Category Archives: Self Care for Parents

Perinatal Mental Health Disorders

Risk Factors, Symptoms, and What To Do

Take a Screening Test for Perinatal Mental Health Disorders

The Baby Blues has become as much an accepted part of being a new birthing parent as engorged breasts and sleep deprivation. But what if the Blues don’t go away? For 10-20% of new parents, a perinatal mental health disorder (PMHD) is an unwanted and difficult part of the first year of parenthood. The causes of PMHDs are many, and can include hormonal and lifestyle changes, a lack of social support, sleep deprivation, a high-risk pregnancy, a traumatic birth or difficult recovery, or breastfeeding problems. You are also at a higher risk of PMHDs if you have suffered previously from anxiety or depression, or have recent losses or trauma in your life. Symptoms of PMHDs can include:

  • Feeling sad, depressed, numb, or crying a lot
  • Restlessness or irritability
  • Excessive worrying or inability to relax
  • Unusually strong feelings of anger or resentment
  • Lack of energy
  • Having headaches, chest pains, heart palpitations, numbness, tingling, dizziness or nausea, hyperventilation or other unexplained physical symptoms
  • Difficulty sleeping or excessive tiredness
  • Loss of appetite or conversely, overeating and weight gain
  • Difficulty concentrating, remembering, and making decisions, or confusion
  • Excessive concern about the baby or lack of interest in the baby
  • Feelings of guilt and worthlessness
  • Lack of interest or pleasure in activities
  • Obsessive thoughts or compulsive behaviors
  • Fear of hurting the baby or yourself

Many new parents experience only a few of these symptoms, but if you feel like something is wrong and you’re not quite yourself, that is an important signal. If these symptoms persist for two weeks or more, you should promptly get support by talking to your doctor or a mental health professional. PMHDs are highly treatable, with therapy, medication, or a combination of the two.

If you need medication and you are told that you must give up breastfeeding, make sure you get the advice of a prescriber who is knowledgeable about medications for breastfeeding parents. There are a few antidepressants which are routinely prescribed during breastfeeding  with untraceable amounts detectable in the baby’s bloodstream. Moreover, breastfeeding can be beneficial both for the birthing parent, the long-term health of the baby, and bonding, which is even more challenging when a parent is depressed.

Depression not only affects you: it affects your relationships with your partner and your baby. Untreated, depression can lead to bonding difficulties and delayed development or failure to thrive. Getting the help you need to recover quickly is the best thing you can do for your baby and yourself.

Most importantly, tell your support people (your family, friends, partner) how you are feeling. The burden of trying to seem happy and “keeping it all together” can make the depression worse. You need to lean on the people who care about you, get as much help as you need until you’re back to feeling like yourself, and don’t beat yourself up for having a PMHD. It is NOT YOUR FAULT.

Commitment and Kids

Why the Couple Relationship Is So Important When You Are Parents

baby shoes

What makes a committed relationship thrive once kids come into the picture? It’s the ability to stay connected—to feel loved, supported, and safe with each other—even through the chaos of raising children. Maintaining that bond helps couples weather the storms of parenting with their relationship (and sanity) intact.

Why Your Relationship Still Matters

After having children, it’s easy for your partnership to slip to the bottom of the list. Work demands attention, the baby needs constant care, and “couple time” can feel like a luxury. But when your relationship is consistently last, even a strong partnership can begin to suffer.

Taking care of your connection isn’t selfish—it’s essential. A loving relationship forms the foundation for your family’s stability and your children’s emotional well-being. Kids thrive when they see their parents treating each other with kindness, respect, and affection.

Nurturing Connection

Keeping your relationship healthy doesn’t mean grand gestures—it means small, intentional efforts to stay close.

  • Spend time together, even briefly, without the kids.
  • Find joy in shared activities as a family.
  • Keep physical affection and intimacy alive in whatever way works for both of you.
  • Accept that your partner, like you, is a human being doing their best—and not a perfect parent.

Studies consistently show that children do best when their parents’ relationship is strong, even when parenting isn’t flawless.

Communicate with Care

Good communication is at the heart of every healthy relationship. It may seem easier to avoid conflict or bury frustration, but unspoken resentment can quietly erode intimacy and affection. Learning how to talk about your feelings calmly and honestly can bring you closer, even when conversations are uncomfortable.

Here’s an example:
Imagine your partner is caring for the baby but spends part of that time watching football on TV. You feel frustrated—it’s understandable. Rather than snapping in the heat of the moment or bottling up your feelings, take a breath and reflect on what you want to say.

You might start with something like:

“I know you’ve had a long day and need to unwind. I appreciate that you’re spending time with the baby, but I feel a bit resentful when I see the TV on after I’ve been with her all day. Can we talk about it?”

This approach invites conversation rather than conflict. Your partner may open up about feeling uncertain or inexperienced with the baby. You may realize that your child won’t be harmed by a little football, and that both of you are simply trying to do your best. Working through the issue helps resentment fade and understanding grow.

Knowing When to Let Go

Not every irritation needs to be discussed—but ask yourself, can I truly let this go? If not, it’s better to talk about it calmly before frustration builds. Conflict handled with care can deepen intimacy and trust.

Getting Support When You Need It

Every couple faces challenges. If you find that your conversations aren’t leading to resolution or connection, consider seeking help from a couples therapist. Having a supportive space to talk can help you rebuild goodwill and rediscover the warmth that brought you together in the first place.

Often, the recurring issues between partners stem from deeper worries—about feeling loved, valued, or secure. Reconnecting on that emotional level can make small conflicts feel manageable again and remind you that you’re on the same team.

A strong relationship isn’t about avoiding conflict—it’s about staying connected through it. When you nurture your partnership, you not only strengthen your bond but also create a more loving, stable home for your children and yourselves.

Letting Go of Parent Guilt

pregnant mom sonThere is no guilt quite like the guilt of a parent. We feel so uniquely responsible for the care of our children. Every lapse in our parenting weighs on us.

Throughout life there are always reasons to feel guilty: the call we forgot to return or the birthday card we forgot to send, or the time we snapped at our partner for no good reason. But when we feel we have failed with our child, this guilt weighs even heavier on our minds.

Guilt is an emotion with a conscience — it helps us try to do our best, and it reminds us of what is important to us. But too much guilt can rob us of enjoyment. And as a parent, there is so much to feel guilty about! If we dote on our child, there’s the house, friends, partner or even job to feel guilty about, and if we try to meet our other obligations, it is easy to feel that you have failed as a parent. It’s a Catch-22!

I wonder sometimes if our parents felt as guilty as we do, or if it is unique to our generation to expect so much from ourselves. And guilt in itself is purposeless. It doesn’t help anyone, but only makes it more difficult to do our best.

When you are feeling guilty, it is important to look at this feeling from some emotional distance, seeing it objectively instead of being its victim. Decide whether your sense of guilt is justified. Sometimes sharing your feelings with a fellow parent can help you sort out what is legitimate and what is perfectionism.

When you feel that you have truly let someone down, it is important to do what you can to make it right. Apologize to the friend you neglected, or the partner or child you yelled at. Try to learn from your guilt to change your priorities and do things differently. Then let the guilt go.

When the guilt is baseless, or unavoidable, like when you feel guilty for a feeling you have, or because you cannot do more than you are capable of, then you need to practice using your “interior parent” to counter those feelings.

If you had a beloved friend who told you she felt terrible because the baby cried while she was on a much-needed outing with her partner, what would you tell her? Probably you would reassure her that she is a wonderful mother, and that she must nurture herself and her relationship in order to be the best mother she can be. You would tell her she has nothing to feel guilty about, and you would also empathize with her pain. This is the role you must also play with yourself.

Listen to your own thoughts, and when they are self-defeating or judgmental, respond to yourself the way you would to a loved one — being a good parent to yourself is part of being a good, loving and joyful parent to your children.

Returning to Work After Parental Leave

By Meri Levy, MFT

Regardless of what you decided about working after the birth of your baby, facing the reality of going back to work or staying at home once the baby is born can be a very stressful time. Many moms, even those who were certain that they wanted to return to work after their maternity leave, have very conflicting feelings about the reality of returning to work. And some moms who always planned on staying home after having children face unexpected emotional challenges in facing the reality of looking toward a future at home full-time with their child.

What is hard to anticipate when considering the decision to work or stay at home before the baby is born is how big a loss either decision represents. For moms returning to work, it is common to feel:

  • An enormous sense of loss associated with leaving your baby in another’s care
  • A concern that her child will be irreparably harmed by the separation from you
  • Anxiety about being away from your baby and having your baby’s care outside of your control
  • An unexpectedly strong desire to quit your job and stay home with your baby
  • Guilt associated with having a desire to return to work or resentment at having to go back to work
  • A feeling that you must rush through your workday to return to your baby as quickly as possible, for fear your baby will forget you, or you will miss important moments.

For moms choosing to stay at home, it is common to feel:

  • An unexpected sense of loss associated with no longer receiving the validation of purpose that is so often gained by outside work and receiving a paycheck
  • A sense of vulnerability associated with being dependent upon their partner’s income
  • Guilt associated with conflicting feelings about leaving the work world
  • Boredom with the tasks of mothering and loneliness, especially in the early months before the baby becomes more interactive and you find activities you enjoy with your baby
  • Loneliness and isolation associated with being at home with a small baby, especially before you connect with other new mothers at home with their babies.

These feelings can be very confusing, and new moms often struggle with the decision regardless of what their prior plans were. As a new mom, your entire world has changed, your priorities have shifted, and your now occupies a huge place in your heart. It can be a struggle to align the new role of motherhood with the values you previously held. Many moms change course and decide to stay home despite having planned to return to work, or choose to go back to work full or part-time despite planning to remain at home. Financial considerations play a big role in this decision, as does the developing relationship with your baby, your own clarification of your needs and wants, and your relationship with your partner.

Many mothers seek therapy during this time. Getting help to clarify your feelings about returning to work, exploring alternative work arrangements or more flexible careers, and getting validation for your choices can make this difficult time of transition go smoother. Whether you ultimately decide to stay at home for now or return to work, making decisions from a place of self-compassion, and understanding that there is no one “right” answer can allow you the freedom to honor who you are and who you are becoming.

My Journey Through Postpartum Depression and Panic Disorder

Whenever I talk about the symptoms of perinatal mood and anxiety disorders, I always include “unusual physical symptoms.” What does that mean? It means that any new physical symptoms that begin during pregnancy and postpartum can be related to mental health.

My own experience with postpartum depression and anxiety was quite atypical, and that was partly why I suffered for months before receiving the proper diagnosis and treatment.

I had lots of risk factors for postpartum depression: a previous bout of depression, the sudden loss of my mother only a few years before, a previous birth trauma, an unsupportive marriage, and breastfeeding difficulties. But even though I had suffered from depression before, after the death of my mother, my postpartum symptoms were not recognizable to me.

I did OK after my first child was born, although it was a difficult time for me. But after my second child, my stress level was off the charts. My older son was kicked out of two day care programs because he wouldn’t use the potty (he regressed after his brother was born). I never made enough milk for the new baby because of my stress level and because he was so big (born almost 10lbs) , and he refused to nurse completely as soon as he started solid foods. I felt guilty about “failing” at breastfeeding, and I was also afraid that I would not be able to go back to work after maternity leave because I couldn’t find daycare that would take my challenging and potty-resistant older son.

In the meantime, I had difficulties in my marriage. My husband worked long hours, and when he was there he criticized my parenting style, my cooking, and my housekeeping. Even our challenging preschooler was my fault! I was trying my best to make everyone happy, but I was clearly failing.

During this time, I started to have odd physical symptoms. I started feeling that the room was tilting and that I was off-balance. I had to lie down and felt the room was spinning around me. My doctor thought it was either an inner-ear infection or possibly Multiple Sclerosis, and I was sent for neurological testing. The tests came back normal, although MS couldn’t be ruled out (a bonus for my anxiety, of course!).

My symptoms came and went, and then began to include nausea and vomiting along with the dizziness, a complete lack of appetite, and an inability to sleep. I had a low-grade fever on and off for a couple of months and my white blood-cell count was high. I lost 16 pounds beyond the baby weight, slept about three to four hours a night, and threw up regularly — out the door of the car, in the sink at the pediatrician’s office, etc. I felt that my body was swaying even when I was perfectly still, and my bed felt like it was shaking as I lay in it trying to sleep. My skin felt prickly, my chest burned and my hands tingled. The dizziness made watching TV or reading impossible, and walking or driving became difficult. I felt sure that I was dying.

My doctor considered an inner ear problem, hormones, diabetes, thyroid issues, and even encephalitis, but every test came back normal. I was living on Ensure and Gatorade, because I couldn’t keep any solid food down. The stress of caring for my children became unbearable, so we hired a babysitter and I spent most of every day lying in bed, praying to fall asleep for a couple of hours to get some rest. I was prescribed Ativan, but it just knocked me out for an hour or two and I would wake up feeling even worse than before.

After about four months, I fell apart completely and told my doctor that he had to hospitalize me because I was dying, and at that point I wanted to die if they couldn’t stop the misery I was living in. I was admitted to a psychiatric inpatient unit, but my doctor was still sending me around to specialists, trying to figure out what was physically wrong with me.

I stopped vomiting as soon as I was admitted to the hospital. That was when I realized that whatever was going on with me had to do with stress. I spent 12 days in the hospital, during which time I started taking antidepressants and was prescribed an anti-anxiety medication that allowed me to sleep. For a few days, all I did was sleep. When I was awake I was no longer nauseous, but I was filled with unbearable emotional pain. I was terrified that I would never be able to care for my children without getting sick. I felt like the worst mother in the world.

After I was released from the hospital I did a full-day partial hospitalization program for a month, which gave me time for the antidepressant to start working and allowed me to take care of myself for a change. I learned in group therapy about the ways in which I had prioritized my responsibility for others way above self-care, in unhealthy and unhelpful ways, and I began to heal. With the help of medication, therapy, and later couples counseling, I recovered. I still had anxiety at times, but I also had joy and passion for life. I became a lactation educator, started a small business helping other new moms, and led new parent support groups for several years. Eight years later I went back to school to become a Marriage and Family Therapist.

I still have to be vigilant about managing stress and maintaining good self-care. I tell myself that this is the “gift” of being prone to depression and anxiety: I don’t have the luxury of tolerating a great deal of stress like some people seem to do, or living life in a way that generally makes me unhappy. I am obligated to do work that I love, to have a healthy relationship with my husband, and to prioritize joy, peace and comfort as well as caring for my family. I know that I always have to be mindful to avoid a recurrence of depression, but I also know that I am strong and resilient and will do whatever I have to do to be healthy and take good care of myself and my children.

My mental health issues began when my second child was seven months old, and yet no one ever considered a postpartum condition. My symptoms were fully consistent with panic disorder and depression, and yet my doctor and my therapist (yes, a trained therapist!) never considered these diagnoses. My hope is that in the future, mothers and their caregivers become better educated to recognize perinatal mood and anxiety disorders so that they can be treated early and mothers can return to enjoying their lives again.

  • If you need immediate help, please call the National Suicide Hotline at 1-800-273-TALK (8255)
  • If you are looking for pregnancy or postpartum support and local resources, please call or email Postpartum Support International:

Call PSI Warmline (English & Spanish) 1-800-944-4PPD (4773)
Email support@postpartum.net

Take a test to see if you have Prenatal or Postpartum Depression

Mindfulness Exercises

Resources for calming and containing strong emotions

Safe Place Exercise

Container Exercise