Postpartum Depression: Signs and Support

You thought you'd be tired, yes, but also happy. In love with your baby. Instead, you feel like a stranger in your own life. Or maybe you feel nothing at all, and that absence frightens you more than sadness would.

 You're not alone. In the United States, postpartum depression affects up to 1 in 5 women, one of the highest rates in the developed world. And that number is likely higher because so many cases go unreported. Women don't talk about it because they're ashamed, because they think they should be grateful, because they don't recognize what's happening as something that has a name and responds to treatment.

 What Is Postpartum Depression?

 Postpartum depression is a mood disorder that can develop after childbirth. It's different from the "baby blues," which affect up to 80% of new mothers and typically resolve within two weeks. Postpartum depression is more intense, lasts longer, and interferes with your ability to function and care for yourself and your baby.

 The symptoms vary, but they often include persistent sadness or emptiness, feeling disconnected from your baby, overwhelming fatigue that doesn't improve with rest, changes in appetite or sleep beyond what's normal with a newborn, difficulty concentrating or making decisions, feelings of worthlessness or guilt, and in severe cases, thoughts of harming yourself or your baby.

 These symptoms can begin anytime in the first year after birth, though they most commonly appear within the first few weeks or months. Some women don't recognize what's happening until they're deep in it.

 If you're experiencing any of these symptoms, please know this is a medical condition. It's not a character flaw or a sign that you're a bad mother. And it responds to treatment.

 Postpartum anxiety is closely related and sometimes occurs alongside depression. We cover this in depth in our article on postpartum anxiety.

 Why Does Postpartum Depression Happen?

 Postpartum depression isn't caused by one thing. It's the result of multiple factors converging at a vulnerable time.

 Hormonal shifts play a significant role. After birth, estrogen and progesterone drop dramatically, the most rapid hormonal change a woman's body ever experiences. These hormones affect neurotransmitters that regulate mood, including serotonin and dopamine. For some women, this crash triggers depression.

 Sleep deprivation compounds everything. Chronic sleep loss affects mood, cognitive function, and the ability to regulate emotions. New mothers are often running on fragmented sleep for weeks or months, and the toll is significant.

 Physical recovery from birth is demanding. Your body has been through an enormous experience. Blood loss, tissue healing, hormonal recalibration, and often pain or discomfort, all while caring for a newborn around the clock.

 But there's something else that matters enormously, and it's often overlooked: support.

 When Birth Itself Was Traumatic

 For some women, postpartum depression is connected to a difficult or traumatic birth experience. Emergency cesarean, prolonged labor, severe complications, feeling unheard by medical staff, fear for your life or your baby's. These experiences leave a mark.

 You can be grateful your baby is healthy and still be affected by what you went through. Both things can be true.

 Birth trauma often goes unrecognized because the focus shifts to the baby. If the baby is fine, everyone assumes you should be fine too. But trauma lives in the body. It doesn't resolve just because the outcome was good.

 If your depression feels connected to what happened during birth, if you have intrusive memories, nightmares, or find yourself avoiding anything that reminds you of the delivery, the trauma piece needs attention. We use Somatic Experiencing to help the body release what it's still holding from that experience.

 What Other Countries Know That We Don't

 Research has shown striking differences in postpartum depression rates across cultures. Countries with strong traditions of postpartum care have significantly lower rates of depression than Western countries, particularly the United States.

 In many Asian, Latin American, Middle Eastern, and African cultures, there's a recognized postpartum period, often 30 to 40 days, during which the new mother is cared for intensively. She rests. She's fed nourishing foods. Family members or hired helpers manage the household and often the baby care, allowing her to recover. She's not expected to do anything except heal and bond with her baby.

 In China, it's called "zuo yuezi" or "sitting the month." In Latin America, "la cuarentena." In Korea, "sanhujori." The specifics vary, but the principle is the same: new mothers need rest, nourishment, and support.

 A study published in the Journal of Affective Disorders found that social support was the strongest protective factor against postpartum depression across cultures. Women who had practical and emotional support had dramatically lower rates of depression.

 In the United States, we expect women to bounce back. To be independent. To manage alone. Many women leave the hospital after two days and are home with a newborn and no help. Their partners may have limited or no parental leave. Extended family may live far away. The isolation is profound.

 This isn't a personal failing. It's a cultural one. And it helps explain why American women struggle at such high rates.

 Your Nervous System After Birth

 Whether you're experiencing postpartum depression, anxiety, or trauma, your nervous system is involved.

 During pregnancy and birth, your body goes through enormous activation. Labor itself is an intense physical and emotional experience. Your nervous system mobilizes tremendous energy to get through it. Ideally, after birth, your body would discharge that activation and return to baseline.

 But often that doesn't happen. The demands of newborn care begin immediately. There's no time to rest, no time to process, no time to let your nervous system complete the cycle. Your body stays in a state of depletion, even when the acute challenge is over.

 This helps explain why postpartum struggles aren't just about hormones or thoughts. They're about the state of your nervous system and whether it has the resources and support to recover.

 How We Support Postpartum Recovery

 We approach postpartum depression from multiple angles, addressing both the physical and the emotional, the biochemical and the nervous system.

 Acupuncture for Postpartum Recovery

 Acupuncture is deeply supportive during the postpartum period. It helps regulate hormones, supports sleep, reduces anxiety, and shifts the nervous system out of stress response.

 Research published in the Journal of Affective Disorders found that acupuncture was effective for treating postpartum depression, with results comparable to medication but without the side effects. For women who are breastfeeding, acupuncture offers relief without concerns about what's passing through their milk.

 We also use acupuncture to address the physical aftermath of birth: healing from tearing or cesarean, supporting milk production, addressing pain or discomfort. When your body feels better, your mood often improves.

 Somatic Work for Nervous System Recovery

 Postpartum depression often has a nervous system component. Your body may be stuck in a depleted state, unable to access rest and restoration.

 We work somatically to help your nervous system recover. This isn't talk therapy. It's body-based work that helps shift your physiological state. Over time, your system learns to settle, to rest, to feel safe again. And the change lasts because it's happening at the level of the nervous system, not just the level of thoughts.

 For women whose depression is connected to a difficult birth, somatic work is particularly important. Trauma lives in the body, and the body needs support to release it.

 Chinese Herbs and Supplements

 The postpartum period is considered a time of significant depletion in Chinese medicine. Blood and qi have been lost through birth. The body needs to be rebuilt.

 We use Chinese herbal formulas to support recovery: nourishing blood, supporting energy, calming the spirit. These formulas have been used for centuries to support postpartum women.

 Certain supplements can also help. Omega-3 fatty acids have research support for postpartum depression. Vitamin D deficiency is common and associated with worse mood. We assess what your body needs rather than giving everyone the same protocol.

 The Importance of Being Witnessed

 Sometimes what women need most is someone who understands what they're going through. Not advice. Not solutions. Just acknowledgement.

 Postpartum can be isolating. Everyone asks about the baby. No one asks how you're doing, and if they do, they expect you to say "tired but happy." There's often no space to say that you're struggling, that this isn't what you expected, that you feel like you're failing.

 We create that space. We've worked with many postpartum women, and we know that what you're experiencing is real. You don't have to pretend here.

 What This Looks Like in Practice

 A woman came to us three months after her first baby. She'd had a long labor that ended in an emergency cesarean. The baby was healthy, everyone said she was lucky, but she didn't feel lucky. She felt flat. Disconnected. She went through the motions of caring for her daughter but felt like she was watching herself from a distance.

 She cried at random times, for no reason she could identify. She couldn't sleep even when the baby slept. She'd lost her appetite. She felt guilty constantly, convinced she was doing everything wrong, that her daughter deserved a better mother.

 She hadn't told anyone how bad it was. Her partner thought she was just tired. Her mother told her the first few months were hard for everyone. She'd started to wonder if this was just what motherhood felt like.

 When we talked, it was clear her nervous system was depleted and still holding the birth experience. She had help at home, a night nurse, a housekeeper, but she couldn't let herself rest. She'd lie awake listening for the baby even though someone else was watching her. She felt guilty not doing everything herself. She had support around her but couldn't receive it.

 We started with weekly acupuncture focused on building her blood and calming her spirit. We added herbs to support her energy and mood. We did somatic work, helping her body release what it was still holding from the birth and learn to let go of the vigilance.

 Part of what we worked on was permission. Permission to rest. Permission to let someone else care for her daughter. Permission to let go of control. Her nervous system needed to learn that it was safe to receive the help she already had.

 After six weeks, she said the fog was lifting. She was starting to enjoy her daughter, not just care for her. She could nap when the night nurse had the baby. She had moments of genuine happiness, which she hadn't felt since before the birth.

 After three months, she felt like herself again. She said she wished she'd reached out sooner.

 Read stories from women we've worked with →

 Your Next Step

 If you're struggling after birth, whether it's been weeks or months, please reach out. Postpartum depression is treatable. You don't have to wait for it to pass on its own, and you don't have to white-knuckle through this.

 We've supported many women through postpartum recovery. We understand both the physical and the emotional dimensions. We can help.

 Learn more about our Fertility & Health path or contact us at 212.432.1110 or info@fafwellness.com.

 If you're having thoughts of harming yourself or your baby, please contact the National Maternal Mental Health Hotline at 1-833-943-5746 (available 24/7) or go to your nearest emergency room.