Signs Of PPD/PPA

Postpartum Depression and Anxiety are much more common that many people realize. 1 in 9 women will experience postpartum depression. It is one of the most common pregnancy “complications” experienced. 


Baby Blues Vs. Postpartum Depression


We hear a lot about the “Baby Blues”  and often many mothers, and even sometimes providers, will mistake PPD for the baby blues. So what is the difference? 


“Baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby. “Baby blues” symptoms typically resolve on their own within a few days.” (


Postpartum Depression. Depression doesn’t feel the same for everyone. What symptoms occur, how long they last, and how intense they may feel will be different for each person. Some signs of depression are: 


Anxious, Sad, or “Empty” Feeling


Feelings of Guilt or Worthlessness as a mother 


Irritability, Anger or Restlessness

Loss of Interest in Hobbies or Activities

Change in Appetite

Difficulty Falling Asleep 

Wanting to Sleep All The Time

Feeling Disconnected from your baby

Worry that you’ll hurt your baby 

Crying more often than usual

Withdrawing from loved ones 

Feelings of Self Harm or Suicide 


PostPartum Anxiety. Approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression (postpartum international). Like PPD, symptoms can and will vary by person. Some of the signs and symptoms of PPA include:


  • Worrying Constantly
  • Feeling that something bad is going to happen or Intrusive Thoughts
  • Racing thoughts
  • Disturbances of sleep and appetite
  • Inability to sit still
  • Physical symptoms like shortness of breath, dizziness, hot flashes, and nausea
  • Irritability or Rage 


Along with general anxiety, other forms of PPA can include Postpartum Panic Disorder and Postpartum Obsessive-Compulsive Disorder. These are more specific forms of anxiety. Postpartum Panic Disorder is a form of anxiety that can make you feel very nervous and has recurring panic attacks. During a panic attack, she may experience shortness of breath, chest pain, claustrophobia, dizziness, heart palpitations, and numbness and tingling in the extremities. Panic attacks seem to go in waves, but it is important to know that they will pass and will not hurt you. (PPI)


Postpartum Obsessive-Compulsive Disorder. Postpartum International describes it as “The most misunderstood and misdiagnosed of the perinatal disorders. You do not have to be diagnosed with OCD to experience these common symptoms of perinatal anxiety. It is estimated that as many as 3-5% of new mothers and some new fathers will experience these symptoms. The repetitive, intrusive images and thoughts are very frightening and can feel like they come “out of the blue.” Research has shown that these images are anxious in nature, not delusional, and have very low risk of being acted upon.


Treating PPD/PPA

The really good news is that PPD and PPA are temporary and can be easily treatable with professional help. Many of the medications used to treat these mood disorders are compatible with breastfeeding. Therapy can also be a very useful tool in treating PPD and PPA. If you feel that you are experiencing any of these symptoms and they are affecting your quality of life, please reach out for help. Talk to your primary care Dr. or OBGYN and they can connect you with resources in your area. If you do not feel supported by your providers, Postpartum International is a very helpful resource. They can connect you with local resources (  They have online support groups (, and they have a helpline 


If you need immediate support or in case of an emergency, there is help available. 


  • National Crisis Text Line

Text HOME to 741741 from anywhere in the USA


  • National Suicide Prevention Hotline and Website

Call for yourself or someone you care about; free and confidential; network of more than 140 crisis centers nationwide; available 24/7


Along with getting professional help, there are many things you can do to help with the symptoms of PPD and PPA. Some things that many have found to be helpful 


A warm bath or shower

Taking a Walk/Exercise

Sunshine and Fresh Air

Yoga and Meditation

Grounding (


Essential Oils (please check with your dr and a certified aroma therapist before using)

Supplements (please check with you Dr. before adding any supplements to your diet) 

Deep Breathing Exercising

Writing Down Feelings/Journaling

Repeating Positive Affirmations

Taking A Nap 


Again, these are all just suggestions. Some may work for you, some may not, and you may have found something not on this list that works for you.


Can PPD/PPA Affect Breastfeeding?


You may have heard that Breastfeeding will reduce your risk of Postpartum Depression or Postpartum Anxiety. While this is true – it may offer some protection – it does not mean that breastfeeding moms will not experience it. 


For some mothers, breastfeeding may make their anxiety and depression symptoms intensify. It may make breastfeeding feel like a very pressured situation. This is not to discourage, but it is important to talk about variations of normal for those experiencing these symptoms. A commonly known breastfeeding issue is called Dysphoric Milk Ejection Reflex or DMER for short.


Dysphoric Milk Ejection Reflex


DMER is wave of negative or even devastating emotion just prior to letdown. The breastfeeding mother experiences this surge of negative emotions about 30-90 seconds prior to her milk release when breastfeeding, pumping or with spontaneous MER. ( Some of the words mothers used to describe these feelings are: 


  • a hollow feeling in the stomach
  • anxiety
  • sadness
  • dread
  • introspectiveness
  • nervousness
  • anxiousness
  • emotional upset
  • angst or irritability
  • hopelessness and general negative emotions


DMER is newly recognized and much research needs to be done. Often some of the same techniques used to manage general anxiety are encouraged. Deep breathing, talking through it with a partner or friend, grounding, and other distraction methods are encouraged as treatment. If you are experiencing these feelings, reaching out to an IBCLC for support and an empathetic ear, can be a great help. 


Dads and PPD


Did you know that dads can experience postpartum depression and anxiety too? Anywhere between 2-25% of dads have reported depression in the first year of their child’s life. This rate can increase up to 50% when the mother is also experiencing PPD. You can read more about how Postpartum Mood Disorders can affect dads here (


Please know that you do not have to suffer alone. With as many as 1 in 5 mothers experiencing some type of PPD or PPA, this affects so many of us. Reaching out for help is not a sign of weakness, but a sign of strength.