Low mood after having a baby
Flatness, exhaustion, and not feeling what everyone said you would feel. Postnatal depression is common, treatable, and not a verdict on you as a parent. Here is how it is recognised and worked with.
Everyone told you what you would feel. The rush of love, the joy, the sense of purpose. What you actually feel is flat. Exhausted in a way that sleep, when you get it, does not fix. Going through the motions of feeding and changing and soothing without much of anything behind them. And underneath, a commentary that has become cruel: a bad mother, a fraud, everyone else manages, the baby deserves better.
Low mood after a birth is common, it is treatable, and it is not a verdict on you as a parent. I want to say how I understand it, and what happens when you get help.
What it looks like
Postnatal depression centres on mood, exhaustion and loss of pleasure. The things that should feel good do not. The tiredness is beyond what the broken nights explain. Small tasks feel enormous. And the mind produces a running assessment of your failings, delivered with a confidence that ordinary tiredness does not have.
It can arrive at any point in the first year, and it does not need a reason beyond the birth itself, though there are often others: a difficult delivery, a loss around the same time, isolation, a baby who does not sleep, a partner who is away. Sometimes there is no reason you can point to, and that makes it worse, because you cannot even justify feeling like this.
What it is not
It is not the same as postnatal anxiety or OCD, though they can occur together and are often mistaken for each other. If the picture is dominated by intrusive thoughts about harm coming to the baby and the checking or avoiding they drive, that is perinatal OCD, and it is treated differently. If both are present, we treat both.
And it is not postpartum psychosis, which is a medical emergency: it usually comes on fast in the first days or weeks, the beliefs feel true rather than distressing, insight is lost, and there may be confusion, elation or not sleeping at all. If you are unsure which you are describing, contact your GP, midwife, health visitor or NHS 111 today rather than waiting for an appointment with me.
Why nobody knows
Most people with postnatal depression tell nobody. They sit through the six-week check being asked whether they have been feeling low, and they say they are tired. Partly this is shame: admitting you do not feel what you are supposed to feel about your own child seems unsayable. Partly it is fear: that saying it will mark you as a bad parent, or bring consequences. And partly it is the depression itself, which tells you that you are the problem and that asking for help would just confirm it.
I will say plainly that low mood after a birth is common enough that the six-week check asks about it, that describing it will not shock anyone who works in this area, and that the question is there for exactly this.
What treatment involves
The treatment is CBT for depression, which NICE recommends, adapted to the reality of a new baby. Behavioural activation comes first: small, realistic steps chosen from where you actually are rather than grand plans, because the feeling follows the doing and depression has removed the motivation to do anything. With a newborn the steps are shaped around the day you actually have, and they can be very small.
Then the thinking: learning to notice the harshest conclusions, bad mother, fraud, as they arrive, and to check them against what is actually true, which is usually a very tired person doing a very hard job. Where the low mood follows a difficult birth or a loss, we work with that directly, and EMDR can be part of it.
Working alongside your other care
If what you are describing needs your health visitor, GP or a specialist perinatal service involved, I will say so, and with your agreement I am glad to work alongside them. Therapy sits happily alongside antidepressants if you and your GP decide on them. And if you are having thoughts of not being here, please tell me; I will not be shocked. If you are in immediate danger, call 999 or go to A&E, and Samaritans are free on 116 123.
The practicalities
Sessions run over secure video, which for new parents is often the difference between having therapy and not having it. You can feed during a session. The baby can be in the room. It is genuinely fine if we are interrupted. Fathers and non-birthing partners get low mood after a birth too, and disclose it even less often; the treatment is the same.
If you have been saying you are tired when you mean something else, there is more on how I treat depression, including after a birth.