The Differences of Postpartum Anxiety vs Depression

The days and weeks following the birth of a baby are a whirlwind of activity and adjustment. And while some fears, doubts, and baby blues are normal, some new parents suffer from one of several Perinatal Mood and Anxiety Disorders (PMAD). Two of the most common are postpartum depression and postpartum anxiety.

Learning the differences and similarities of postpartum anxiety vs depression can give you clarity and a greater sense of control. Most importantly, knowing what’s happening helps you take the next step toward getting the right support. Experiencing any PMAD doesn’t reflect negatively on your parenting or mean you’re failing; you just need support and strategies to feel your best and show up for your baby.

What is Postpartum Anxiety?

It’s normal to have some fear around having a newborn, especially if it’s your first baby. Are they getting enough to eat? Are they sleeping enough? What is “too much” crying? Postpartum anxiety (PPA), however, exceeds these concerns. It is a persistent, overwhelming sense of worry or sense of dread that doesn’t go away, even when things are going well.

Research shows that postpartum anxiety can affect up to 10-20% of new mothers, and it may appear anytime within the first year after giving birth. Because postpartum anxiety and depression symptoms sometimes overlap, understanding the distinctions means you can get the right kind of support.

Common Signs and Symptoms

Signs of postpartum anxiety can include racing thoughts, physical restlessness, panic attacks, trouble sleeping (even when your baby is asleep), or feeling constantly “on edge.” These symptoms can make it hard to relax, enjoy time with your baby, or focus on anything beyond your worries.

What is Postpartum Depression?

Postpartum depression (PPD) is a mental disorder characterized by sadness, mood swings and other depressive symptoms. Some may confuse it with the baby blues, but PPD lasts longer and can be much more intense. PPD can cause ongoing changes in mood and energy that can affect your daily life and your ability to enjoy time with your baby.

Common Signs and Symptoms

Symptoms mirror those of regular depression:

• Persistent sadness
• Loss of interest or joy in activities
• Feelings of hopelessness or guilt
• Changes in appetite or sleeping patterns 
• Difficulty bonding with your baby.

Postpartum depression affects about 1 in 7 mothers. The condition usually shows up during the “fourth trimester,” AKA the first 3 months postpartum, though it can show up anytime within the first year.

Due to their similarities and how often new parents experience both, PPD and PPA are frequently grouped as postpartum depression and anxiety.

Key Differences Between PPD and PPA

Between sharing some similar symptoms and the frequency with which parents tend to experience both simultaneously, knowing the differences between postpartum anxiety vs depression can be confusing. There are some key distinctions to be aware of. 

Emotional Symptoms (fear/worry vs sadness/hopelessness)

Worry and fear drive PPA. You may find yourself constantly thinking about what could go wrong, feeling “on high alert,” or imagining worst-case scenarios even when your baby is safe and healthy. And while it’s likely you’re aware that your thoughts are irrational, you’re unable to stop them.

Postpartum depression, on the other hand, has more to do with feelings of sadness and hopelessness. Parents often describe feeling empty, numb, or disconnected and withdrawn from things that they used to enjoy. 

Where anxiety pushes your mind into overdrive, depression tends to slow everything down, making it hard to feel motivated or engaged.

Physical symptoms (restlessness vs fatigue)

Some physical symptoms of PPA include restlessness, a racing heart, shortness of breath, or constant muscle tension. You might struggle to relax, even when you’re exhausted, or have insomnia due to racing thoughts.

Postpartum depression, however, usually feels like lethargy or fatigue. It can be hard to get out of bed, or you still feel drained, no matter how much you rest. Depression can also cause changes in your appetite, such as overeating for comfort or losing interest in food altogether.

Overlap and co-occurrence

Research shows that nearly 1 in 5 women who screened positive for postpartum depression just two weeks after birth also displayed signs of anxiety. This is compared to just 1.3% of women who didn’t have postpartum depression. 

So it’s not uncommon to experience both postpartum anxiety and depression at the same time.

The Causes of Postpartum Anxiety and Depression

The causes of postpartum anxiety and depression are often a combination of physical changes, personal and family history, stress, and life circumstances. Everyone’s experience is different, but some common factors are:

• Postpartum hormonal changes: The sudden drop in pregnancy hormones can significantly impact mood and emotions.
• Severe lack of sleep: Exhaustion and fatigue exacerbate feelings of worry or sadness.
• Previous history of mental health struggles: If you’ve experienced anxiety or depression before, you may be more vulnerable to PMAD.
• Stressful or traumatic birth experiences: Postpartum PTSD (PP-PTSD) stemming from labor and delivery complications can affect you mentally and emotionally.
• Social stressors: Limited support, financial strain, or having a baby in intensive care can all add extra pressure.

Remember, postpartum depression & anxiety are not your fault; they’re a response to a very real set of challenges that many new parents face.

Is This Normal, or Postpartum Anxiety or Depression?

It’s not always easy to distinguish between a normal adjustment and something more serious. If you’re wondering if what you’re experiencing is postpartum depression or anxiety, it can help to pause and reflect on what you’re feeling day to day. Ask yourself:

• Are your worries constant, racing, or uncontrollable, even when nothing is wrong?
• Do you feel persistently sad, hopeless, or disconnected from your baby?
• Have these feelings lasted longer than two weeks without easing?

If the answer is “yes” to one or more of these questions, it may be a sign of postpartum anxiety or depression rather than just temporary stress. Trust your instincts. If something doesn’t feel right, reaching out for help is a positive and important step.

When to Seek Professional Help

It’s crucial you know that it’s ok to seek help if you think you’re dealing with a mental health issue. If your symptoms are interfering with your everyday life, making it hard to care for yourself, or affecting your ability to bond with your baby, contact your healthcare provider.

Both postpartum anxiety and depression are treatable, and seeking support is never a personal failing. It’s a sign of strength.

The National Maternal Mental Health Hotline provides free, confidential support, resources, and referrals from professional counselors to pregnant and postpartum individuals facing mental health challenges 24 hours a day, 7 days a week. Counselors offer support in English and Spanish, and interpreter services are available in 60 additional languages. Call (833) 852-6262.

If you ever have thoughts about harming yourself or your baby, please seek emergency help immediately.

Disclaimer: This information is for general understanding and should not replace medical advice. Always contact your doctor or a mental health professional if you’re concerned. In an emergency or crisis, call your local emergency number or a crisis helpline right away.

Frequently Asked Questions

How long does postpartum depression last?

There’s no set timeline for recovery from postpartum depression. Some people start to feel better after a few months, while others may need treatment for a year or longer. The most important thing is to reach out early so you don’t have to struggle alone. People who get the support typically feel better faster than those who don’t.

How do I know if I have postpartum depression?

If, after having your baby, you feel persistently sad, hopeless, or lose interest in things you once enjoyed for more than two weeks, it could be a sign of postpartum depression. Pay attention to whether these feelings interfere with your ability to care for yourself or connect with your baby.

What are the symptoms of postpartum anxiety?

Postpartum anxiety often looks like racing or intrusive thoughts, restlessness, or a constant feeling of dread. You may also have panic attacks, a racing heartbeat, or find that you can’t sleep even when your baby is resting peacefully.

How do I know if I have postpartum depression or anxiety?

Professional screening is the best way to confirm a diagnosis. If you’re struggling with your mental health or suspect that your feelings exceed the “normal” postpartum adjustment, then make an appointment with your healthcare provider.

Can postpartum anxiety turn into depression?

Yes, it can. You can start with anxiety and later develop symptoms of depression, or you may experience both together from the start. This doesn’t mean you’re failing: it just shows how complex postpartum mental health can be.

How common is postpartum anxiety compared to postpartum depression?

Studies suggest that anxiety is more common than PPD. One important finding is that many women show signs of postpartum anxiety without meeting the criteria for postpartum depression. Which means anxiety can be overlooked or underdiagnosed, underscoring the need to screen new parents for both.

Is postpartum anxiety included in postpartum depression screening?

Not always. Many standard postpartum screenings focus on depression, sometimes overlooking anxiety symptoms. If you think you may be experiencing postpartum anxiety, it’s important to bring it up directly with your healthcare provider.

Can men experience postpartum depression or anxiety?

Yes. While less common, partners can develop postpartum depression or anxiety, too. Hormonal changes, disrupted sleep, and the stress of new parenthood affect the whole family, not just the birthing parent.

How long does postpartum anxiety usually last?

Like postpartum depression, there’s no set timeline for how quickly recovery from postpartum anxiety happens. Some parents see an improvement in symptoms within months, particularly if they receive treatment for their symptoms. Unfortunately, many people think their postpartum anxiety symptoms are “normal” and don’t reach out for support, leading to their anxiety lasting longer.

Can postpartum depression or anxiety go away without treatment?

Mild symptoms may resolve on their own over time, but treatment can support recovery and reduce the risk of worsening symptoms. Medical intervention is recommended for severe cases of postpartum depression or anxiety, such as therapy, medication, and support groups.

Does breastfeeding affect postpartum depression or anxiety?

Some research says there is a connection between breastfeeding and mental health. Certain hormones or the overall experience can severely impact your mood. However, studies have yielded conflicting results, and every experience is unique.