Postpartum Depression (PPD) has been an important topic in recent media with many expecting and early mothers sharing their stories on how PPD affects them. Something that is not talked about enough is postpartum anxiety, which does and will continue to affect mothers and expecting moms. But how do we tell and/or know the difference? Well, let’s get into this discussion as we differentiate and categorize the two. 

What is Postpartum Depression?

Postpartum is a time that is widely assumed to be nothing but a happy time for new mothers; however, this is far from the reality for many. In fact, nearly 13% to 19% of mothers experience postpartum depression (PPD) following childbirth. Notably, PPD differs from what is known as the “baby blues.” While the “baby blues” are a common experience affecting up to 80% of new mothers, they are typically characterized as a transient “prodrome of emotional disturbances” that appears within a few days of delivery. Suryawanshi and Pajai mention that these disturbances generally resolve on their own within 10 days. 

In contrast, according to Suryawanshi and Pajai, PPD involves a continuous feeling of a low state of mind that is far more persistent and debilitating. They note that while the timing of onset for PPD is debated, it can begin during pregnancy or anytime within the first year following delivery. For approximately 30% of women, PPD symptoms can continue for up to two years postpartum. 

While both conditions may involve anxiety, irritability, and sleep troubles, PPD is distinguished by more severe features such as anhedonia (the inability to feel pleasure), poor concentration, and feelings of worthlessness or guilt. Because PPD can be so much more intense and persistent than the “baby blues,” it often manifests in ways that impact every part of a mother’s life. Understanding these specific symptoms can help you or a loved one identify when it is time to reach out for extra support. These symptoms can take emotional and physical form:

The Emotional Weight of Postpartum Depression

Every mother will experience “off days,” however, PPD is marked by persistent sadness that does not seem to go away. Beyond just feeling down, the following is a list of symptoms you or a loved one may experience: 

  • Anhedonia: This is the total loss of interest or pleasure in things that used to bring joy, such as a new baby.
  • Severe irritability: Small things may generate intense anger or a constant feeling of being “on edge” that goes beyond typical parenting stress.
  • Poor Concentration: It may be difficult to focus, manage daily schedules or make decisions.
  • Overwhelming Guilt: One may experience feelings of unworthiness, or thoughts that you are doing a poor job even when trying your absolute best.

Physical Signs (Somatic Symptoms)

One of the hardest parts of PPD, according to Suryawanshi and Pajai, is that many of its physical signs are often misinterpreted as the normal exhaustion of motherhood. However, in PPD, these somatic symptoms are often significantly more severe: 

  • Sleep Disruptions: This can include insomnia, which is the inability to sleep even when the baby is sleeping, or hypersomnia, where one feels as though they cannot stay awake or cannot stop sleeping.
  • Appetite Changes: One may experience a disturbed appetite, meaning one may feel unable to eat or begin eating significantly more than usual.
  • Extreme Fatigue: This is a significant lack of energy that makes everyday tasks feel nearly impossible.

If you or a loved one is experiencing any of these symptoms, it is important to remember that postpartum depression is a treatable medical condition, and seeing a therapist is a powerful first step towards recovery. Many women find that psychological therapy is their preferred treatment of choice as it offers effective management of symptoms without the risk of exposing a nursing infant to medication. Research provided by Fitelson and others strongly supports several therapeutic approaches, including Interpersonal Therapy (IPT), Cognitive Behavioural Therapy (CBT), and psychodynamic psychotherapy, all of which have been proven effective in significantly decreasing depressive symptoms compared to usual care. 

These forms of therapy can help individuals navigate the transition into motherhood, address the connection between one’s mood and relationships, and provide practical tools to modify distorted patterns of negative thinking. Outside of structured clinical sessions, other psychosocial interventions, including non-directive counselling and peer support, can help reduce feelings of isolation, guilt and hopelessness that are often associated with depression. Taking the crucial step in seeking therapy is a very important step for both the well-being of the baby and for the well-being of the mother. According to Fitelson and others, this is because the remission of postpartum depression is directly associated with better emotional and behavioural outcomes for the child.

What is Postpartum Anxiety? How is it Different from Postpartum Depression?

Now that we have determined what PPD is, let us talk about Postpartum Anxiety (PPA). PPA is a condition that can occur after childbirth and can be accompanied by PPD or result in a separate experience entirely. PPA is essentially the fear or exaggerated worry that something can or will go wrong. This form of anxiety can be similar to generalized anxiety but is typically connected to women having a baby or future parents.

PPA affects new mothers and the symptoms of it can include but are not limited to excessive worry, fear, intrusive thoughts and heightened tension related to the baby, themselves or their parental role. Early recognition and treatment are very beneficial to allow the mother the ability to function and enjoy the postpartum period. 

The main common factor that differentiates PPA and PPD is that PPA is based on the feelings of worry for the baby’s safety and PPD is based more on the persistent feelings of sadness, hopelessness and a lack of interest in daily activities or routines. 

What does this mean exactly? 

Let us highlight some of the common factors that differentiate the two conditions: 

  • The Emotional State: PPD is characterized by sadness and hopelessness, whereas PPA is characterized as excessive worry or fear. 
  • Levels of Energy: Women with PPD experience symptoms of fatigue or a lack of motivation and PPA can feel like a sense of restlessness or the inability to relax. 
  • Intrusive Thoughts: PPD involves negative thoughts of the self and the feeling of worthlessness, but PPA is the actual manifestation of constant worrying for potential dangers.
  • Relationship with Baby: PPD may lead to a mother finding it difficult to bond with their baby. On the other hand, PPA is the result of overprotectiveness and constant concerns for the baby’s well-being and safety. 
  • Sleep Patterns: Both of the conditions affect the new mom’s sleep patterns; however, PPD is the result of oversleeping and having trouble getting out of bed to do daily activities. Whereas PPA involves the difficulty of falling asleep and having racing thoughts.

What are the Causes of Postpartum Anxiety and How Does it Develop?

Like any disorder, there is not one concrete cause for PPA. Listed below are some risk factors:

  • Existing or Previous Anxiety Disorder: If new moms have had anxiety in the past before having children, they are more likely to develop PPA. 
  • Hormone Changes: After a mother gives birth, there is a huge decrease in hormones, causing one’s mood to change and making it harder to manage stress.
  • Lack of Sleep: Newborns require 24-hour supervision which can lead to parents, specifically mothers, developing sleep deprivation.
  • A Sense of Responsibility: Feelings of needing to protect and care for your newborn can be overwhelming. 
  • Stress: Cleveland Clinic’s medically reviewed article on postpartum anxiety suggests several factors contribute to a new mother’s stress levels which can trigger their anxiety, whether it is breastfeeding issues or a stressful delivery. 
  • Pressures from Society: Felton and Laddha mention that new mothers can experience a major amount of societal and self-inflicted pressures to be “perfect.”
A happy mother joyfully holding her daughter while standing in the kitchen.

Is it Necessary to Distinguish Between Postpartum Anxiety and Postpartum Depression?

The answer is YES! Something most people do not know is that even though CBT can be used to treat both PPD and PPA, CBT can be created to target each of them in a specific way. Let’s observe PPD, for example. If the patient is experiencing deep sadness and a lack of motivation, the therapist will focus more on behavioural activation and processing of feelings. Whereas with a patient experiencing PPA, who faces anxiety and racing thoughts, the therapist can focus on cognitive behavioural techniques in order to counteract this kind of thinking. Ultimately, it is important that we make the distinction between the two conditions to allow patients to get proper diagnoses and treatments. 

Final Thoughts 

What should I take away from this blog? Understand that Postpartum Depression and Anxiety are normal conditions that affect mothers after childbirth. It is important to understand the differences by seeking proper help to alleviate the long-term effects of the conditions. 

PPD and PPA do not affect a newborns’ quality of life or reflect what kind of parent you are. Both conditions are treatable, either separately or at the same time, to help benefit the mom. It is important if you or a loved one is experiencing one of the conditions discussed that you/they know they are not alone and solutions are available. 

At Colibri NeuroWellness, therapists Dana Orton and Michelle Helder are available to meet with you and explore treatment options that feel supportive and comfortable. As a community, we benefit from continually learning about and sharing knowledge on the experiences of motherhood.

References

Alderdice, F., & Gargan, P. (2019, March). Exploring subjective wellbeing after birth: A qualitative deductive descriptive study. European Journal of Midwifery, 3. https://doi.org/10.18332/ejm/104679

Cleveland Clinic. (2025, August 27). Postpartum anxiety. https://my.clevelandclinic.org/health/diseases/22693-postpartum-anxiety 

Felton, K., & Laddha, S. (2024, February 14). Postpartum anxiety. What to Expect. https://www.whattoexpect.com/first-year/postpartum-health-and-care/postpartum-anxiety/ 

Fitelson, E., Kim, S., Baker, A. S., & Leight, K. (2010, December 30). Treatment of postpartum depression: clinical, psychological and pharmacological options. International Journal of Women’s Health, 3, 1–14. https://doi.org/10.2147/IJWH.S6938

Mental Health America. (2025, May 7). Postpartum anxiety. https://mhanational.org/resources/postpartum-anxiety/

Overbaugh, J. (2024, August 13). Postpartum depression vs. postpartum anxiety: What’s the difference?. Jenna Overbaugh LPC. https://jennaoverbaughlpc.com/postpartum-depression-and-postpartum-anxiety/ 

Phoenix Health. (2025, September 13). Sadness vs. worry: What’s the difference between postpartum depression and anxiety?. https://www.joinphoenixhealth.com/resourcecenter/postpartum-depression-vs-anxiety/ 

Suryawanshi, O., & Pajai, S. (2022, December 20). A comprehensive review on postpartum depression. Cureus, 14(12), e32745. https://doi.org/10.7759/cureus.32745

Texas Children’s. (2025, March 28). Recognizing & treating postpartum anxiety. https://www.texaschildrens.org/content/wellness/recognizing-signs-postpartum-anxiety 

Authors: Kianna Simpson and Tamara Popovic, Undergraduate Student Volunteers

Edited by: Caden Grandy, Undergraduate Student Volunteer