Beyond postpartum depression: why more new mothers should consider therapy
After giving birth, it is now standard practice for mothers to be screened for postpartum depression (PPD) at follow-up OB appointments and even during their baby's early pediatric visits. Ideally, mothers are screened both during pregnancy and postpartum so that, if they meet criteria for postpartum depression, a healthcare provider is aware and can offer appropriate treatment referrals.
The challenge is that PPD is just one perinatal mental health condition to consider, and not everyone who is struggling meets its criteria. Other Perinatal Mood and Anxiety Disorders (PMADs) include postpartum anxiety, postpartum obsessive-compulsive disorder, postpartum PTSD, and others. It is encouraging that mothers are being screened for postpartum depression more often, but focusing on this one diagnosis creates a gap in perinatal mental health care. Mothers who do not meet criteria for PPD may meet criteria for other disorders that are not routinely screened for and are discussed less frequently.
This gap stops women from getting the referrals to therapy that they might need. Even more commonly, mothers struggling to adjust to the new excitements and challenges of postpartum life might assume that if they aren’t officially diagnosed with a postpartum condition they do not need to, or would not benefit from, therapy.
This assumption is understandable. When we hear about perinatal mental health in the news or from our providers, the conversation almost always centers on postpartum depression. It makes sense that mothers would internalize that and conclude that if they don't fit that box, they must be fine, or at least fine enough. But struggling to sleep even when the baby sleeps, feeling disconnected from your sense of self, experiencing intrusive worries, or simply feeling overwhelmed by this enormous transition…none of these require a diagnosis to deserve support. In fact, signaling to new parents that you should only receive support once your struggles reach a level that meets criteria for a "disorder" or "condition" increases stigma and shame. Any parent experiencing a major life event and transition, especially one as important as having a new child to figure out without a playbook, has reason enough to reach out for support.
Support to Consider
Mothers bring their full histories into new parenthood: their own experiences of being parented, previous losses, relationship dynamics, and any mental health challenges that preceded pregnancy. These factors can shape the postpartum experience in ways that a brief screening tool is not designed to capture. A therapist can help a new mother connect those dots in a way that a support group is not designed to help with.
Therapy with a licensed clinician offers benefits such as processing change, learning emotional regulation skills while dealing with change, improving relationships through transition periods, gaining insight about what is happening in the brain and body, and addressing internalized beliefs and stigmatic thought patterns. Anyone navigating a major life transition can benefit from these skills, and those entering parenthood can continue to draw on these skills for years to come.
In addition to therapy, social support groups are often recommended and widely accessible. New mom groups are common and have been shown to improve women's experience during the transition to motherhood.
The goal is not to pathologize new motherhood or suggest that every mother needs clinical therapy. The goal is to broaden the amount of mothers who feel permitted to seek support. You do not need to be in crisis or meet specific diagnostic criteria to benefit from talking to someone. Feeling like a different version of yourself, grieving parts of your pre-baby life, or simply wanting support through this major life change are reasons enough. Supporting yourself during this stage is an act of love towards yourself and your child which can impact you both for a lifetime.
If you need support navigating your child’s big emotions, Expand Psychology is here to help. Reach out to our office for a free 15-minute phone consultation with an experienced therapist to learn more about how therapy can benefit you and your family.
Margaret Tucker Cardon, LPC, PMH-C is a therapist at Expand Psychology specializing in perinatal and maternal mental health. In her work she supports adolescents and adults across the lifespan struggling with anxiety, depression, major life changes, and other stressors.
This content is for informational purposes only and does not constitute mental health treatment. If you are in crisis call 911 or contact your local crisis hotline immediately.