Postpartum Depression: It’s Not Just About Feeling Sad

Mother lying in bed with newbornHave you recently been experiencing difficulty after having a baby but question whether you fit a postpartum diagnosis? Maybe you aren’t necessarily sad. Or maybe the four- to six-week period you read about online has passed.

As both a therapist and mom of a 6-month-old, I’d like to share my experience with postpartum depression and provide an overview of some different ways it can manifest.

After each of my babies was born, I was over the moon and, unlike many new parents, I did not struggle with adjusting to a growing family the first few weeks. I didn’t mind the lack of sleep, breastfeeding was a breeze, and I couldn’t get enough of holding my sweet babies.

I was given the Edinburgh Postnatal Depression Scale at my son’s newborn and two-weeks pediatric appointments, and took it again at my six-week postpartum appointment with my obstetrician-gynecologist. My scores probably showed I was doing great. However, my issue with that scale, and with the name postpartum depression, is that they don’t really encompass or screen for the symptoms I began experiencing.

My symptoms started around week seven postpartum, at which point you aren’t visiting doctors or being monitored as regularly. Rather than experiencing some of the classic symptoms of depression, such as sadness, decreased energy, and loss of interest in activities I previously enjoyed, I instead felt extremely anxious, frustrated, and irritable. While I know these can be a part of depression in some people, I initially ignored them, assuming I was just facing the stress of parenting two little kids.

Despite the lack of sleep that comes with a new baby, I had an incredible amount of energy and focus for certain tasks. For example, I felt an almost manic need to organize my spices one night, ignoring my crying baby so I could finish putting spice jars in alphabetical order. My mind often felt like it was racing, and I felt an overwhelming need to constantly be doing something productive, other than just caring for a little one.

At the same time, I had an incredibly hard time focusing and concentrating on simple things. Making logistical plans and decisions, like what time to meet for dinner or when to leave for an appointment, seemed confusing. I felt scattered and like I was living in a whirlwind and a fog.

The racing thoughts made it hard to take advantage of those precious hours of sleep, and the anxiety and the need to constantly be doing something caused me to start overeating. I snacked even when I wasn’t at all hungry. I remembered weeks six to 10 being the hardest with my first baby, so I found myself justifying what I was going through, saying this will likely pass and it was harder this time around because two kids are more challenging than one.

But the sound of my baby crying became like nails on a chalkboard. This was surprising to me, as I’ve always loved and wanted to care for little babies. I attributed it to being exceptionally tired. Soon, I started to feel symptoms of guilt, feeling badly about not bonding with my second baby the same way I had with my first. I worried I wasn’t giving him enough attention, then began hearing a pesky voice in the back of my head telling me I was a terrible mother.

My breaking point finally came one night when both of my kids were crying and I just couldn’t take it. I went downstairs and cried, too, wondering whether throwing my baby down the staircase might make me feel better. Although I had tried to dismiss or justify other symptoms, I knew that thoughts of harm were definite indicators of postpartum depression.

Thankfully, the therapist in me started recognizing this voice as similar to the voices I’m often told about by the people I help. I started to tell myself, “If you heard someone saying these things in your office, a red flag for depression and anxiety would definitely be raised.” I went back and forth in my mind, arguing between thoughts of, “I don’t need medication. I teach coping skills!” and, “You tell people all the time that depression is not a weakness or something to be ashamed of. It’s an involuntary condition that deserves attention!”

My breaking point finally came one night when both of my kids were crying and I just couldn’t take it. I went downstairs and cried, too, wondering whether throwing my baby down the staircase might make me feel better. Although I had tried to dismiss or justify other symptoms, I knew that thoughts of harm were definite indicators of postpartum depression.

I called my ob-gyn the next day and went in to discuss medication. After listening to my symptoms, she nodded and said, “For me, it was questioning whether I should throw my baby in the pot of chili.” I felt so much validation and relief from her comment, knowing I wasn’t alone, crazy, or a bad mom. I started an antidepressant that day with a plan to talk to one of my colleagues and eventually taper off the medication.

I typically tell people to expect it to take at least a few weeks before they truly begin experiencing the effects of new antidepressant medication, but within a few days I was feeling much better and found myself thinking, “Oh, yeah! This is what normal feels like!” The anxiety, irritability, and confusion have all gone away, and I’m more available to focus on my kids, knowing I’m doing a pretty decent job.

After experiencing this relief, I found myself worried about all the new moms out there who may not have the clinical experience I do, nor the ability to step outside themselves and rationally view what they are going through. If you find yourself feeling scattered, anxious, irritable, or like a failure, please recognize that these experiences are associated with postpartum depression.

Additionally, know that there is much controversy in the medical and mental health worlds regarding the specific causes and criteria for postpartum depression, especially regarding the time frame in which it can occur. Regardless of when post-baby you feel a struggle, I encourage you to talk with a therapist and your doctor so you can feel better and enjoy those precious moments with your family.

© Copyright 2016 All rights reserved. Permission to publish granted by Megan MacCutcheon, LPC, Topic Expert Contributor

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Rudy

    January 13th, 2016 at 10:22 AM

    This has to be a strange feeling for a new parent, thinking that this should be the happiest time of your life and at the same time not really feeling that way at all.

  • cosette

    January 13th, 2016 at 2:57 PM

    No matter how hard I find this to relate to, I would never in any way say anything disparaging about those moms who have been through this depression and have felt it so deeply.
    It is a very real thing that can happen to anyone, and I think that we have to let them know that the love and the support is there.

  • Lois

    January 14th, 2016 at 10:28 AM

    I guess there is no real way to predict ahead of time those who might wind up struggling with this?

  • Megan MacCutcheon, LPC

    January 14th, 2016 at 7:02 PM

    As far as I know, there is no way to really predict but some of the risk factors include history of depression, stressful life events during the 12 months prior to delivery, lack of social or financial support, marital discord, child-care related stressors, and pre-gestational or gestational diabetes. From my own research I’ve learned that the specific cause of PPD is unknown; however, some hypotheses include that it is related to hormonal changes, to activity of certain genes in the hippocampus, and to endocrine factors. So pretty much anyone could have at least one of those those predisposing factors!

  • Marina

    January 14th, 2016 at 4:06 PM

    And you feel so ashamed knowing that there are hundreds of people who would trade anything to be where yu are, and still there is that loneliness and sadness that will just not go away

  • Megan MacCutcheon, LPC

    January 14th, 2016 at 7:19 PM

    Yes! Thanks, Marina, for adding this. The shame and guilt are big and a major part of PPD! Knowing there are people out there who would love to be in your position, like you said, or for anyone who tried for a long time to have a baby and feels like, now that they do, they should be happy.

    Guilt and shame are present in so many ways – I’ve heard many women talk about guilt around treating their husbands horribly due to the irritability but feeling unable to control it. And I think many moms with PPD are afraid to admit the scary thoughts of harm to themselves or their babies. Actually, when my husband proofread this article he asked, “Are you sure you want to put that part about considering throwing the baby down the stairs?” But I think it’s really important for people to know these thoughts happen—and that they are involuntary, caused by postpartum depression.

    I also want to add that while I had some of those thoughts, I was always in a rational place in that I never actually considered acting on them. It was just more of a random “What if” thought that popped into my mind. Postpartum psychosis is another, separate diagnosis where psychotic symptoms and dangerous behaviors actually occur.

  • Marina

    January 16th, 2016 at 5:06 AM

    Thanks- I watched both of my sisters go through this, and thankfully they both understood that the way that they were feeling was not right and they sought help, but for a while it was almost painful to be aorund them given the amount of pain that they were in and trying not to show.

  • Jan

    January 18th, 2016 at 7:42 AM

    It is so important for all of us to be having this conversation, to get it out and in the open so that more women who are struggling will feel a little more at ease about coming forward and sharing their experiences.

  • Nina

    January 18th, 2016 at 11:19 AM

    It can such a relief to find the ways that will help you put all of those negative voices away, keep them at bay

  • Megan MacCutcheon, LPC

    January 19th, 2016 at 6:51 PM

    Yes! And I preach all the time about “monitoring your self-talk voice” in terms of self-esteem…I am good at it overall but knew I had PPD when that voice was beyond my control!

  • kristen

    January 19th, 2016 at 10:29 AM

    I was so sad when I had to go back to work and leave my baby in child care. I knew that I had done all the research to make sure that she was getting the best care available, but you know, it would have been so nice to be able to stay home with her for a little longer. So I really struggled with that guilt of going back to work and feeling like there were other people who got to interact with her throughout the day way more than I could afford to do.

  • Harmony

    August 23rd, 2016 at 9:11 PM

    It’s also important to note that women who have experienced miscarriage, still birth or infant loss can experience postpartum as well. It is not isolated to those with living children.

  • Jen

    November 24th, 2019 at 8:18 PM

    Thanks for this perspective. I’ve struggled with very similar types of thoughts and feelings during both of my pregnancies and shortly afterward, but none of my symptoms really meet the true diagnostic criteria for depression. This reinforced for me that there is some heterogeneity there and that I’m probably the best judge of whether/how much I’m struggling.

  • Megan MacCutcheon, LPC, PMH-C

    November 25th, 2019 at 5:11 PM

    Hi Jen – YES! Since writing this article, I’ve done extensive training and become certified in perinatal mental health and want everyone to know there are SEVERAL perinatal issues that can occur besides just depression (including perinatal anxiety, OCD, panic disorder, PTSD, and bipolar). You are definitely the best judge of whether you are struggling. If you are, get help – and if your concerns aren’t being taken seriously, find somebody who is trained in perinatal mental health. Much of the world, including many doctors and therapists, has a lot of catching up to do in terms of understanding all of the mental health disorders that can become stirred up during pregnancy or after having a baby. For resources near you, check out

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