartum psychosis is an emergency and needs quick medical help.** You may feel or notice: - Hearing voices or whispers that others don’t hear - Seeing things others don’t see - Scary beliefs about yourself or your baby - Feeling confused or mixed up - Trouble talking or making sense - Feeling very restless or over-energized - Thoughts of harming yourself or your baby - Not sleeping at all or feeling you don’t need sleep - Feeling very suspicious of others - Severe mood swings ###### Learn More and Get Help - [BMC Wellness and Recovery After Psychosis (WRAP) Program](/departments/psychiatry/wellness-and-recovery-after-psychosis-wrap-program "Department of Psychiatry: Wellness and Recovery After Psychosis (WRAP) Program | Boston Medical Center") - [MGH Postpartum Psychosis Project](https://www.mghp3.org/ "MGH Center for Women’s Mental Health: MGH Postpartum Psychosis Project (MGHP3) | Massachusetts General Hospital (mghp3.org)") - [MGH Postpartum Psychosis Project: Resources for Patients and Families](https://www.mghp3.org/resources "MGH Center for Women’s Mental Health: MGH Postpartum Psychosis Project (MGHP3): Resources for Patients | Massachusetts General Hospital (mghp3.org)") - [Postpartum Support International (PSI) Perinatal Psychosis Help](https://postpartum.net/get-help/postpartum-psychosis-help/ "Perinatal/Postpartum Psychosis Help | Postpartum Support International (postpartum.net)") [Get Help Now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center") ## What Can I Do to Help Myself After the Baby Is Born? ### Use the 1–2–3 Postpartum Rest Rule **First week: In bed** - Stay in your pajamas. - Feed yourself, feed your baby, and rest as much as possible. - Cuddle your baby and let others help with meals and cleaning. **Second week: Around the bed** - Move gently around your room. - Get help when it is offered. **Third week: Around the house** - Take short walks. - Eat at the table. - Rest when you need to. ### Self-Help for Your Mind and Body - Do something for yourself every day. Take a moment to do something that will make you feel good. Take a shower, eat a meal sitting at the table, listen to your favorite music, or get your hair or nails done. - Think of three people you can talk to. It’s important not to feel alone after the baby is born. Set up calls and visits. - When you are ready to go out, get out with your baby. Try: - [Boston Public Library](https://www.bpl.org/kids/ "Kids | Boston Public Library (bpl.org)") baby lap sit and story time (the [BPL calendar of free parent–child events](/departments/pediatric-primary-care/adolescent-medicine/teen-and-tot-program/resources-patients "Department of Pediatrics: Division of Adolescent Medicine: Teen and Tot Program: Patient Resources | Boston Medical Center") is posted regularly by BMC’s Teen and Tot Program) - [Family Nurturing Center](https://familynurturing.org/calendar/list/ "Calendar | Family Nurturing Center of Massachusetts (familynurturing.org)") activities - Kid Activities: [Community Kangaroo](https://communitykangaroo.com/ "Find Things to Do with Kids: Boston Area | Community Kangaroo (communitykangaroo.com)"), [Mommy Poppins](https://mommypoppins.com/boston "Things to Do with Kids: Boston | Mommy Poppins (mommypoppins.com)") - BMC support groups (ask your provider for more information about these), including: - Haitian Mamas - Resilient Parents [Learn More About Caring for Your Mental Health After Baby’s Birth](/bump-beyond/postpartum-experience/mental-health/mental-health-after-your-babys-birth "Bump & Beyond: Caring for Your Mental Health after Your Baby’s Birth | Boston Medical Center") ### Get Help Now for a Mental Health Crisis If you or someone you know [needs help now](/bump-beyond/postpartum-experience/mental-health/get-help-now-your-mental-health "Bump & Beyond: Postpartum Experience: Get Help Now for Your Mental Health | Boston Medical Center"), you can use these resources: - Call [**1.800.981.HELP**](tel:800.981.HELP) 24 hours a day, seven days a week - Visit [BMC Community Behavioral Health Services](/cbhc "Community Behavioral Health Center (CBHC) | Boston Medical Center") for walk-in appointments - Call or text Postpartum International Support (PSI) at [**1.800.944.4773**](tel:800.944.4773). - Para contactar [PSI en Español](https://postpartum.net/en-espanol/ "Postpartum Support International (PSI) en Español (postpartum.net/en-espanol)"), llama al [1.800.944.4773](tel:800.944.4773) (4PPD) #1 o manda un mensaje de texto al [971.203.7773](tel:971.203.7773) mental-health-after-birth