Postpartum depression and anxiety are common and serious, and loved ones play a crucial role in noticing symptoms and offering support.Simple, practical help can make daily life feel more manageable.Encouraging professional help and continuing to show up with patience and compassion can be lifesaving for new parents.
The postpartum phase is “supposed” to be a joyous time—the celebration of a new arrival (or new arrivals). And it can be. However, it can also be full of overwhelming emotions that make daily functioning difficult for the approximately 20 to 25% of people who experience a perinatal mood and anxiety disorder (PMAD), like postpartum depression (PPD) or postpartum anxiety (PPA).
We still have a long way to go in normalizing and supporting new parents with a PMAD, but psychologists stress that it’s also vital to lift the people around them. Often, the challenges of loving someone with a PMAD force them to remain silent.
“They may expect mom to be happy, tired, but overall grateful,” says Caitlin Slavens, BAACS, MC, R Psych, a psychologist. “People can be confused when a new mom feels numb, overwhelmed, or angry. Often, people feel out of their element and unsure what to do or say, so that they may do or say nothing at all.”
Or, the person may worsen the problem with well-meaning but potentially harmful words or actions.
We want to change that. We spoke with mental healthcare professionals and OB/GYNs and asked them: How can partners, friends, and family members assist someone with a PMAD? Their actionable and compassionate advice is provided below.
Know the Signs of Postpartum Depression and Anxiety
The postpartum period can be physically and emotionally overwhelming. In the days after delivery, a birthing person’s hormones change. As a result, up to about 80% of women report baby blues symptoms within two to three days of birth, explains Sherry Ross, MD, FACOG, a board-certified OB/GYN and Women’s Health Expert at Providence Saint John’s Health Center.
”New moms may begin to feel depressed, anxious, upset, and frustrated,” Dr. Ross says. “The baby blues get better within days or one to two weeks after delivery, whereas postpartum depression and postpartum anxiety start to ramp up around this time.”
First off, understanding the signs of PPD and PPA can help loved ones assist the people in their lives who may be suffering from the condition.
Signs of postpartum depression
PPD is sometimes tricky to pinpoint. “It doesn’t always look the same for every woman,” Dr. Slavens says. “For many, it can manifest as anger, irritability, numbness, or not feeling connected to the baby.”
Dr. Slavens shares some other signs of PPD:
Feelings of homelessness or emptiness. Crying easily or feeling emotionally flat.Irritability or rage that may come out of nowhere.Guilt or shame about not being a “happy new mom.” Not feeling bonded to the baby.Low energy.Changes in appetite or sleep (beyond what would be expected in the postpartum period).Feeling overwhelmed by daily tasks.Thoughts of wanting to escape or feeling like your family would be better off without you.
Signs of postpartum anxiety
Postpartum anxiety includes persistent worry, tension, or fear about the baby or their health that interferes with daily life, explains Brooke Wacker, PMHNP-BC, a psychiatric mental health nurse practitioner with Mindpath Health.
“It’s more than typical ‘new mom worries,’” adds Emily Guarnotta, PsyD, PMH-C, a psychologist and founder of Phoenix Health. “It feels like a constant state of being on high alert.”
Wacker says common signs and experiences associated with postpartum anxiety include:
Excessive and/or uncontrollable worry.Worst-case scenario fears (sometimes referred to as “spiraing”).Feeling on edge consistently.Restlessness or inability to relax.Irritability or agitation.Difficulty falling or staying asleep.Panic attacks or symptoms.Intrusive/unwanted thoughts.
What To Do (and Avoid) When Supporting Someone With a PMAD
Since everyone is different, it’s impossible to provide a cookie-cutter guidebook for helping a loved one navigate a PMAD. But experts say they wish support people had more direction. These tips will help you support a friend, partner, or family member with a PMAD.
Be specific
“Let me know if you need anything” is a well-meaning phrase, but the experts Parents spoke with suggest making a more personalized offer.
“Open-ended offers…feel like one more thing on her to-do list,” Dr. Guarnotta says. “Instead, make a specific offer, such as ‘I’m running to the grocery store. Can I pick you up anything, like diapers or dinner for tonight?”
Double up on the hard tasks
When I was struggling with postpartum depression, I felt like I had a heavy weight on my body that made getting out of bed seem like a Herculean event. But I felt “bad” about letting anyone help me, so I loved this advice from Dr. Slavens, which lets a new parent complete tasks with a gentle assist.
“PPD/PPA can make relatively simple tasks feel impossible,” Dr. Slavens says. “Having someone alongside while completing tasks makes it much more attainable. Fold laundry, prep meals, and do dishes together.”
Protect their sleep
Babies need to eat frequently—that’s natural. But Dr. Guarnotta points out that poor sleep is a risk factor for PPD and PPA.
“This is why it’s so important to help her get good sleep,” Dr. Guarnotta says. “One way to do this is to offer to take on a shift, whether that’s in the middle of the night or in the early morning, providing her with several hours of uninterrupted sleep time.”
If the person is nursing or pumping, partners and other caretakers can:
Handle diaper changes. Put the baby back to sleep.Wash pump parts. Manage most or all other household tasks so the lactating parent can sleep when the baby sleeps.
Open your ears first
This one is especially crucial because, as we said, there’s no one-size-fits-all support for someone with a PMAD.
“First and foremost, express empathy and understanding,” says Meghan Rattigan, DO, a board-certified OB/GYN with Hackensack Meridian Jersey Shore University Medical Center. “Let them know that this is not something that they are choosing, and it is not their fault. Validate their feelings by asking what needs they need met at this time.”
Avoid common pitfalls
Witnessing someone going through a PMAD can put you on an emotional rollercoaster. You may feel overwhelmed, frustrated, surprised, or helpless. While understandable, one OB/GYN stresses it’s important to steer clear of standard responses to PMAD.
Dr. Rattigan does not suggest:
Ignoring their behavior and acting as if nothing is wrong.Shaming them for their feelings, such as telling them to “just snap out of it.”Discouraging the person from seeking help or medication.Offering unsolicited advice.
“Some people are afraid to reach out to a person who may be suffering from PPD/PPA simply because they don’t know what to say or what to do,” Dr. Rattigan says. “This only amplifies their feelings of isolation.”
Try these helpful phrases instead
The experts we spoke with share that not knowing what to say is a common concern of people caring for someone with a PMAD. These phrases can help start or continue a conversation.
“You are going through so many hormonal changes, and much of what you’re experiencing is out of your control.” Dr. Ross notes that this phrase reminds a postpartum person that they didn’t do anything to cause their experience.
“I will touch base with you in the morning.” Dr. Ross reports that people in the throes of PPD and PPA may not know how to express themselves after you approach them. “Letting them know you’ll reach out tomorrow morning allows them to prepare, emotionally and physically, to have another chance to express their feelings with you,” Dr. Ross says.
“You don’t have to pretend to be OK around me.” People with a PMAD often worry about burdening others. Dr. Slavens loves that this phrase tells them they don’t need to wear a mask.
“You are a good parent who is having a hard time.” Guilt and a PMAD can go hand in hand. “Many moms with PPD and PPA feel like they are failing at motherhood and failing their babies,” Dr. Guarnotta says. “A statement like this separates who she is from her condition and tells her that you can be a good parent and struggle.”
“Thank you for telling me, that takes strength.” Wacker says that people with a PMAD may view it as a weakness. This phrase conveys that recognizing their struggles and reaching out for assistance shows strength.
Gently encourage and normalize professional support
Dr. Slavens says parents struggling with PPA and PMD can feel like finding support is impossible. You can do some of that legwork.
“When someone is there to give them the link, phone number, or a personal recommendation, it is way more likely they will follow through,” Dr. Slavens says. “It can simply be, ‘This is my therapist’s recommendation for a perinatal therapist,’ or ‘Let’s make a doctor’s appointment for next week.’”
Keep showing up
One phrase or tag-teamed laundry-folding marathon isn’t going to “fix” a person’s PMAD. It takes time, and progress isn’t always linear.
“PPA/PPD can make moms withdraw from their support system,” Dr. Slavens explains. “You want to be consistent, yet gentle, and show them they are enough, and that you are there for them, even if they are struggling. This may look like a quick text check-in, food or coffee drop-off, and send an uplifting or funny meme.”
Care for yourself
Caring for a person with a PMAD — and a baby, too — can feel all-consuming. But remember that you matter, too.
“Caring for people who are suffering from PPD/PPA can invoke feelings of frustration and anger within yourself,” Dr. Rattigan says. “Know when to take a break. Make sure that you are practicing self-care — getting adequate sleep, nutrition, and exercise — and that you have an outlet — a trusted friend or therapist — to help you be as supportive as possible.”
When To Seek Crisis Assistance
PMADs are treatable and take time. But there are instances when it’s critical to call for immediate help.
Wacker says it’s crucial to look out for signs that a new parent wants to disappear, die, or cause harm to themselves. Statements like “Everyone would be better off without me” are a red flag.
Additionally, Dr. Guarnotta says it’s important to be aware of the signs of postpartum psychosis (PPP). PPP—like PPD and PPA—is treatable with the appropriate support (including emergency intervention).
Keep an eye out for signs like these in your loved one.
A break from reality.Hallucinations (seeing or hearing things that are not there).Delusions (fixed beliefs that are false).Paranoia.
“If a loved one is showing signs, do not leave them alone,” Dr. Guarnotta says. “Take them to the nearest emergency room and contact 911. Be sure to let emergency services know that she is experiencing a mental health crisis, so they can be sensitive in how they approach her.”
The Suicide and Crisis Lifeline has people standing by 24/7 in English and in Spanish for text or voice calls at 988.