Beyond the Baby Blues: Recognizing Anxiety and Depression in New Mothers
Navigating the Emotional Landscape of Motherhood—When Normal Struggles Signal Something More
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A quick primer on terminology and acronyms. In this article, we will use the terms postnatal, perinatal. They are similar. Postnatal refers to the period after childbirth. Perinatal, however, includes both the period during pregnancy and after childbirth. And of course, DSM stands for the Diagnostic and Statistical Manual of Mental Disorders, which most of us are very well acquainted with.
Supporting Postnatal Mental Health: A Therapeutic Opportunity
Take a moment to reflect on a significant life transition—starting college, becoming a parent, or beginning your career. How did you feel in the months or years that followed? Did it take time to adjust and find your footing? I remember my first few weeks in college. I went from being an athlete with a thriving social life in high school, to feeling invisible those first few months while in college. It was a difficult and painful experience, to say the least.
Transitions can be hard. Whether starting school, entering the workforce, or becoming a parent, major life changes often blend seemingly opposite emotions—joy and anxiety, pride and fear. One of the most profound transitions in life is childbirth. For many women, the postnatal, or after childbirth, period is filled with emotional intensity that’s both expected and, at times, overwhelming.
While it’s normal for new mothers to experience a wide range of emotions (the baby blues are a real thing), for some, the intensity and duration of these feelings can become impairing. When emotional struggles persist and interfere with daily functioning, they may lead to postnatal depression (PND) or postnatal anxiety (PNA). These aren’t rare conditions. Research suggests that up to 1-in-5 women experience postnatal anxiety and/or postnatal depression the first year after giving birth.
Symptoms of postnatal anxiety include excessive anxiety and worry, and physical or cognitive symptoms such as restlessness, fatigue, impaired concentration or sleep, irritability, or increased muscle soreness. For postnatal depression, symptoms may include feeling sad or low in mood, agitated or irritable, having a loss of interest or lack of energy, trouble with sleep, and problem concentrating and making decisions, among other symptoms. Both of these also have a time and intensity element to them: The symptoms usually have to occur for most days over an extended period of time.
Postnatal depression and anxiety affect more than the individual woman—they influence the family, the developing mother-infant bond, and, over time, the child’s emotional and behavioral development. That’s why it's so important for mental health professionals to actively screen, diagnose, and support women during this sensitive time.
Diagnosing postnatal anxiety and postnatal depression
It’s important to understand that there is no separate and distinct diagnosis for postnatal anxiety or postnatal depression at this time. Instead, postnatal depression falls under the Major Depressive Disorder diagnosis with a specifier for “peripartum-onset depressive disorders”. Remember that specifiers are extensions to a diagnosis that can provide more clarity around diagnosis and treatment. For example, an individual can be diagnosed with Autism Spectrum Disorder and a specifier for “With or without accompanying intellectual impairment” or “With or without accompanying language impairment”.
That being said, in the DSM-5, postnatal depression is coined Major Depressive Disorder, with Peripartum Onset.
There is also no distinct diagnosis for postnatal anxiety. But unlike postnatal depression, postnatal anxiety does not have its own specifier under the anxiety disorders. Given this, postnatal anxiety would be diagnosed as an anxiety disorder such as Generalized Anxiety Disorder. Or, if there is both postnatal anxiety and postnatal depression, the diagnosis “Major Depressive Disorder” with specifiers “With Peripartum Onset, With Anxious Distress” can be used. You will notice that there are two specifiers there: Peripartum onset and anxious distress. The DSM does state that you can have multiple specifiers.
Group-based Therapy for Postnatal Mental Health
One recent study from Australia examined the effectiveness of a structured, in-person group therapy program designed to treat postnatal anxiety and depression. This program, currently available to the community at a public health center free of charge, provides accessible support for new parents. It spans eight weeks, with weekly two-hour sessions, offering a consistent and supportive environment for participants.
A total of 141 postnatal women were enrolled in the study, but the final sample included 101 women due to missing data from 40 individuals. The majority of the women had symptoms severe enough for a diagnosis and a history of mental illness. Most participants were between the ages of 30 and 39.
An interesting part of the treatment was its integration of multiple therapeutic modalities, including:
Strengths-Based Therapy – helping clients identify their existing resources, values, and resilience
Attachment Theory – supporting secure bonds, especially in the new mother-infant relationship
Mindfulness-Based Cognitive Therapy (MBCT) – building awareness and presence to reduce rumination and anxiety
Dialectical Behavior Therapy (DBT) – improving emotional regulation and interpersonal effectiveness
Acceptance and Commitment Therapy (ACT) – helping women clarify their values and take meaningful steps forward, even in the presence of difficult emotions
This research study found that group therapy treatment was helpful for postnatal mothers with symptoms of postnatal anxiety and depression. Specifically, the results showed:
Symptom Reduction: The treatment was effective in reducing postnatal anxiety and depression in women. Women with a prior history of mental illness or more severe symptoms showed the greatest improvements, which is important because previous mental health illness is a risk factor for postnatal depression and anxiety.
Durability: The benefits lasted at least one month post-program, showing promise for longer-term outcomes.
Depth Over Breadth: The program was less effective for women with milder symptoms. It could be, however, that the program prevented these women from developing more serious symptoms. This is an area of opportunity for future studies.
Why This Matters for Therapists
Therapists are uniquely positioned to identify postnatal mental health challenges early and guide clients toward effective support. Here are some takeaways:
Assess risk proactively. Screen clients before and after they have given birth—not just those presenting with symptoms. You can use tools like the Edinburgh Postnatal Depression Scale (EPDS) and the Edinburgh Postnatal Depression Scale-3A
Offer or refer to effective group-based interventions. For women with a history of mental health struggles, group support can be transformative. Shared experiences foster connection, reduce isolation, and provide emotional validation. Structured programs, such as peer-led support groups or therapist-facilitated sessions, help participants develop coping strategies in a safe, understanding environment.
Consider different modalities. Therapeutic approaches like Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and mindfulness each offer valuable tools for supporting postnatal clients. When integrated thoughtfully within a cohesive framework—and delivered in a supportive, well-facilitated environment—these modalities can work together to enhance emotional regulation, deepen self-understanding, and build lasting resilience.
Normalize the emotional complexity. The postnatal period often brings a swirl of emotions—joy, anxiety, grief, and fear—all at once. Validating this emotional complexity helps clients recognize that such feelings are not only normal but expected during major life transitions. Offering a nonjudgmental space for reflection can ease guilt and promote self-understanding. While many parents adjust naturally, some may develop symptoms that warrant clinical attention, making early recognition and support essential.
The postnatal period is a time of profound transformation, and for many women, it brings emotional challenges that deserve serious attention. This study shows that structured, group-based therapy—especially when integrating multiple therapeutic approaches—can be a powerful tool in reducing anxiety and depression in postnatal women. As therapists, we have a crucial role to play: by screening early, normalizing emotional complexity, and connecting clients with effective support, we help not just mothers—but families—thrive.
Thanks for reading.
Attribution: This summary was created by the team at Psychvox and is based on “Evaluation of Group Therapy Intervention for Anxiety and Depression in the Postnatal Period” by Appleton and colleagues. The article is licensed under Creative Commons Attribution 4.0 International License. Changes were made to adapt the content for clarity, style, and length. No additional restrictions have been applied, and nothing in this summary should be taken to imply endorsement by the original authors.
As per the researcher’s request, we’re also sharing the organization that runs the program: https://www.tresillian.org.au/
And here’s the link to the program: https://www.tresillian.org.au/courses/for-parents/postnatal-depression-anxiety/canterbury-thursday-24-july-2025/