Postpartum Depression Symptoms And What To Do About Them

If you are reading this because you haven't been feeling right since your baby arrived, or perhaps long before that, please know you are not imagining it. What you are experiencing is real, and it deserves to be taken seriously.

Postpartum depression is a genuine mood disorder that can begin during pregnancy or in the weeks and months following birth. It shapes the way you feel, the way you move through your days, the way you connect with your baby, and the way you relate to the people you love. It is far more than the tiredness and tender emotions that often come with early motherhood. It is disruptive and exhausting, and it is not something you need to carry quietly.

You may be recognising some of these experiences in yourself. Or you may be here because someone you love is struggling, and you are searching for a way to understand and support them. Whatever brought you to this page, learning about postnatal depression, including what it is and what can contribute to it, can help you move toward feeling like yourself again.

If you are aware that something is wrong and need to seek support, then Floralia Wellness helps postpartum women address the underlying reasons for mood swings alongside the care of your GP or mental health professional.

You are not alone in this, and you do not have to find your way through it by yourself.

How postpartum depression feels (not just what the textbooks say)

While the clinical checklists can help diagnose the situation, they do not necessarily describe what it really feels like to experience postpartum depression. It may not be possible to see yourself in the list of symptoms because PPD is very individual. It is filtered through your personality, your circumstances, your relationship, and the mother you thought you would be.

What remains consistent is the gap between how you thought you'd feel and how you actually feel. The confusion of this gap is also a problem. A review published in the Journal of Clinical Medicine in 2025 describes PPD as having symptoms of sadness, anxiety, fatigue, and impaired functioning. PPD is present in about 10-20% of postpartum women.

Emotional symptoms

The feeling of PPD is difficult to explain to someone who has not experienced it. The feelings of extreme sadness, which everyone expects, can be overwhelming. Guilt, however, can be the most debilitating symptom. You might feel guilty for not enjoying your baby, or guilty for feeling angry, or guilty for wanting to be alone when you think you should want to be with your baby. Some women report feeling numb instead of sad, as though a glass wall has gone up between them and the rest of their life.

Irritability is a common symptom, too, although a poorly understood one. You may get angry with your partner over little things, or you may have a general sense of irritation with no clear object for your frustration. Anxiety is another emotion that is closely tied to depression, especially concerning your child's health and well-being. The emotional symptoms of depression and anxiety can sometimes blur together so that you're not sure which emotion you're experiencing, and the answer is both.

The feeling of not being worthwhile can be quite intense during the postpartum period because it can attach itself to who you are as a mother. It can go from "I'm struggling" to "I'm failing" in an instant.

Physical symptoms

PPD is as present in your body as in your mind. Lack of sleep when the baby sleeps is one of the more telling signs, as you can feel the exhaustion but cannot seem to rest. You may lie in bed with racing thoughts or wake up at 3 am with a sense of dread that has no explanation.

The loss of appetite also works in two ways: some women stop eating altogether, and some women eat obsessively, not even tasting their food. Headaches and muscle tension never seem to go away, and some women even feel a heaviness in their legs, making even simple acts such as standing up a chore. Your energy level will be so depleted that even simple things such as showering or cooking a meal will feel as if they require more than you have to give.

Behavioural changes you or your partner might notice

This is where other people may notice the signs before you. Withdrawal from friends and family is one of the most common behavioural symptoms. It can be a gradual process. You might not return messages and calls, and start making excuses to stay indoors.

The difficulty in bonding with the baby may not look like what you think it will look like. Difficulty in bonding with a child may look like going through the motions of feeding, changing, and settling without ever really connecting with any of this. It may even feel like you're babysitting someone else's child.

Another indicator is the loss of interest in activities you once enjoyed. Sometimes, your partner will notice this change before you do, as it is a gradual process. Take heed if your partner tells you that they think something is different with you, such as being distant or not yourself.

Baby blues or postpartum depression: how to tell the difference

The majority of new mothers will get some type of baby blues in the first two weeks after delivery. Mood swings and crying are normal reactions to the hormonal changes and sleep deprivation associated with having a new baby.

The main difference between baby blues and postpartum depression is the duration and the intensity. Baby blues start on the fourth or fifth day and resolve by the two-week point. Blues caused by the postpartum experience feel uncomfortable, yet manageable. You can still function and still connect with the people in your life.

PPD does not improve. PPD worsens. The symptoms do not improve after those two weeks. While baby blues are like stormy weather, PPD is like a new kind of weather that is here to stay. You may want to consider talking to your GP or a mental health care professional if you are past the two weeks and are not feeling better, or if what you are feeling is out of proportion to what is happening around you.

When symptoms can start (and why it's not always straight after birth)

It is a common belief that postpartum depression occurs in the first two weeks after childbirth. While this is true for some women, in other women, postpartum depression can occur before pregnancy, or even a year after giving birth.

The broader term used to describe the whole process is perinatal depression. The woman who felt well in the early days might start to notice the symptoms creeping in at three or four months, coinciding with the end of the support bubble. The partners go back to work. The visitors stop arriving. The high of the newborn phase wears off, but what's left underneath doesn't feel right. If you're experiencing mood symptoms during the pregnancy rather than the post-baby phase, Floralia's pregnancy clinic in Perth is here to support you through this stage alongside your midwife or obstetrician.

Late-onset PPD is also more difficult to diagnose as the symptoms do not present within the expected time frame. If you were doing well initially, you might attribute the symptoms that occur later to stress, lack of sleep, and the reality of parenthood. The postpartum period is not just the initial months; the reality is that PPD occurring at six months is still PPD.

What causes postpartum depression

There is no single cause. Postpartum depression is the result of a combination of biological and psychological factors, along with the situational pressures of new parenthood, all occurring during one of the most challenging periods of your life.

Hormonal changes after giving birth

Oestrogen and progesterone levels are increased in pregnancy to levels many times higher than those before pregnancy began. After delivery, these hormone levels fall very quickly, sometimes in as little as 24 hours. This is a significant change, especially in the case of progesterone, which has a soothing effect on the nervous system, and its withdrawal leaves the nervous system without a buffer it has grown accustomed to having.

Thyroid hormones also change after birth, and this can cause postpartum thyroiditis, which can contribute to the symptoms of depression. This is worth investigating because if your thyroid is part of the picture, treating the depression will not completely alleviate the way you feel. Thyroid tests, which extend beyond the simple blood tests for TSH, can help determine if thyroid dysfunction is part of the equation.

Personal and family history of depression

One of the strongest predictors of the onset of PPD is a personal or family history of depression. If you have experienced an episode of major depression before, whether during a previous pregnancy or at another time in your life, your risk is increased. The same is true for people with a history of bipolar disorder or mood disorders.

A history of depression within your family is also important, even if you have not experienced it yourself. This is because while your genes do not predetermine PPD, they do lower your threshold. Women who experienced PPD during the last birth are also at high risk.

Life circumstances that increase your risk

Stressful life events during or after pregnancy are a significant risk factor. Financial stress, relationship problems, a difficult delivery, a lack of help with practical tasks, domestic violence, a recent death in the family; any of these can be enough to push you over the edge. Being a young mother or having a low income are associated with a higher risk of postnatal depression, and a lack of social support is one of the most consistent risk factors in the research.

Complications that occurred during childbirth, such as emergency interventions, birth trauma, or a baby who has to spend time in the NICU, also increase risk. The disparity between the birth you anticipated and the birth you actually had is not to be dismissed with "at least the baby is healthy."

Postpartum depression in partners and fathers

Postpartum depression is not limited to the mother. An estimated 10% of fathers can experience depression in the first year following the birth of their child. Paternal postpartum depression usually occurs between three to six months following birth.

The risk factors have a similar pattern to those of maternal depression. These include young fathers, fathers who have a previous history of depression, fathers who are facing financial problems, and fathers who have strained relationships. Paternal postpartum depression correlates with maternal depression, too, and if the other parent is suffering from depression, then the other parent will likely follow suit.

This is important for the whole family. The children of men experiencing depression have a 33-70 per cent greater risk of developing emotional or behavioural problems themselves. Partners who realise they are not coping should have access to mental health support as much as the mother in labour. Non-biological partners, including adoptive partners, can experience postpartum depression too. The hormone may not be the same, but the lack of sleep and new identity as a parent are universal.

How untreated postpartum depression affects your baby

This isn't here to guilt you. If you're already worried about how what you're feeling is affecting your baby, then you're clearly a concerned parent. Understanding why treatment is important can be what gets you to take that first step.

The effects of untreated PPD on bonding between the mother and child have a significant impact on the child's developmental progress. A child whose mother has depression will experience increased occurrences of crying, sleeping issues, and temperament. This can lead to developmental delays, such as those concerning cognition and emotions, as well as verbal skills.

The process is simple: babies learn to control their emotions through a process called co-regulation with their caregiver. If this caregiver is withdrawn, disengaged, or emotionally unavailable due to depression, the child does not receive these early regulatory signals. Being well enough to show up is what matters, and getting treatment helps this to happen.

The untreated outcomes of maternal depression can include ongoing withdrawal and hostility, which can affect your relationship with your partner and other children. If PPD is not treated, it can progress to chronic major depression, which can be more difficult to treat the longer it has gone on. The causes of that depression can be more complex than hormones.

The gut-hormone connection most postpartum content ignores

If you've been told that postpartum depression is simply a hormone or psychological problem, you've been given a partial explanation at best. What is going on in your gut during the postpartum period has a direct impact on your mood and energy level during your recovery.

Your gut microbiome is responsible for producing 90% of your body’s serotonin. It is also important in the regulation of inflammation and the metabolism of hormones, your brain needs to maintain stable moods. During pregnancy, the microbiome undergoes significant changes. After the baby is born, it does not return to its pre-pregnancy state. Should antibiotics be administered during labour, which is common with caesarean sections and GBS-positive status, the disruption is even greater. A review published in 2025 in the journal Neuroimmunomodulation describes the main mechanisms by which the gut microbiome influences mood-related signalling during the perinatal period.

Then there is the nutrient depletion aspect. Growing a baby is a costly business, metabolically speaking. Iron, zinc, vitamin B6, vitamin B12, folate, magnesium, and omega-3 fatty acids are depleted during pregnancy and lactation. All of these nutrients play a direct role in neurotransmitter synthesis and nervous system regulation. A systematic review and meta-analysis of randomised controlled trials showed that omega-3 fatty acid supplements had a significant impact on perinatal depressive symptoms, particularly those with a high EPA/DHA ratio. A woman depleted in iron and vitamin B will not be able to make serotonin and dopamine regardless of what is going on in her world. A standard blood test may not reveal a woman's nutrient deficiencies, particularly if they are only testing for haemoglobin rather than ferritin, and vitamin B12 rather than active vitamin B12.

Progesterone withdrawal is not an isolated process. It is also related to your state of gut health, your nutrient reserves, and your baseline inflammatory state. The woman who is well-nourished in terms of her microbiome, iron stores, B vitamins, and so on, will do better with the progesterone withdrawal than the woman who is depleted in every way. This is the underlying perspective that Floralia Wellness brings to the postpartum period. Instead of focusing on the depression as an isolated issue, your naturopath can work with you to look at the underlying terrain on which the depression is occurring: what is depleted, what is inflamed, and what is not being absorbed properly. Our gut health support services are aimed at helping you investigate imbalances in your gut health that may be contributing to your mood and energy symptoms.

A holistic approach works in conjunction with conventional treatment. If you're receiving therapy, thinking about the medication, and still feeling like there's something lacking, then the answer might not be in your head, but in your blood and gut.

Postpartum anxiety, postpartum psychosis, and other mood disorders

While postpartum depression gets most of the attention, it is not the only mental health condition that may appear after childbirth. Postpartum anxiety is just as prevalent and is also overlooked because the mother is functioning. She is hyper-vigilant. She is constantly checking on her baby. The world may think she is a good mother for checking on her baby so often, but the reality is, she cannot stop checking.

Postpartum anxiety can exist on its own with depression. Thoughts about something bad happening to the baby can be a hallmark. These are the ones women are probably the most nervous about mentioning because they worry it says something about them as parents. Intrusive thoughts can be a feature of anxiety. They don’t say anything about your intent as parents.

Postpartum psychosis is a rare psychiatric emergency occurring in about 1-2 per 1,000 births. Symptoms of postpartum psychosis include hallucinations, delusions, confusion, and rapid changes in emotional state ranging from mania to depression. Postpartum psychosis usually occurs in the first two weeks after childbirth and needs urgent medical care. The risk of postpartum psychosis is greatest for those who have a history of bipolar disorder and previous episodes of psychosis.

Other mood disorders, such as obsessive-compulsive behaviours and post-traumatic stress disorder caused by birth trauma, can also occur. If something doesn't feel right, it is worthwhile to discuss it with your healthcare provider, even if it does not fit the textbook definition of PPD. While these diagnostic criteria can be helpful in treatment, your experience does not have to fit neatly into one of these boxes before you can seek help.

Screening and diagnosis: the Edinburgh Postnatal Depression Scale

The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used instrument for screening for postnatal depression in Australia and worldwide. The test is a 10-question report that requires about five minutes to complete, and your GP or maternal health nurse may present the test to you during your six-week postnatal check or during your routine visits.

EPDS questions ask about your emotional state over the last seven days, including feelings of low mood, anxiety, guilt, sleep difficulties, and if you've had any thoughts of harming yourself. Each question is scored from 0 to 3. A high score is anything above 12 or 13. It doesn't mean you are suffering from depression; it means you need to talk to your doctor. It is not a diagnosis. It is a tool to help your doctor determine if you might be suffering from depression.

In reality, the EPDS will identify the obvious cases of PPD, but it might not pick up women whose depression is manifested as irritability, numbing, or anxiety. If your results indicate that you don’t have PPD, but you still feel something is wrong, it is okay to say so. The scale is only the starting point.

The diagnosis of postpartum depression is based on the guidelines provided in the "Diagnostic and Statistical Manual of Mental Disorders." Postpartum depression is classified as a major depressive episode with peripartum onset. Your doctor, psychiatrist, or any other mental health professional will take your EPDS result, personal interview, and medical history, along with observations on how your symptoms are interfering with your daily life, into consideration.

How postpartum depression is treated

The good news is that PPD is treatable, although it can be hard to believe that when you are in the thick of it. The basic approach is some combination of therapy, medication, and support. The specifics will depend on the severity of your symptoms and your own preferences, including if you are breastfeeding.

Talk therapy: CBT and interpersonal therapy

One of the best treatments for mild to moderate PPD is cognitive behavioural therapy (CBT). CBT is helpful because it challenges the negative thinking that is holding you back, especially the guilt and shame, which can cause withdrawal. It helps you to think more realistically about what is happening.

Interpersonal therapy, or IPT, takes a different approach. IPT emphasises relationships and the transition that comes with being a parent. If relationship strain or conflict with a partner, or issues of identity loss associated with becoming a parent, are a big part of depression, IPT can be particularly helpful. Both forms of therapy are evidence-based, and both can be done in-person or virtually, which matters when going outside with a newborn feels like a logistical nightmare.

Medication options while breastfeeding

Antidepressants may be prescribed in cases of moderate to severe depression in conjunction with therapy. Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for postpartum depression due to a well-studied safety record in breastfeeding infants. The dose is small in breast milk, and in most cases, the benefit of the drug clearly outweighs the risk.

Tricyclic antidepressants are an older class of medication that can be considered as a secondary option when SSRIs are not effective. There are new drugs in development as well. Zuranolone is a once-daily oral medication designed to treat PPD and has a different mechanism of action by interacting with GABA receptors rather than serotonin receptors. Brexanolone is a synthetic form of allopregnanolone, a hormone that declines significantly after childbirth. It is given by IV and was the first medication designed to treat PPD.

The decision about psychiatric medications during breastfeeding is a personal one that involves your prescribing doctor. What matters is that you have correct information rather than fear-based assumptions.

Naturopathic support alongside conventional treatment

This is where Floralia Wellness fits into the treatment model. Naturopathic support can help with the biochemical and nutritional factors that can either contribute to the severity of your depression or impede your recovery.

The starting point is usually testing. A postpartum blood panel should include ferritin levels (not haemoglobin), B12, folate, vitamin D, zinc, and thyroid function, including antibodies. Women are often told that their levels are "normal" according to reference ranges. However, these reference ranges are actually the averages of the population, not the optimal levels for recovery. The naturopath, being familiar with postpartum care, will look at these levels from a different perspective. They will look at where you are in comparison to where you need to be for your nervous system to function optimally. Floralia's hormone testing is advanced, looking at how your hormones and adrenal function are interacting with your thyroid health.

From there, a personalised plan may include practitioner-grade nutritional supplements to address a particular nutritional need and herbal medicine to support nervous system recovery and stress resistance. When an imbalanced microbiome is causing malabsorption of nutrients and/or high levels of inflammation, restoring the gut may also be a part of the plan. Certain types of herbal medicine, such as withania and passionflower, and saffron, have a body of research supporting them for use in mood support, but what is on the pharmacy shelf is often not a therapeutic dose that would be prescribed by a practitioner.

Another area that the practitioners at Floralia often focus on is blood sugar balance, because unstable blood sugar can contribute to severe mood swings and anxiety, and sleep support that is more than just "sleep when the baby sleeps" (which is advice you can really follow only if you can actually fall asleep). Taking a magnesium supplement in combination with specific herbs can help, as can figuring out what physiological reason you are having trouble sleeping in the first place.

An approach like this can be extremely supportive with what you're working on already with your GP and your psychologist. The idea is to ensure that your body has the resources it needs to react to your treatment. If you want to learn more about how this works in detail, then you read about Floralia's postpartum care consultations.

Practical things that actually help when you're in it

General advice about self-care can be unhelpful when you can barely get through the day. What follows is more particular advice, based on what the practitioners at Floralia see making a real difference to women in the postpartum.

Make sure to have a source of protein in every meal, including breakfast. When you're in a state of depression, it's easy to forget to eat or to live on toast and coffee. Your brain cannot manufacture those vital neurotransmitters without amino acids, and it cannot get those from carbohydrates alone. Even something simple like two eggs or nuts with your breakfast can have you feeling different by mid-morning. A clinical nutritionist can design a postpartum meal plan that is tailored to your individual needs and preferences. Often this in itself can help to stabilise your mood without adding more complications to your life.

Accept help with specifics, not generalities. If someone says, "let me know if you need anything," the usual response is for the new mother to say nothing. Try telling people exactly what you need. "Can you hold the baby for an hour on Tuesday so I can sleep?" "Can you bring dinner on Thursday?" It is much easier to say yes to these kinds of requests, and it actually gets you the support you need.

Get outside in the sunlight before 10 am. This will help to reset your circadian rhythm, which can be out of whack in the postpartum period. You don’t have to do anything strenuous. A ten-minute walk with the pram or sitting out the back with a cup of tea works. The light, not the movement, is important, but both are helpful. A systematic review in the British Journal of Sports Medicine in 2025 concluded that postpartum physical activity reduced the severity of both depressive and anxiety symptoms.

Stop comparing your inside to other people's outside. Social media is a big culprit for this, but it also happens in mothers' groups. The mother who appears to have her act together may be losing her mind at home. Compare yourself only to how you felt last week.

Have an honest conversation with one person. Not the superficial one of "I'm fine, just tired," but one person (your partner, your friend, your mother, your GP), and have an honest conversation about how you feel. PPD feeds on secrecy. One honest conversation can end the cycle of withdrawal.

Seek support groups, either in person or online. Support groups have been shown to help alleviate postnatal depression, and sometimes it is only when another person describes what you're feeling that you can think, "I'm not crazy, I'm sick, and there's a difference." A systematic review in the World Journal of Clinical Cases in 2025 found that moderate-intensity aerobic exercises, performed three to four times a week, significantly reduced depression, and that nutrition, including vitamin D supplements and high-fibre foods, can help because they modulate the gut microbiota and decrease systemic inflammation.

When to ask for help and who to call in Australia

You should talk to your doctor or a mental health professional if your symptoms persist longer than two weeks or get worse, or if you are having thoughts of harming yourself or your baby. The last bit is very deliberate, and if you are experiencing those kinds of thoughts, please seek help now.

In Australia, the following services offer support:

PANDA (Perinatal Anxiety and Depression Australia): 1300 726 306. Free national helpline for anyone affected by perinatal mental health conditions, including partners and family members. Lifeline: 13 11 14. 24-hour crisis support and suicide prevention. Beyond Blue: 1300 22 4636. Mental health support and information. Postpartum Support International helpline: available internationally for those who need to connect with perinatal mental health resources.

Your GP can refer you to see a psychologist or psychiatrist through a Mental Health Treatment Plan, which means you can access subsidised sessions. Maternal and child health nurses can also screen you for postnatal depression and connect you with local mental health services.

If you are interested in the naturopathic approach we offer at Floralia Wellness, our postpartum consultations help to determine the nutritional and hormonal factors, as well as gut health issues, that may be affecting you. Floralia Wellness's women's health clinic in Perth provides expert naturopathic care for a range of women's health issues, including postnatal care. You are welcome to book an appointment on our website or phone us directly.